Immune Modulators of Implantation and Placental Development— A Workshop Report

Robertson, Sarah A.; Redman, Christopher W.G.; McCracken, Sharon A.; Hunt, Joan S.; Dimitriadis, Evdokia; Moffett-King, Ashley; Chamley, Larry

doi:10.1053/plac.2002.0937

Cited by 14 publications

(10 citation statements)

References 20 publications

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“…33,34 It is an imbalance of these immune responses that results in insufficient tolerogenesis to the fetus and leads to adverse pregnancy outcomes, such as miscarriage and PE. [35][36][37] A well-regulated cytokine network is crucial for normal immune reactions. Cytokines produced by type 1 CD4 þ helper T (Th1) cells are primarily proinflammatory and promote protection against infectious pathogens while that of type 2 CD4 þ helper T (Th2) cells are mainly anti-inflammatory and responsible for the regulation of humoral responses.…”

Section: Pregnancy and Immunitymentioning

confidence: 99%

Innate Immunity, Decidual Cells, and Preeclampsia

2013

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Preeclampsia (PE) manifested by hypertension and proteinuria complicates 3% to 8% of pregnancies and is a leading cause of fetal-maternal morbidity and mortality worldwide. It may lead to intrauterine growth restriction, preterm delivery, and long-term sequelae in women and fetuses, and consequently cause socioeconomic burden to the affected families and society as a whole. Balanced immune responses are required for the maintenance of successful pregnancy. Although not a focus of most studies, decidual cells, the major resident cell type at the fetal-maternal interface, have been shown to modulate the local immune balance by interacting with other cell types, such as bone marrow derived-immune cells, endothelial cells, and invading extravillous trophoblasts. Accumulating evidence suggests that an imbalanced innate immunity, facilitated by decidual cells, plays an important role in the pathogenesis of PE. Thus, this review will discuss the role of innate immunity and the potential contribution of decidual cells in the pathogenesis of PE.

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Section: Pregnancy and Immunitymentioning

confidence: 99%

Innate Immunity, Decidual Cells, and Preeclampsia

2013

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“…It increases in the blood of preeclamptic women, probably due to an exaggerated apoptosis or even ischaemic necrosis of the oxidatively stressed placenta. This event could represent a further pathogenic mechanism of preeclampsia, through the release of pro-inflammatory cytokines [98]. …”

Section: Pathologic Pregnancymentioning

confidence: 99%

Control of human trophoblast function

Lunghi

Ferretti

Medici

et al. 2007

Reprod Biol Endocrinol

229

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The trophoblast, i.e. the peripheral part of the human conceptus, exerts a crucial role in implantation and placentation. Both processes properly occur as a consequence of an intimate dialogue between fetal and maternal tissues, fulfilled by membrane ligands and receptors, as well as by hormone and local factor release. During blastocyst implantation, generation of distinct trophoblast cell types begins, namely the villous and the extravillous trophoblast, the former of which is devoted to fetal-maternal exchanges and the latter binds the placental body to the uterine wall. Physiological placentation is characterized by the invasion of the uterine spiral arteries by extravillous trophoblast cells arising from anchoring villi. Due to this invasion, the arterial structure is replaced by amorphous fibrinoid material and endovascular trophoblastic cells. This transformation establishes a low-resistance, high-capacity perfusion system from the radial arteries to the intervillous space, in which the villous tree is embedded. The physiology of pregnancy depends upon the orderly progress of structural and functional changes of villous and extravillous trophoblast, whereas a derangement of such processes can lead to different types of complications of varying degrees of gravity, including possible pregnancy loss and maternal life-threatening diseases. In this review we describe the mechanisms which regulate trophoblast differentiation, proliferation, migration and invasiveness, and the alterations in these mechanisms which lead to pathological conditions. Furthermore, based on the growing evidence that proper inflammatory changes and oxidative balance are needed for successful gestation, we explain the mechanisms by which agents able to influence such processes may be useful in the prevention and treatment of pregnancy disorders.

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“…A complicated and gestation-related interaction between cells of foetal and maternal origin, hormones, growth factors and matrix components is a prerequisite for successful implantation and subsequent placental development [3,12,30]. Effector cells and molecules of the maternal immune system are key participants, and decidual leucocytes may both promote and limit placental development through influencing trophoblast survival, invasion, proliferation and differentiation.…”

Section: Introductionmentioning

confidence: 99%

Serious foetal growth restriction is associated with reduced proportions of natural killer cells in decidua basalis

et al. 2005

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Extravillous trophoblasts are major participants in placental development and remodelling of spiral arteries. Trophoblast invasion is regulated by maternal immune cells, and abnormal leucocyte subpopulation composition has been reported in implantation failure. In pre-eclampsia (PE), with or without foetal growth restriction (FGR), superficial trophoblast invasion and insufficient remodelling of spiral arteries are common findings. In the present study, we have compared spiral artery remodelling and leucocyte composition in decidual tissue from 30 cases (PE=8, FGR=5, PE + FGR=17) and 31 controls. Six histological remodelling criteria were established, and each pregnancy obtained a remodelling score. Numbers of natural killer (NK) cells (CD56+), T cells (CD3+) and activated (CD25+ or CD69+) leucocytes were determined and related to total leucocyte (CD45+) numbers in serial sections. Cases demonstrated significantly impaired spiral artery remodelling, inappropriate placental growth and reduced NK cell proportions, as compared to controls (P=0.02, P<0.001 and P=0.01, respectively). Reduced NK cell proportion was primarily found in pregnancies complicated by FGR, with or without PE, and a significant positive correlation was observed between NK cell proportion, trophoblast infiltration and placental growth. Our in vivo observations support the hypothesized association between NK cells, impaired placental development and pathogenesis of PE/FGR.

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Immune Modulators of Implantation and Placental Development— A Workshop Report

Cited by 14 publications

References 20 publications

Innate Immunity, Decidual Cells, and Preeclampsia

Innate Immunity, Decidual Cells, and Preeclampsia

Control of human trophoblast function

Serious foetal growth restriction is associated with reduced proportions of natural killer cells in decidua basalis

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