臨床婦人科産科70巻9号

2016年09月発行

今月の臨床 卵管は脇役か？─その生理と病態

卵管の生理

女性生殖器における免疫機能と卵巣ホルモンの関連

著者： カレクカーン¹ 岩佐弘一¹

所属機関： ¹京都府立医科大学大学院女性生涯医科学

ページ範囲：P.801 - P.808

文献概要

●上部女性生殖器（FRT）の上皮細胞は密着結合により物理的障壁をなすと同時に自然免疫および獲得免疫の哨戒役を担う．卵巣ホルモンの変動はFRTの免疫系に影響する．

●グラム陰性菌由来のリガンドであるリポ多糖類（LPS）がTLR4を介する骨盤内炎症の伝播や子宮内膜症成長に関与していると考えられ，子宮内膜症の病理に「細菌混入仮説」という新しい概念を提案する．

●卵管上皮の精子および胚に対する免疫寛容に，ERβとPRを同時発現したCD8陽性Tリンパ球が関与する．卵管上皮細胞はTLR3を介して，ウイルス感染に敏感に反応する一方で，TLR4発現がないためLPSには反応しない．

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