The immunology of pregnancy

Current Opinion in Infectious Diseases

Volumn 10, Issue 3, 1997, Pages 171-176

  Lea, Richard G ^a   Calder, Andrew A ^b  

^a ROWETT RESEARCH INSTITUTE   (United Kingdom)

^b UNIVERSITY OF EDINBURGH   (United Kingdom)

Author keywords

[No Author keywords available]

Indexed keywords

CELLULAR IMMUNITY; DISEASE PREDISPOSITION; FEMALE; FETUS; HOST PARASITE INTERACTION; HUMAN; HUMORAL IMMUNITY; IMMUNE RESPONSE; IMMUNOLOGY; LEUKOCYTE; PARASITOSIS; PREGNANCY; REVIEW; SURVIVAL; TROPHOBLAST;

EID: 0030917095     PISSN: 09517375     EISSN: None     Source Type: Journal    
DOI: 10.1097/00001432-199706000-00003     Document Type: Review

References (50)

1. Medawar PB: Some immunological and endocrinological problems raised by evolution of viviparity in vertebrates. In Society for experimental biology, evolution symposia No 11. New York: Academic Press; 1953:320-338.
2. Loke YW, King A: Human trophoblast development. In Human implantation, cell biology and immunology, Cambridge: Cambridge University Press; 1995:32-62.
3. Piotrowski P, Croy BA: Maternal cells are widely distributed in murine fetuses in utero. Biol Reprod 1996, 54:1103-1110.
4. King A, Loke YW: Human trophoblast and JEG choriocarcinoma cells are sensitive to lysis by IL-2 stimulated decidual NK cells. Cell Immunol 1990, 129:435-448.
5. Starkey PM: The decidua and factors controlling placentation. In The human placenta. Edited by Redman CWG, Sargent IL, Starkey PM Oxford: Blackwell Scientific Publications; 1993:362-413.
6. ++ population. Dev Immunol 1991, 1:169-190.
7. King A, Loke YW: On the nature and function of human uterine granular lymphocytes Immunol Today 1991, 12:432-435.
8. Loke YW, King A: Immunology of human implantation: an evolutionary perspective Human Reprod 1996, 11:283-286.
9. Lee N, Malacko AR, Ishitani A, Chen M, Bajorath J, Marquardt H, Geraghty DE: The membrane bound and soluble forms of HLA-G bind identicle sets of endogenous peptides but differ with respect to TAP association Immunity 1995, 3:591-600.
10. Sanders SK, Giblin PA, Karathus P: Cell-cell adhesion mediated by CD8 and human histocompatibility leukocyte antigen G, a non-classical major histocompatibility complex class I molecule on cytotrophoblast. J Exp Med 1991, 174:737-740.
11. Carosella ED, Dausset J, Kirszenbaum M: HLA-G revisited, Immunol Today 1996, 9:407-409.
12. King A, Boocock C, Sharkey A, Gardner L, Loke YW: Evidence for the expression of HLA-C class I mRNA and protein by human first trimester trophoblast. J Immunol 1996, 156:2068-2076 In addition to HLA-G, first trimester trophoblast expresses HLA-C which is known to interact with natural killer cells.
13. Lanier LL, Phillips JH: Inhibitory MHC class I receptors on NK cells and T-cells. Immunol Today 1996, 17:86-91.
14. Arck PC, Ferrick DA, Steele-Norwood D, Croitoru K, Clark DA: Murine T-cell determination of pregnancy outcome. I. Effects of strain αβT cell receptor, γδT cell receptor, and γδT cell subsets. Am J Reprod Immunol 1997, (in press).
15. Sandor M, Sperling AI, Cook GA, Weinstock JV, Bluestone JA: Two waves of γδT cells expressing different V delta genes are recruited into schistosome-induced liver granulomas. J Immunol 1995, 155:275-284.
16. Heyborne K, Fu YX, Nelson A, Farr A, O'Brien R, Born W: Recognition of trophoblast by γδT cells. J Immunol 1994, 153:2918-2926.
17. Lea RG, Flanders KC, Harley CB, Manual J, Banwatt D, Clark DA: Release of a transforming growth factor (TGF)-β2-related factor from post-implantation murine decidual tissue can be correlated with the detection of a subpopulation of cells containing RNA for TGF-β2. J Immunol 1992, 148:778-787.
18. Lea RG, Underwood J, Flanders K, Hirte H, Banwatt D, Finotto S, Ohno I, Daya S, Harley C, Michel M et al.: A subset of patients with recurrent spontaneous abortion is deficient in transforming growth factor β2-producing "suppressor cells" in uterine tissue near the placental attachment site. Am J Reprod Immunol 1995, 34:52-64.
