{"id":267,"title":"The Role of NK‑Cell Dysregulation in Adverse Pregnancy Outcomes Associated with Rheumatic Immune Diseases: Mechanisms and Translational Advances","title_zh":"NK细胞失调在风湿免疫病相关不良妊娠结局中的作用：机制与转化进展","url":"https://pubmed.ncbi.nlm.nih.gov/42966991","doi":"10.2147/ijwh.s641811","pmid":"42966991","journal":"Int J Womens Health","kind":"paper","lang":"en","published_at":"2026-10-26T00:00:00+00:00","fetched_at":"2026-11-08T03:44:00+00:00","authors":["Zhu L","Hua L","Du H"],"primary_topic":"endometrium","topics":[{"slug":"endometrium","score":6.0,"hits":["decidual","maternal-fetal interface","placental","spiral artery","trophoblast invasion","uterine"]},{"slug":"early-pregnancy","score":6.0,"hits":["antiphospholipid","preeclampsia","pregnancy outcomes","spontaneous abortion"]},{"slug":"repro-immunology","score":2.0,"hits":["autoimmune","immune tolerance"]},{"slug":"contraception-health","score":2.0,"hits":["abortion","childbearing"]},{"slug":"omics-methods","score":2.0,"hits":["multi-omics","single-cell"]},{"slug":"ethics-policy","score":1.0,"hits":["regulation"]}],"topic_score":6.0,"preference_score":10.0,"preference_labels":["多组学整合分析（任意生殖对象）"],"llm_score":69.0,"final_score":79.0,"score_dims":{"novelty":55,"rigor":50,"impact":62,"relevance":78,"translation":65},"recommend_reason":"对风湿免疫病背景下NK细胞介导胎盘损伤的机制与转化策略做了较完整的归纳，并明确区分抗磷脂综合征与其他疾病的证据强度，对生殖免疫与流产机制研究方向有参考价值；但为叙述性综述、缺乏原始数据与定量整合，方法学严谨性有限，适合浏览而非必读。","keywords":["蜕膜自然杀伤细胞","外周NK细胞","抗磷脂综合征","复发性流产","胎盘损伤","单细胞多组学"],"selected":1,"story_id":324,"llm_provider":"deepseek","llm_model":"deepseek-flash","llm_effort":"low","source_key":"pubmed-uterus-pregnancy","source_name":"PubMed · 内膜/植入/早孕","source_tier":1,"mention_count":1,"has_interpretation":false,"journal_key":null,"journal_tier":"unknown","journal_if":null,"is_mock":false,"summary_zh":"本文为综述，系统梳理蜕膜自然杀伤细胞（dNK）与外周NK细胞（pNK）在表型、细胞毒性与分泌功能上的异质性，指出NK细胞数量、亚群分布、受体信号及细胞因子释放失调可扰乱蜕膜免疫-血管微环境，参与复发性流产、子痫前期、早产与胎儿生长受限等不良结局。作者归纳六条驱动NK介导胎盘损伤的炎症轴，并指出机制证据在抗磷脂综合征中较充分，而在系统性红斑狼疮、干燥综合征、类风湿关节炎与系统性硬化中尚待阐明；同时总结NK靶向抗炎策略的转化进展，提出基于单细胞多组学与大规模队列的研究方案。原文未提供原始数据。","summary":"Rheumatic autoimmune diseases induce sustained systemic inflammatory imbalance and substantially elevate the incidence of adverse pregnancy complications, such as recurrent spontaneous abortion, preeclampsia, preterm delivery, and fetal growth restriction. Decidual natural killer (dNK) cells constitute the major lymphocyte subset at the maternal-fetal interface and maintain the homeostasis of immune tolerance, trophoblast invasion and spiral artery remodeling; peripheral NK (pNK) cells differ greatly from dNK cells in phenotype, cytotoxicity and secretory function under the regulation of local uterine microenvironment. Emerging evidence indicates that dysregulated NK‑cell number, subset distribution, receptor signalling and cytokine release may perturb the decidual immune‑vascular microenvironment and contribute to inflammatory placental‑associated pathology, with considerably more robust mechanistic support in antiphospholipid syndrome than in systemic lupus erythematosus, primary Sjögren's syndrome, rheumatoid arthritis, and systemic sclerosis. Solid preclinical and clinical evidence confirms that excessive NK cell activation participates in placental injury in antiphospholipid syndrome, whereas the direct inflammatory pathogenic cascades underlying gestational complications remain insufficiently clarified for other rheumatic disorders. This work elucidates the physiological heterogeneity of pNK and dNK cells, delineates six core inflammatory axes driving NK-mediated placental injury, characterizes disease-specific aberrant inflammatory phenotypes of NK cells, summarizes translational advances in NK-targeted anti-inflammatory strategies, and identifies existing research bottlenecks. We also put forward prospective research schemes based on single-cell multi-omics and large-scale clinical cohorts to reveal NK-centered inflammatory pathology, which offers theoretical support for immune inflammation regulation in childbearing-age women with rheumatic autoimmune diseases.","interpretation_basis":null,"fulltext_status":null,"interpretation":null,"fulltext":{"available":false,"status":null,"reason":"尚未抓取全文（未入选、分数未达阈值，或还没跑 fulltext 步骤）","pmcid":null,"license":null,"chars":0,"source":null,"fetched_at":null}}