Cambridge Journals Online

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

Ana Claudia Zenclussen a1c1 , Anne Schumacher a1 , Maria Laura Zenclussen a1 , Paul Wafula a1 and Hans-Dieter Volk a1 a1 AG Reproduktionsimmunologie, Institut für Medizinische Immunologie, Charite, Medizinische Universität zu Berlin, Germany.

Article author query zenclussen ac     schumacher a     zenclussen ml     wafula p     volk h-d

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.