Immunological analogy between allograft rejection, recurrent abortion and pre-eclampsia - the same basic mechanism?
There are still controversies concerning the role of immunological mechanisms engaged both in recurrent abortions (RA) and pre-eclampsia (PE). According to some opinions, recurrent miscarriage is comparable to organ-specific autoimmune disease. Analysis of immune reactions shows that graft rejection shares many similar mechanisms with RA and PE. This fact allows us to conclude that rejection of transplanted alloantigenic organs and pregnancy loss have probably the same evolutionary origin. Subsets and functions of immunocompetent cells (T CD4, suppressor gammadeltaT, cytotoxic T CD8, Treg, Tr1, uterine NK cells), over-activation of innate immunity (activation of NK cytotoxic cells, macrophages, neutrophils and complement), changes of Th1/Th2 cytokine balance (IL-2, IL-12, IL-15, IL-18, IFNgamma, TNFalpha vs. IL-4, IL-10, TGFbeta), importance of HLA-G molecule, CD200/CD200R interaction, over-expression of adhesion molecules, fgl2 prothrombinase activation and stimulation of IDO and HO expression, all suggest that RA and PE are syndromes of fetal allograft rejection, and not organ-specific autoimmune diseases. According to that supposition, an analogy might exist between acute graft rejection and recurrent abortion, and between chronic graft rejection and pre-eclampsia.
Wilczyński
Jacek R
JR
Department of Gynecological Surgery, Polish Mother's Health Center Research Institute, Lodz, Poland. jrwil@post.pl
D000026:Abortion, Habitual / Q000201:enzymology / Q000276:immunology*; D000818:Animals; D016207:Cytokines / Q000378:metabolism; D005260:Female; D006084:Graft Rejection / Q000201:enzymology / Q000276:immunology*; D006680:HLA Antigens / Q000276:immunology / Q000378:metabolism; D059951:HLA-G Antigens; D051547:Heme Oxygenase-1 / Q000378:metabolism; D015395:Histocompatibility Antigens Class I / Q000276:immunology / Q000378:metabolism; D006801:Humans; D050503:Indoleamine-Pyrrole 2,3,-Dioxygenase / Q000378:metabolism; D007694:Killer Cells, Natural / Q000201:enzymology / Q000276:immunology; D023421:Models, Animal; D011225:Pre-Eclampsia / Q000201:enzymology / Q000276:immunology*; D011247:Pregnancy; D018417:Th1 Cells / Q000201:enzymology / Q000276:immunology; D018418:Th2 Cells / Q000201:enzymology / Q000276:immunology
D016207:Cytokines; D006680:HLA Antigens; D059951:HLA-G Antigens; D015395:Histocompatibility Antigens Class I; D050503:Indoleamine-Pyrrole 2,3,-Dioxygenase; D051547:Heme Oxygenase-1