19. Chaouat G, Meliani AA, Martal J, Raghupathy R, Elliot J, Mosmann T, Wegmann TG: IL-10 prevents naturally occurring fetal loss in CBA × DBA/2 mating combination, and local defect in IL-10 production in this abortion-prone combination is corrected by invivo injection of INF-γ. J Immunol 1995, 154:4261-4268.
20. Clark DA, Flanders KC, Vince G, Starkey P, Hirte H, Manuel J, Underwood J, Mowbray J: Novel transforming growth factor betas (TGF-β2) in pregnancy and cancer. In Immunobiology of reproduction. Serono Symposia USA. Edited by Hunt J. New York: Springer-Verlag; 1994:125-135.
21. Clark DA, Daya S, Coulam CB, Gunby J, Aoki K, Carp HJA, Cauchi MN, Lim D, Cowchock S, Smith JB et al. Implication of abnormal human trophoblast karyotype for the evidence-based approach to the understanding, investigation and treatment of recurrent spontaneous abortion. Am J Reprod Immunol 1996, 35:495-498.
22. + cells can predict pregnancy outcome. Am J Reprod Immunol 1995, 33:40-46
23. + cells exhibit greater natural killer activity than CD 16 cells, these data suggest that natural killer cells may play a role in immunologically mediated abortion.
24. + T cells as a basis for stress-triggered substance Pmediated abortion in mice. Cell Immunol 1996, 171:226-230.
25. Silva DA, Spector TD: The role of pregnancy in the course of and aetiology of rheumatoid arthritis. Clin Rheumatol 1992, 11:189-194.
26. Varner MW: Autoimmune disorders and pregnancy. Semin Perinatol 1991, 15:238-250.
27. Wegmann TG, Lin H, Guilbert L, Mosmann TR: Bidirectional cytokine interactions in the maternal fetal relationship: is successful pregnancy a Th2 phenomenon? Immunol Today 1993, 14:353-356.
28. Chaouat G, Menu E, Clark DA, Dy M, Minkowski M, Wegmann T: Control of fetal survival in CBA × DBA/2 mice by lymphokine therapy. J Reprod Fertil 1990, 89:447-458.
29. Tangri S, Raghupathy R: Expression of cytokines in placentas of mice undergoing immunologically mediated spontaneous fetal resorptions. Biol Reprod 1993, 49:850-856.
30. Maeda H, Shiraishi A: TGF-β contributes to the shift towards Th-2 type responses through direct and IL-10-mediated pathways in tumor bearing mice. J Immunol 1996, 156:73-78.
31. Hill JA, Polgar K, Anderson DJ: T-helper 1-type immunity to trophoblast in women with recurrent spontaneous abortion. JAMA 1995, 273:1933-1936.
32. Critchley HOD, Kelly RW, Lea RG, Drudy TA, Jones RL, Baird DT: Sex steroid regulation of leukocyte traffic in human decidua. Human Reprod 1996, 11:2257-2262. Women scheduled for surgical termination of pregnancy were given the antigestogen mifepristone (RU486) 6, 12, 24 or 36 h before vacuum aspiration of the uterus at which stage decidua parietalis was collected. Progesterone antagonism (RU486 binds to and blocks the progesterone receptor) led to an increase in the number of tissue monocytes 12-36 h after administration and before this, in-vitro culture studies revealed an increased release of chemokines (IL-8, monocyte chemattractant protein-1). This study illustrates the regulation of inflammatory mediators by progesterone.
33. Cheng L, Kelly RW, Thong KJ, Hume R, Baird DT: The effects of mifepristone (RU486) on the immuno-histochemical distribution of prostaglandin E and its metabolite in decidual and chorionic tissue in early pregnancy. J Clin Endocrinol Metabol 1993a, 77:873-877.
34. Cheng L, Kelly RW, Thong KJ, Hume R, Baird DT: The effects of mifepristone (RU486) on prostaglandin dehydrogenase in decidual and chorionic tissue in early pregnancy. Human Reprod 1993b, 8:705-709.
35. Kelly RW: Pregnancy maintenance and parturition: the role of prostaglandin in manipulating the immune and inflammatory response. Endocrin Rev 1994, 15:684-706.
