Immunological Basis for Recurrent Fetal Loss and Pregnancy Complications.
Immunological Basis for Recurrent Fetal Loss and Pregnancy Complications.
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DOI：
10.1146/annurev-pathmechdis-012418-012743
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发表时间：
2019-01-24
期刊：
影响因子：
--
通讯作者：
Way SS
中科院分区：
文献类型：
--
作者：
Deshmukh H;Way SS
怀孕平行于一个复杂的动态变化的分类，允许密切接近遗传不一致的母体和胎儿组织。尽管这一过程的细胞和分子细节在很大程度上仍未确定，但从评估先前怀孕如何影响未来怀孕的结果中获得了重要线索。并发症的风险随着先前妊娠的并发症而持续增加。反过来，以前成功的怀孕可以防止未来怀孕的并发症。在这里，我们总结了与胎儿丢失相关的免疫扰动，特别关注这些有害和保护性适应如何在母亲中持续存在。免疫异常作为妊娠并发症的根本原因也被认为是由于它们共同重叠的危险因素和在整个妊娠期间避免母胎冲突的持续要求。了解妊娠引起的免疫变化不仅可以为改善妊娠结局提供新的治疗策略，而且可以为免疫耐受如何在其他生理和病理环境中发挥作用提供新的方面。
Pregnancy parallels an elaborate assortment of dynamic changes allowing intimate approximation of genetically discordant maternal and fetal tissues. Although the cellular and molecular details for how this works remains largely undefined, important clues arise from evaluating how prior pregnancy influences the outcome of future pregnancy. Risk of complications is consistently increased with complication in prior pregnancy. Reciprocally, prior successful pregnancy protects against complications in future pregnancy. Here we summarize immunological perturbations associated with fetal loss, with particular focus on how these harmful and protective adaptations may persist in mothers. Immunological aberrancy as a root cause of pregnancy complications is also considered given their shared overlapping risk factors and the sustained requirement for averting maternal-fetal conflict throughout pregnancy. Understanding pregnancy induced immunological changes can not only expose new therapeutic strategies for improving pregnancy outcomes, but also new facets on how immune tolerance works applicable in other physiological and pathological contexts.
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