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The human endometrial gland plays a vital role in maternal immune tolerance and placental development. Decidual macrophages are the major phagocytic cells that regulate tissue remodeling during pregnancy. This study examines the regulatory effect of endometrial gland secretome on macrophage polarization and functions using endometrial organoid. We demonstrated that endometrial organoids treated with hormones mimicking the environment of the secretory phase/early pregnancy polarize macrophages to acquire a decidua-like macrophage phenotype, including higher expressions of decidual macrophage markers, reduced phagocytic capacity and altered cytokine secretion. The results indicated that endometrial gland secretomes are critical for maintaining macrophage homeostasis at the maternal-fetal interface., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier B.V. All rights reserved.)

Exosomes are a subset of extracellular vesicles with an average diameter of ~100nm. Exosomes are released by all cells through an endosome-dependent pathway and carry nucleic acids, proteins, lipids, cytokines and metabolites, mirroring the state of the originating cells. The function of exosomes has been implicated in various reproduction processes, such as embryo development, implantation, decidualization and placentation. Placenta-derived exosomes (pEXO) can be detected in the maternal blood as early as 6 weeks after conception and their levels increase with gestational age. Importantly, alternations in the molecular signatures of pEXO are observed in pregnancy-related complications. Thus, these differentially expressed molecules could be the potential biomarkers for diagnosis of the pregnancy-associated diseases. Recent studies have demonstrated that pEXO play a key role in the establishment of maternal immune tolerance, which is critical for a successful pregnancy. To gain a better understanding of the underlying mechanism, we highlighted the advanced studies of pEXO on immune cells in pregnancy., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Bai, Li, Zhong, Ng, Yeung, Lee and Chiu.)

(B) First trimester serum CD147 levels of the normotensive and PE pregnant women were measured by ELISA (normotensive N = 52, PE N = 26, early-onset PE = 8, late-onset PE N = 18). * P < .05 gl CD147 has an unusual transmembrane domain characterised by a single-charged glutamic acid in the hydrophobic transmembrane region, which promotes protein-protein interactions.4 CD147 is a component of two receptor complexes (Figure 3F; Table S2) on the plasma membrane of human EVCT. Dear Editor, Trophoblastic CD147, also known as basigin (BSG), regulates the differentiation and spiral artery remodelling functions of extravillous trophoblasts (EVCTs), and its deficiency contributes to the pathophysiology of preeclampsia (PE). Dysregulation of the CD147 complex confers defective placental development: A pathogenesis of early-onset preeclampsia. [Extracted from the article]