Immunological mechanisms in recurrent spontaneous abortion

The acceptance and maintenance of pregnancy remains a biological mystery. The conceptus expresses paternal and embryonic antigens that are foreign to its maternal host yet is not always immunologically rejected. In this chapter we have presented a review of protective immunologic mechanisms possibly responsible for the maintenance of pregnancy, as well as a summary of current data suggesting immunologic mechanisms responsible for pregnancy wastage. Major rapid advances in understanding immunoreproduction should occur over the next several years due to major advances in the rapidly expanding field of immunology. It is now possible to perform in depth studies of immunoregulatory mechanisms. Numerous biochemical mediators of immunological responses have been defined and mass produced for use in research. These mediators have enabled the definition of cellular and humoral interactions within the immune system, and between the immune system and reproductive tissues. Monoclonal antibodies have also been produced that identify many of these mediators and leukocyte markers associated with immune function. It is now possible using these new immunological reagents to probe the immune mechanisms and immunoregulatory events responsible for the success and failure of reproduction. Systematic approaches utilizing these techniques are and will continue to contribute significantly to a further understanding of the immunological mechanisms involved in recurrent spontaneous abortion, which is prerequisite for developing truly effective treatment modalities.