Role of progesterone and progestin therapy in threatened abortion and preterm labour.
Progesterone (P) has been widely used in an attempt to prevent threatened miscarriage, recurrent miscarriage and pre-term labour. Successful pregnancy depends on maternal tolerance of the fetal "semi-allograft". Along with its endocrine effects, P also acts as an "immunosteroid", by controlling the bias towards a pregnancy protective immune milieu. A protein called progesterone-induced blocking factor (PIBF), by inducing a Th2 dominant cytokine production mediates the immunological effects of progesterone. Progesterone plays a role in uterine homing of NK cells and up-regulates HLA-G gene expression, the ligand for various NK inhibitory receptors. At high concentrations, progesterone is a potent inducer of Th2-type cytokines as well as of LIF and M-CSF production by T cells. The possible mechanisms by which progesterone contributes to the maintenance of early and late pregnancy are discussed.
Szekeres-Bartho
Julia
J
Department of Medical Microbiology and Immunology, Medical School, Pecs University, H-7643 Pecs, Hungary. Julia.szekeres@aok.pte.hu
Wilczynski
Jacek R
JR
Basta
Pawel
P
Kalinka
Jaroslaw
J
D000033:Abortion, Threatened / Q000378:metabolism*; D000818:Animals; D016207:Cytokines / Q000378:metabolism; D005260:Female; D006801:Humans; D007249:Inflammation; D007694:Killer Cells, Natural / Q000378:metabolism; D009000:Monocytes / Q000378:metabolism; D007752:Obstetric Labor, Premature / Q000378:metabolism*; D018384:Oxidative Stress; D011247:Pregnancy; D011374:Progesterone / Q000378:metabolism / Q000502:physiology*; D011372:Progestins / Q000627:therapeutic use*; D011453:Prostaglandins / Q000378:metabolism
D016207:Cytokines; D011372:Progestins; D011453:Prostaglandins; D011374:Progesterone