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首页> 外文期刊>Current Immunology Reviews >Immunological Puzzle Related to Recurrent Miscarriage: Overview
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Immunological Puzzle Related to Recurrent Miscarriage: Overview

机译：与反复流产有关的免疫难题：概述

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The maternal immune-system must be modified in order to tolerate the semi-allogeneic conceptus. Because maternal alloreactive lymphocytes are not depleted, local mechanisms have to play a key role in altering the immune response. Both humoral and cellular immunity are affected. Th1/Th2 cytokine balance is not essential to have normal pregnancies. Alloreactive Th1 cells must be regulated, for instance, by regulatory T cells. Animal and human experiments showed that Treg number and/or function are diminished in spontaneous abortions. Miscarriage can be prevented by transfer of Treg from normal pregnant mice. Treg at the maternal-fetal interface avoid fetal allo-rejection by means of the creation of a “tolerant” microenvironment characterized by expression of IL-10, TGF-β, HO-1 and IDO, rather than diminishing the Th1 cytokines. Treg or CTLA-4 expression on Treg enhances IDO expression. T-regFoxp3+ can increase placental HO-1. In turn, HO-1 may lead to up-regulation of TGF-β, IL-10 and CTLA-4. The role of progesterone, β-HCG and hPGH and their relation to uNK cell and Treg activity are discussed. A new linking between trophoblast apoptosis, Treg, aPL and NK cell is also raised. Finally, a relationship between HLA-haplotypes and HLA-G molecule, Babs, NK cells, Th1/Th2/Th3/Tr1/Treg balance, aPL and cytotoxic TCD8+, CD4+ is discussed.
机译：必须修改产妇的免疫系统，以耐受半同种异体概念。由于孕妇的同种异体反应性淋巴细胞并未耗尽，因此局部机制必须在改变免疫反应中起关键作用。体液和细胞免疫都受到影响。 Th1 / Th2细胞因子的平衡对于正常怀孕并不是必不可少的。必须通过例如调节性T细胞来调节同种反应性Th1细胞。动物和人体实验表明，自然流产会降低Treg的数量和/或功能。可通过从正常妊娠小鼠转移Treg来防止流产。母胎界面上的Treg通过建立以IL-10，TGF-β，HO-1和IDO的表达为特征的“耐受”微环境，避免了胎儿异体排斥，而不是减少了Th1细胞因子。 Treg上的Treg或CTLA-4表达可增强IDO表达。 T-regFoxp3 +可增加胎盘HO-1。反过来，HO-1可能导致TGF-β，IL-10和CTLA-4上调。讨论了孕酮，β-HCG和hPGH的作用及其与uNK细胞和Treg活性的关系。还提出了滋养细胞凋亡，Treg，aPL和NK细胞之间的新联系。最后，讨论了HLA-单倍型与HLA-G分子，Babs，NK细胞，Th1 / Th2 / Th3 / Tr1 / Treg平衡，aPL和细胞毒性TCD8 +，CD4 +之间的关系。

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