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Immunology of pregnancy: cellular mechanisms allowing fetal survival within the maternal uterus

Published online by Cambridge University Press:  27 April 2007

Ana Claudia Zenclussen ,
Anne Schumacher ,
Maria Laura Zenclussen ,
Paul Wafula  and
Hans-Dieter Volk
Ana Claudia Zenclussen*
Affiliation:
AG Reproduktionsimmunologie, Institut für Medizinische Immunologie, Charite, Medizinische Universität zu Berlin, Germany.
Anne Schumacher
Affiliation:
AG Reproduktionsimmunologie, Institut für Medizinische Immunologie, Charite, Medizinische Universität zu Berlin, Germany.
Maria Laura Zenclussen
Affiliation:
AG Reproduktionsimmunologie, Institut für Medizinische Immunologie, Charite, Medizinische Universität zu Berlin, Germany.
Paul Wafula
Affiliation:
AG Reproduktionsimmunologie, Institut für Medizinische Immunologie, Charite, Medizinische Universität zu Berlin, Germany.
Hans-Dieter Volk
Affiliation:
AG Reproduktionsimmunologie, Institut für Medizinische Immunologie, Charite, Medizinische Universität zu Berlin, Germany.
*
*Corresponding author: Ana Claudia Zenclussen, AG Reproduktionsimmunologie, Institut für Medizinische Immunologie, Charite, Medizinische Universität zu Berlin, CVK, Biomedizinisches Forschungszentrum, Raum 2.0534, Augustenburger Platz 1, 13353 Berlin, Germany. Tel: +49 30 450 559886; Fax: +49 30 450 559986; E-mail: ana.zenclussen@charite.de
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Abstract

Pregnancy success remains a fascinating phenomenon to immunologists as it defies the immunological rules of rejection. Although it was previously thought that the maternal immune system does not see the fetus, it is now well documented that fetal cells reach the maternal body and encounter host immune cells. Natural tolerance mechanisms following this interaction remain to be fully elucidated. This article reviews the current literature on mechanisms of adaptive immunity, with emphasis on regulatory T cells and heme oxygenase 1 (HO-1). We propose a scenario in which regulatory T cells create a tolerant microenvironment at the fetal–maternal interface characterised by the presence of tolerance-associated molecules such as HO-1, which has been shown to be of vital importance for fetal survival.

Type
Research Article
Information
Expert Reviews in Molecular Medicine , Volume 9 , Issue 10 , April 2007 , pp. 1 - 14
Copyright
Copyright © Cambridge University Press 2007

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References

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Further reading, resources and contacts

The following websites provide patient support for miscarriage:

Guleria, I. and Sayegh, M. (2007) Maternal acceptance of the fetus: true human tolerance. J Immunol 178, 3345-3351CrossRefGoogle ScholarPubMed
Hunt, J. (2006) Stranger in a strange land. Immunol Rev 213, 36-47CrossRefGoogle Scholar
Moffett, A. and Loke, C. (2006) Immunology of placentation in eutherian mammals. Nat Rev Immunol 6, 584-594CrossRefGoogle ScholarPubMed
Kling, C. et al. (2006) Transfusion related risks of intradermal allogeneic lymphocyte immunotherapy: single cases in a large cohort and review of the literature. Am J Reprod Immunol 56, 157-171CrossRefGoogle Scholar
Abrahams, V.M. and Mor, G. (2005) Toll-like receptors and their role in the trophoblast. Placenta 26, 540-547CrossRefGoogle ScholarPubMed
http://fertilityusa.com/ (Advanced Reproductive Care Inc)Google Scholar
http://www.patient.co.uk/showdoc/433/ (Patient UK)Google Scholar
http://www.miscarriageassociation.org.uk/ (The Miscarriage Association)Google Scholar
http://smfm.org/ (The Society for Maternal-Fetal Medicine)Google Scholar
http://royaninstitute.org/ (The Royan Institute, Iran)Google Scholar
Guleria, I. and Sayegh, M. (2007) Maternal acceptance of the fetus: true human tolerance. J Immunol 178, 3345-3351CrossRefGoogle ScholarPubMed
Hunt, J. (2006) Stranger in a strange land. Immunol Rev 213, 36-47CrossRefGoogle Scholar
Moffett, A. and Loke, C. (2006) Immunology of placentation in eutherian mammals. Nat Rev Immunol 6, 584-594CrossRefGoogle ScholarPubMed
Kling, C. et al. (2006) Transfusion related risks of intradermal allogeneic lymphocyte immunotherapy: single cases in a large cohort and review of the literature. Am J Reprod Immunol 56, 157-171CrossRefGoogle Scholar
Abrahams, V.M. and Mor, G. (2005) Toll-like receptors and their role in the trophoblast. Placenta 26, 540-547CrossRefGoogle ScholarPubMed
http://fertilityusa.com/ (Advanced Reproductive Care Inc)Google Scholar
http://www.patient.co.uk/showdoc/433/ (Patient UK)Google Scholar
http://www.miscarriageassociation.org.uk/ (The Miscarriage Association)Google Scholar
http://smfm.org/ (The Society for Maternal-Fetal Medicine)Google Scholar
http://royaninstitute.org/ (The Royan Institute, Iran)Google Scholar