Search

Maternal lymphocytes recognize fetal antigens, so tolerance is necessary to prevent rejection. Seminal plasma is important for induction of paternal antigen-specific Treg cells in the uterine draining lymph nodes and the pregnant uterus. Elimination of Treg cells during implantation or early pregnancy induces implantation failure or fetal resorption in mice. Immunosuppressive therapy with an anti-TNF antibody or the immunosuppressive agent tacrolimus improves the pregnancy rate in women with repeated implantation failure and recurrent pregnancy loss of unknown etiology, suggesting that Treg cells play an essential role in successful implantation and pregnancy in humans., (© 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Objective: To estimate the stage of histological chorioamnionitis (h-CAM) antenatally using clinical data., Materials and Methods: Four hundred and twenty-eight singleton mothers were recruited. Clinical data including the levels of white blood cell count (WBC), C-reactive protein (CRP), amniotic fluid interleukin-8 (AF-IL-8) at Cesarean section, and maternal body temperature (MBT) were collected., Results: Histological chorioamnionitis was present in 45.3% of the cases. Poor neonatal prognosis was highest (59.1%) in cases with h-CAM stage III. AF-IL-8 (odds ratio: 8.5, 95% CI: 5.1-14.8, P < 0.0001) and MBT (odds ratio: 2.3, 95% CI: 1.13-4.1, P = 0.0192) were independent risk factors for h-CAM. The cutoff value of AF-IL-8 for predicting each stage of h-CAM (stage I or higher, stage II or higher, and stage III) were ≥9.9 ng/mL, ≥17.3 ng/mL, and ≥55.9 ng/mL, respectively., Conclusion: The stage of h-CAM was able to be predicted accurately by the level of AF-IL-8 before delivery., (© 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Regulatory T cells (Treg) play essential roles in implantation and allogeneic pregnancy maintenance in mice and humans. Recent data have shown the heterogeneity of Treg, such as thymic (naturally occurring) Treg, extrathymic (inducible or peripheral) Treg, naïve Treg, effector Treg, resting (non-proliferating) Treg and activated (proliferating) Treg. Importantly, Foxp3, which was believed to be a specific marker for Treg, is transiently expressed in T cells when conventional T cells are activated and proliferating in humans showing that Foxp3 is not a specific marker for Treg. Therefore, we should evaluate the true Treg level and clarify which types of Treg cells play important roles in implantation and pregnancy maintenance in mice and humans., (© 2013 John Wiley & Sons A/S.)

Immunological dysfunction has been proposed to explain the etiology of recurrent pregnancy loss (RPL). The immunological environment differs between the decidua basalis and decidua parietalis, and also between RPL cases with normal fetal chromosomes and those with abnormal fetal chromosomes. The problem with analyzing decidual tissues from spontaneous abortions is that cause versus effect phenomena are difficult to distinguish. Recent data show that the immune system in a late-stage miscarriage is completely different from that in an early-stage miscarriage. If immunocompetent cells can cause RPL, the immunological environment may be a causative factor, especially in an early-stage miscarriage, at the decidua basalis, and/or in cases of RPL with a normal embryo. Careful examination of the immune system at the decidua basalis in an early-stage miscarriage in RPL cases with normal fetal chromosomes may reveal useful information. This paper aimed at finding a cause of RPL by analyzing the balance of the immune system between T cells and NK cells in an early-stage miscarriage., (© 2012 John Wiley & Sons A/S.)