PROGESTERONE AND MAINTENANCE OF PREGNANCY: IS PROGESTERONE NATURE'S IMMUNOSUPPRESSANT? *
PROGESTERONE AND MAINTENANCE OF PREGNANCY: IS PROGESTERONE NATURE'S IMMUNOSUPPRESSANT? *
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黄体酮与妊娠维持：黄体酮是天然的免疫抑制剂吗？
DOI：
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发表时间：
1977
影响因子：
5.2
通讯作者：
D. Stites
中科院分区：
文献类型：
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作者：
P. Siiteri;F. Febres;L. E. Clemens;R. J. Chang;B. Gondos;D. Stites
来自黄体或胎盘或两者的孕激素已被证明是维持妊娠所必需的。1903年，Frankel发现了黄体的重要作用，大约30年后，艾伦和Corner证明了黄体提取物对维持家兔妊娠有效。更重要的是，最近的研究，利用优雅的免疫学和化学技术，进一步阐述了孕激素对维持妊娠的重要性。然而，孕酮的功能作用仍不清楚。Csapo的开创性研究导致了这样的概念，即子宫的孕酮优势抑制子宫收缩力，直到接近妊娠结束。然而，孕酮的其他作用可能同样重要（关于孕酮和妊娠维持的广泛综述，见参考文献I）。20多年前，有人提出胎儿与正常和致敏母亲之间存在“屏障”，阻止母亲对胎儿的父系组织相容性抗原产生移植免疫状态。人们对滋养层发挥这种功能的可能性给予了很大的关注，这仅仅是因为滋养层代表了胎儿细胞成分，在不同物种中，滋养层在不同程度上与母体血液和组织（蜕膜）直接接触。胎盘屏障的有效性归因于滋养层细胞的非抗原性、滋养层细胞分泌纤维素或粘多糖掩盖组织相容性抗原、4s 5和滋养层细胞分泌物抑制细胞和体液免疫。6考虑到一方面可以通过给予异源抗胎盘血清终止妊娠，另一方面种间交配已经成功，似乎很明显，一种普遍的、高效的机制必须防止胎儿的免疫破坏。滋养层激素可能在调节妊娠免疫耐受中起重要作用的观点最近引起了人们的极大兴趣。在体内和体外都观察到母体细胞免疫的抑制，特别是在人类妊娠的第三个三个月期间。用有丝分裂原（植物血凝素，PHA）或在混合淋巴细胞培养物（MLC）中进行刺激后测量的胸腺依赖性淋巴细胞增殖"*I2是超增殖的。
Progesterone derived either from the corpus luteum or the placenta, or both, has been shown to be essential for the maintenance of pregnancy in every species examined. The essential role of the corpus luteum was discovered by Frankel in 1903, and extracts of the corpus luteum were shown to be effective in maintaining pregnancy in rabbits by Allen and Corner about 30 years later. Many more,recent studies that utilized elegant immunologic and chemical techniques have further elaborated on the importance of progesterone for pregnancy maintenance. However, the functional role of progesterone remains unclear. The pioneering studies of Csapo led to the concept that progesterone dominance of the uterus suppresses uterine contractility until near the end of gestation. However, other effects of progesterone may be equally as important (for an extensive review of progesterone and pregnancy maintenance, see Reference I). More than 20 years ago, it was proposed2 that a '*barrier" exists between fetuses and both normal and sensitized mothers that prevents the mother from developing a state of transplantation immunity to the paternal histocompatibility antigens of the fetus. Much attention has been directed to the possibility that the trophoblast serves this function, simply because it represents the fetal cellular element that, to varying degrees in different species, has direct contact with maternal blood and tissue (decidua). The effectiveness of the placental barrier has been ascribed to nonantigenicity of trophoblastic cells,' secretion of fibrinoid or mucopolysaccharide by trophoblasts that masks histocompatibility antigens,4s5 and suppression of cellular and humoral immunity by trophoblastic hormones.6 Considering that pregnancy can be terminated by administration of heterolcgous antiplacental serum, on the one hand, and that interspecies matings have been successful, on the other, it seems obvious that a universal, highly efficient mechanism must prevent the immunologic destruction of the fetus. The idea that trophoblastic hormones may be important in mediating immunologic tolerance of pregnancy has gained considerable interest recently. Depression of maternal cellular immunity, particularly during the third trimester of human pregnancy, has been observed both in vivo7.8 and in vitro. Thymus-dependent lymphocytic proliferation measured after s t i m ~ l a t i o n ~ ~ ~ ~ with mitogens (phytohemagglutinin, PHA) or in mixed lymphocyte cultures (MLC)"*I2 is sup-