| INTRODUC TI ONAs a member of an integrin family, CD49a is expressed on a variety of immune cells including T cells, natural killer T cells (NKT), and NK cells. CD49a plays important roles in innate and adaptive immunemediated responses as well as in inflammation, regulation of growth, differentiation, 1 and liver cirrhosis. 2,3 CD8 + CD49a + Trm (Tissue-resident memory T cells) cells and CD8 + CD49a − Trm cells exert significantly different immune effects. 4 CD49a also regulates the migration, retention, and preservation of immune cells. Interaction of CD49a with collagen promotes immune cells proliferation and the secretion of inflammatory cytokines, which upregulate the expression of CD49a on endothelial cells and mesangial cells, promoting the formation of blood vessels. 2,3 In normal pregnancy, embryonic trophoblast cells and maternal decidual stromal cells comprise the maternal-fetal interface. NK cells, components of the innate immune system, are concentrated within the decidual tissue of the maternal-fetal interface. 5,6 A recent study has shown integrin, αvβ3, to regulate adhesion between villous trophoblastic cells. When a small molecule inhibitor (SB-273005) was used to inhibit the expression of Problem: The function of CD49a on human decidual natural killer (dNK) cells is unknown. Method of study: The expression of CD49a on dNK cells from human patients with recurrent spontaneous abortions or age-matched healthy controls was analyzed by flow cytometry. DNK cells were treated with CD49a neutralizing antibody and analyzed for function (cytokines production and cytotoxic activity). Long non-coding RNA (lncRNA) microarray analysis was used to identify a potential regulator of CD49a. Results: DNK cells from human patients who underwent recurrent spontaneous abortions had lower levels of CD49a and increased perforin, granzyme B, and IFN-r expression, when compared to dNK cells from age-matched healthy controls. Perforin, granzyme B, and IFN-r expression levels in dNK cells were upregulated, while the migration and adhesion of dNK cells were downregulated by CD49a-neutralizing antibody. By the 51 Cr release assay, the killing activity of dNK cells also increased with CD49a neutralizing antibody. Further, lnc-49a, a newly identified lncRNA, was shown to be a positive regulator of CD49a in primary human NK cells. Conclusion: CD49a is involved in the regulation of dNK cells functions, including cytotoxic activity, migration, and adhesion. Further, lnc-49a is a positive regulator of CD49a in human primary dNK cells. K E Y W O R D S adhesion, CD49a, long non-coding RNAs, migration, natural killer cells S U PP O RTI N G I N FO R M ATI O N Additional supporting information may be found online in the Supporting Information section at the end of the article. How to cite this article: Li H, Hou Y, Zhang S, et al. CD49a regulates the function of human decidual natural killer cells. Am J Reprod Immunol. 2019;81:e13101. https://doi.