Immunological Mechanisms of Pregnancy Maintenance and Failure: A Critique of Theories and Therapy

Hill, Joseph A.

doi:10.1111/j.1600-0897.1990.tb01029.x

Cited by 76 publications

(21 citation statements)

References 77 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…When the analysis was done to include the five patients undergoing IVF, the significance increased to P Ͻ 0.005. The overall pregnancy success rate (65%) in patients with RSA was similar to that seen in other studies (19,20).…”

Section: Resultssupporting

confidence: 75%

Proliferative responses to recall antigens are associated with pregnancy outcome in women with a history of recurrent spontaneous abortion.

Bermas

Hill

1997

J. Clin. Invest.

View full text Add to dashboard Cite

Maternal tolerance of the fetal hemiallograft suggests that immunomodulation occurs during gestation. Therefore, recurrent spontaneous abortion (RSA) may represent a failure of the immune changes that maintain pregnancy. We hypothesized that fertile women but not women with RSA may lose their immune responses to recall antigens when pregnant. This phenomenon has been seen in immunosuppressed transplant recipients and is associated with graft survival. Therefore, we evaluated proliferative responses to recall antigens in four groups of women: group 1, nonpregnant fertile women with no history of pregnancy loss and at least one prior healthy pregnancy, n ϭ 13; group 2, nonpregnant women with a history of three or more spontaneous abortions, n ϭ 28; group 3, healthy pregnant women between 6 and 9 wk of gestation without a history of prior pregnancy loss, n ϭ 15; and group 4, pregnant women between 6 and 9 wk of gestation, with a history of RSA, n ϭ 22. Proliferative responses of peripheral blood leukocytes to the recall antigens influenza and tetanus, alloantigens, and phytohemagglutinin were determined prospectively. Positive responses (stimulation index Ͼ 3) to recall antigens (a response to either influenza or tetanus was considered positive) were as follows: group 1 (nonpregnant fertile women), 11/13 (85%); group 2 (nonpregnant RSA women), 24 / 28 (86%); group 3 (pregnant fertile women), 4/15 (27%) ( P Յ 0.007); and group 4 (pregnant RSA women), 13/22 (59%) ( P ϭ NS). In group 4, there was 100% fetal survival in the nine women who lost responsiveness to recall antigens; however, in the 13/22 patients who responded to recall antigens, 9/13 (69%) had a repeat spontaneous abortion. These findings suggest that immunosuppression, indirectly measured by proliferation to recall antigens, is necessary for early pregnancy maintenance. Furthermore, this approach may be useful for predicting pregnancy outcome for women with RSA and may provide a useful means for designing and monitoring therapies. ( J. Clin. Invest. 1997. 100:1330-1334.)

show abstract

Section: Resultssupporting

confidence: 75%

Proliferative responses to recall antigens are associated with pregnancy outcome in women with a history of recurrent spontaneous abortion.

Bermas

Hill

1997

J. Clin. Invest.

View full text Add to dashboard Cite

show abstract

“…Known causes of reproductive loss include chromosomal anomalies, endocrine disorders and physiological abnormalities, although ca. 40% of recurrent human pregnancy failures are unexplained (Hill 1990;Clark 1999). The association between female mating behaviour and early reproductive failure described appears worthy of further investigation in the context of explaining the genetic benefits of polyandry.…”

Section: Discussionmentioning

confidence: 99%

Female multiple mating behaviour, early reproductive failure and litter size variation in mammals

Stockley

2003

Proc. R. Soc. Lond. B

105

View full text Add to dashboard Cite

Female promiscuity is widespread among mammals, although its function is poorly understood. Recently, much interest has been generated by the hypothesis that female promiscuity, combined with postcopulatory paternity-biasing mechanisms, may function to reduce the costs of reproductive failure resulting from genetic incompatibility. Here, a comparative approach is used to determine if average rates of reproductive failure differ for polytocous mammal species with contrasting levels of female multiple-mating behaviour. After control for phylogeny, promiscuous species were found to have significantly lower rates of early reproductive failure than monogamous and polygynous species, in which females are relatively monandrous. Monandrous females appear to compensate for higher early reproductive failure with increased ova production, and thus produce comparable average litter sizes to those of more promiscuous females. However, there is significantly more variation around the average litter sizes produced by relatively monandrous females. These findings are broadly consistent with predictions of the genetic incompatibility avoidance hypothesis, although it is emphasized that alternative explanations cannot be ruled out on the basis of the comparative evidence presented. Further studies are needed to explore ecological correlates of multiple-mating behaviour, to investigate potential post-copulatory paternity-biasing mechanisms, and to identify the causes of reproductive failure in natural mammal populations.

show abstract

“…The observed immunosuppressive effects on the maternal immune system [2,10,19] and proposed immune escape phenomena [12] are discussed to be functionally involved in the absence of a host versus graft reaction against the semiallogenic conceptus. Placental hormones and trophoblastic antigens show immunosuppressive activities [23] and might therefore be involved in this phenomenon.…”

Section: Introductionmentioning

confidence: 99%

Human choriogonadotropin (hCG) and placental lactogen (hPL) inhibit interleukin-2 (IL-2) and increase interleukin-1β (IL-1β), -6 (IL-6) and tumor necrosis factor (TNF-α) expression in monocyte cell cultures

Schäfer¹,

Pauli²,

Friedmann³

et al. 1992

Jpme

View full text Add to dashboard Cite

The effect of the human trophoblast hormones chorionic gonadotropin (hCG) and placental lactogen (hPL) on the expression of cytokines in peripheral blood mononuclear cell cultures was followed under a variety of culture conditions, (a) phytohemagglutinin stimulated cells (PHA-MSC), (b) allogenic mixed cells (AMC) and (c) spontaneously proliferating cells (SPC). A dose dependent enhanced release of IL-6, IL-1 beta and TNF-alpha by hCG and hPL was observed under all culture conditions. However, an inhibitory effect on the IL-2 release was seen in PHA-MSC by hPL and in AMC by hPL and hCG. The role of the suppression of IL-2 production/release on cytotoxicity towards trophoblast is discussed. These results suggest a sensitive, dose dependent hormonal control of the modulation of the immune response during pregnancy and strengthen the concept of a distinct regulation of monocytes and lymphocyte subpopulation by trophoblast hormones.

show abstract

Immunological Mechanisms of Pregnancy Maintenance and Failure: A Critique of Theories and Therapy

Cited by 76 publications

References 77 publications

Proliferative responses to recall antigens are associated with pregnancy outcome in women with a history of recurrent spontaneous abortion.

Proliferative responses to recall antigens are associated with pregnancy outcome in women with a history of recurrent spontaneous abortion.

Female multiple mating behaviour, early reproductive failure and litter size variation in mammals

Human choriogonadotropin (hCG) and placental lactogen (hPL) inhibit interleukin-2 (IL-2) and increase interleukin-1β (IL-1β), -6 (IL-6) and tumor necrosis factor (TNF-α) expression in monocyte cell cultures

Contact Info

Product

Resources

About