Etiological characteristics of genital tract infections in recurrent spontaneous abortion patients,expressions of TLR4,MIF and bax/bcl-2 in decidual tissues and clinical significance
OBJECTIVE To explore the etiological characteristics of genital tract infections in the patients with re-current spontaneous abortion(RSA),observe the expressions of Toll-like receptor 4(TLR4),macrophage migra-tion inhibitory factor(MIF),B cell lymphoma/leukemia-2(bcl-2)and bcl-2-related proteins in decidual tissues and analyze the clinical significance.METHODS A total of 103 RSA patients who had threatened abortion for sec-ond pregnancy and were treated in Hengshui People's Hospital from Apr 2022 to Jul 2023 were assigned as the RSA group and were divided into the infection group and the no infection group according to the status of genital tract infection.Meanwhile,101 normal early pregnancy patients who required for termination of pregnancy by in-duced abortion were chosen as the control group.The levels of TLR4,MIF and bax/bcl-2 mRNA in decidual tis-sues were detected by real-time fluorescent quantitative polymerase chain reaction,and logistic regression analysis was performed for the influencing factors for RSA.RESULTS Among the 103 RSA patients,52 had genital tract infection,with the incidence of infection 50.49％.The levels of decidual tissue TLR4 mRNA and bax mRNA of the RSA group were higher than those of the control group,while the levels of MIF mRNA and bcl-2 mRNA of the RSA group were lower than those of the control group,and the ratio of bax to bcl-2 of the RSA group was higher than that of the control group(P＜0.05).The result of logistic regression analysis showed that the repro-ductive system infection,cryptorrbea,high expression of TLR4 and high ratio of bax to bcl-2 were the risk fac-tors for the RSA,while the high expression of MIF was the protective factor for RSA.The expression levels of de-cidual tissue TLR4 mRNA,MIF mRNA and bax mRNA of the infection group were higher than those of the no infection group,while the expression level of bcl-2 mRNA of the infection group was lower than that of the no in-fection group,and the ratio of bax to bcl-2 of the infection group was higher than that of the no infection group(P＜0.05).CONCLUSION The RSA patients show the high expression of TLR4 in decidual tissue,low expression of MIF and the rise of the ratio of bax to bcl-2.The genital tract infection may increase the risk of RSA and lead to the rise of TLR4 and the ratio of bax to bcl-2.
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