Discussion on the Role of Decidual Macrophage Polarization in TAI Complicated with Abortion Based on the Theory of"Spleen Nourishing Fetal Qi"
The correlation between thyroid autoimmunity(Thyroid Autoimmunity,TAI)and adverse pregnancy outcomes is a research hotspot in this field,in which simple thyroid antibody elevation can independently lead to miscarriage without relying on(Thyroid Stimulating Hormone,TSH)reduction.Traditional Chinese medicine believes that the spleen function is closely related to the pathogenesis of TAI combined with abortion,in which the main movement of the spleen can nourish the fetus.The rise of qi makes the fetus appendage the uterus;The guard of qi can cause the fetus to be innocent.Therefore,the three aspects of"transporting and transforming nutrients","rise of spleen qi"and"spleen prosperity free from evil"in the spleen theory are collectively referred to as the theory of"spleen nourishing fetal qi".This is similar to the functions of spiral artery formation,trophoblasts formation,immune rejection and receptivity in the maternal-fetal interface.The polarization imbalance of the em-bryonic immune cell Type-1 Macrophage(M1)/Type-2 Macrophage(M2)is the potential mechanism of TAI induced abor-tion.The unique phenotypes exhibited by M1 and M2 play a key role in establishing the immunology of maternal-fetal interac-tion.Therefore,the two are compared with the polarization imbalance of deciduous macrophages as the pathological basis of West-ern medicine,the theory of"spleen nourishing fetal qi"as the basis of traditional Chinese medicine,and the meaning of"nour-ishing source,lifting spleen qi,and preventing evil qi",and exploring the correlation between the functions of"spiral artery re-modeling,trophoblast implantation,and mother-fetal interface immune tolerance"in decidua macrophage polarization,which provides a reliable basis for the modern research of traditional Chinese medicine and provides new research ideas for the patho-genesis of TAI combined with abortion.
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