36. Robertson SA, Mayrhofer G, Seamark RF: Ovarian steroid hormones regulate granulocyte-macrophage-colony-stimulating factor synthesis by uterine epithelial cells in the mouse. Biol Reprod 1996, 54:183-196.
37. Lazar G Jr, Duda E, Lazar G: Effect of RU486 on TNF production and toxicity. FEBS Left 1992, 308:137-140.
38. Piccini M, Giudizi M, Biagiotti R, Beloni L, Giannarini L, Sampognaro S, Parronchi P, Manetti R, Annunziato F, Livi C et al. Progesterone favours the development of human T helper cells producing the Th2-type cytokines and promotes both IL-4 production and membrane CD30 expression in established Th1 cell clones. J Immunol 1995, 155:128-133.
39. Szekeres-Bartho J, Autran B, Debre P, Andreu G. Denver L, Chaouat G: Immunoregulatory effects of a suppressor factor from healthy pregnant women's lymphocytes after progesterone induction. Cell Immunol 1989, 122:281-294.
40. Szekeres-Bartho J, Chaouat G, Kinsky R: A progesterone-induced blocking factor corrects high resorption rates in mice treated with anti-progesterone. Am J Obstet Gynecol 1990, 163:1320-1322.
41. Szekeres-Bartho J, Faust Z, Varga P, Szereday L, Kelemen K: The immunological pregnancy protective effect of progesterone is manifested via controlling cytokine production. Am J Reprod Immunol 1996a, 35:348-351.
42. Szekeres-Bartho J, Wegmann TG: A progesterone-dependent immunomodulatory protein alters the Th1/Th2 balance. J Reprod Immunol 1996b, 31:81-95.
43. Szekeres-Bartho J, Szekeres G, Debre P, Autran B, Chaouat G: Reactivity of lymphocytes to a progesterone receptor-specific monoclonal antibody. Cell Immunol 1990, 125:273-283.
44. Schust DJ, Andersen DJ, Hill JA: Progesterone-induced immunosuppression is not mediated through the progesterone receptor. Human Reprod 1996, 5:980-985.
45. Liggins GC: Cervical ripening as an inflammatory reaction. In The cervix in pregnancy and labour, clinical and biochemical investigations. Edited by Ellwood J, Anderson ABM. Edinburgh: Churchill Livingstone; 1981:1-9.
46. Kelly RW, Leask R, Calder AA: Choriodecidual production of interleukin-8 and mechanism of parturition. Lancet 1992, 339:776-777.
47. Barclay CG, Brennand JE, Kelly RW, Calder AA: Interleukin-8 production by the human cervix. Am J Obstet Gynecol 1993, 169:625-632.
48. Krishnan L, Guilbert LJ, Russel AS, Wegmann TG, Mosmann TR, Belosevic M: Pregnancy impairs resistance of C57BL/6 mice to Leishmania major infection and causes decreased antigen-specific INF-γ responses and increased production of T helper 2 cytokines. J Immunol 1996a, 156:644-652. A curative response against L. major infection is associated with Th1 type immunity, whereas pregnancy has been associated with Th2 type immunity. In this study, pregnant C57BL/6 mice were infected with L. major by footpad injection on day 0 of gestation. Pregnancy was found to impair the resolution of infection. This was accompanied by a reduced Th1 cytokine production (IFN-γ) and increased Th2 cytokine production (IL-4, IL-5, IL-10) by spleen and popliteal lymph node cells stimulated in vitro with Leishmania antigens.
49. 48] this study was designed to investigate if a strong Th1 response against Leishmania infection could overcome the progestational effects of the Th2 type cytokines at the maternal-fetal interface. A curative Th1 response was found to increase the number of fetal resorptions. This was accompanied by a decrease in the placental production of Th2 cytokines (IL-4, IL-10) and an increased production of Th1 cytokines (IFN-γ, TNF). This study in combination with [43] are in strong support of a Th2 bias during pregnancy.
50. Hanson LA, Hahn-Zoric M, Wiedermann U, Lundin S, Dahlman-Hoglund A, Salman R, Erling V, Dahlgren U, Telemo E: Early dietary influence on later immunocompetence. Nutr Rev 1996, 54:S23-S24.