Immune cellular homeostasis and its breakdown at the maternal-fetal interface

Area of Science:

• Reproductive immunology
• Maternal-fetal medicine
• Immunology

Background:

• Pregnancy necessitates intricate immune adaptations at the maternal-fetal interface, balancing tolerance, homeostasis, and defense.
• Understanding cellular immune responses in mid-to-late gestation is crucial for analyzing major obstetrical complications.

Purpose of the Study:

• To propose a unifying paradigm for pregnancy complications: the breakdown of maternal-fetal immune homeostasis.
• To highlight key immune cells and inflammatory processes involved in maintaining or disrupting pregnancy.

Main Methods:

• Integration of findings from human placental samples.
• Analysis of refined animal models of pregnancy.
• Review and synthesis of current knowledge on immune cell functions in gestation.

Main Results:

• Regulatory T cells and decidual macrophages are identified as key regulators of immune tolerance and homeostasis.
• Effector T cell infiltration characterizes chronic placental inflammation.
• Neutrophil-driven inflammation is associated with acute chorioamnionitis.

Conclusions:

• Dysregulation of immune programs that sustain mid-to-late pregnancy drives pathological conditions.
• Understanding these immune dysregulations opens new avenues for therapeutic interventions in obstetrical complications.