Innate immunity, coagulation and placenta-related adverse pregnancy outcomes.
Innate immunity, coagulation and placenta-related adverse pregnancy outcomes.
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DOI：
10.1016/j.thromres.2009.07.012
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发表时间：
2009-12
影响因子：
7.5
通讯作者：
Huang SJ
中科院分区：
文献类型：
--
作者：
Li M;Huang SJ
母体免疫力经过微妙的调整，以耐受半同种异体胚胎并维持宿主对潜在病原体的防御。同时，凝血系统从抗凝状态变为促凝血状态，以满足胎盘形成和分娩的止血挑战。先天免疫和凝血系统是保护宿主免受外源性挑战（包括同种异体抗原和机械损伤）并保持生物体完整性的第一道防线。凝血和免疫系统之间的相互作用已被广泛研究。免疫细胞在凝血级联反应的启动中起关键作用，而凝血蛋白酶显示出显著的免疫调节作用。在外源性挑战时，免疫和凝血系统能够相互增强，导致恶性循环。自然杀伤（NK）细胞、巨噬细胞（Mφs）和树突状细胞（DCs）是三种主要的先天性免疫细胞，已被证明在早期妊娠中发挥重要作用。然而，免疫适应不良和止血失衡已被认为是不良妊娠结局的原因，如先兆子痫（PE），流产，复发性自然流产（RSA）和宫内生长受限（IUGR）。本文就凝血与先天免疫系统的相互调节及其在维持正常妊娠和不良妊娠结局发生中的作用进行综述。
Maternal immunity undergoes subtle adjustment in order to tolerate the semi-allogeneic embryo and maintain the host defense against potential pathogens. Concomitantly, coagulation systems change from an anti-coagulant state to a pro-coagulant state to meet the hemostatic challenge of placentation and delivery. Innate immunity and blood coagulation systems are the first line of defense to protect a host against exogenous challenges, including alloantigens and mechanical insults, and preserve the integrity of an organism. The interactions between coagulation and immune systems have been extensively studied. Immune cells play a pivotal role in the initiation of the coagulation cascade, whereas coagulation proteases display substantial immunomodulatory effects. Upon exogenous challenges, the immune and coagulation systems are capable of potentiating each other leading to a vicious cycle. Natural killer (NK) cells, macrophages (Mϕs) and dendritic cells (DCs) are three major innate immune cells that have been demonstrated to play essential roles in early pregnancy. However, immune maladaptation and hemostatic imbalance have been suggested to be responsible for adverse pregnant outcomes, such as preeclampsia (PE), miscarriage, recurrent spontaneous abortion (RSA) and intrauterine growth restriction (IUGR). In this review, we will summarize the mutual regulation between blood coagulation and innate immune systems as well as their roles in the maintenance of normal pregnancy and in the pathogenesis of adverse pregnancy outcomes.
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DOI：
10.1073/pnas.91.19.8767
发表时间：
1994-09-13
影响因子：
11.1
作者：
CELI, A;PELLEGRINI, G;FURIE, B
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