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Immunological Modes of Pregnancy Loss: Inflammation, Immune Effectors, and Stress
Author(s) -
KwakKim Joanne,
Bao Shihua,
Lee Sung Ki,
Kim Joon Woo,
GilmanSachs Alice
Publication year - 2014
Publication title -
american journal of reproductive immunology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.071
H-Index - 97
eISSN - 1600-0897
pISSN - 1046-7408
DOI - 10.1111/aji.12234
Subject(s) - immune system , trophoblast , immunology , inflammation , cytotoxic t cell , biology , decidua , angiogenesis , cellular immunity , natural killer cell , pregnancy , placenta , cancer research , fetus , biochemistry , genetics , in vitro
Inflammatory immune response plays a key role in reproductive failures such as multiple implantation failures ( MIF ), early pregnancy loss, and recurrent pregnancy losses ( RPL ). Cellular immune responses particularly mediated by natural killer ( NK ), and T cells are often dysregulated in these conditions. Excessive or inappropriate recruitment of peripheral blood NK cells to the uterus may lead to cytotoxic environment in utero , in which proliferation and differentiation of trophoblast is hampered. In addition, inadequate angiogenesis by uterine NK cells often leads to abnormal vascular development and blood flow patterns, which, in turn, leads to increased oxidative stress or ischemic changes in the invading trophoblast. T ‐cell abnormalities with increased T h1 and T h17 immunity, and decreased T h2 and T regulatory immune responses may play important roles in RPL and MIF . A possible role of stress in inflammatory immune response is also reviewed.