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Cytokines, Hormones and Cellular Regulatory Mechanisms Favoring Successful Reproduction
Marie-Pierre Piccinni1, Raj Raghupathy2, Shigeru Saito3
1Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.
Frontiers in Immunology
|August 16, 2021
Summary
Pregnancy relies on immune tolerance, supported by progesterone and regulatory T cells (Treg). Dydrogesterone enhances protective Th2 immunity and Treg function, crucial for preventing pregnancy loss and immune rejection.
Area of Science:
- Reproductive Immunology
- Maternal-Fetal Tolerance
- Endocrinology
Background:
- The semi-allogeneic conceptus faces maternal immune attack.
- Pregnancy involves significant endocrine shifts, with progesterone playing a vital role in immune modulation.
- Immune mechanisms are essential for successful gestation, preventing fetal rejection.
Purpose of the Study:
- To review the immune mechanisms supporting a healthy pregnancy.
- To explore the role of progesterone, its mediators like PIBF, and progestogens such as dydrogesterone in immune tolerance.
- To discuss the involvement of T helper cell subsets (Th1, Th2, Th17, Th22) and regulatory T cells (Treg) in maternal-fetal interactions and pregnancy pathologies.
Main Methods:
- Review of existing literature on reproductive immunology and endocrinology.
- Analysis of cytokine profiles (Th1, Th2, Th17) and their impact on trophoblast.
- Examination of the role and distribution of regulatory T cells (Treg) in pregnancy and disease states.
Main Results:
- Progesterone and dydrogesterone promote Th2-type immunity and suppress Th1/Th17 cytokines, which can be embryotoxic.
- Dydrogesterone's ability to induce PIBF and modulate cytokines may explain its efficacy in miscarriage.
- Regulatory T cells (Treg) are crucial for feto-maternal tolerance, with their numbers decreasing in miscarriage and preeclampsia.
Conclusions:
- Successful pregnancy depends on a delicate balance of immune responses, favoring tolerance.
- Progesterone and dydrogesterone are key players in establishing and maintaining this immune tolerance.
- Dysregulation of these immune mechanisms, particularly involving Th cells and Treg, contributes to pregnancy complications.
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