title: Immunological modes of pregnancy loss: inflammation, immune effectors, and stress.
abstract: Inflammatory immune response plays a key role in reproductive failures such as multiple implantation failures (MIF), early pregnancy loss, and recurrent pregnancy losses (RPL). Cellular immune responses particularly mediated by natural killer (NK), and T cells are often dysregulated in these conditions. Excessive or inappropriate recruitment of peripheral blood NK cells to the uterus may lead to cytotoxic environment in utero, in which proliferation and differentiation of trophoblast is hampered. In addition, inadequate angiogenesis by uterine NK cells often leads to abnormal vascular development and blood flow patterns, which, in turn, leads to increased oxidative stress or ischemic changes in the invading trophoblast. T-cell abnormalities with increased Th1 and Th17 immunity, and decreased Th2 and T regulatory immune responses may play important roles in RPL and MIF. A possible role of stress in inflammatory immune response is also reviewed.
authors.affiliation: Reproductive Medicine, Department of Obstetrics and Gynecology, Chicago Medical School, Rosalind Franklin University of Medicine and Science, Vernon Hills, IL, USA; Department of Microbiology and Immunology, Chicago Medical School, Rosalind Franklin University of Medicine and Science, North Chicago, IL, USA.
authors.forename: Joanne
authors.initials: J
authors.lastname: Kwak-Kim
authors.forename: Shihua
authors.initials: S
authors.lastname: Bao
authors.forename: Sung Ki
authors.initials: SK
authors.lastname: Lee
authors.forename: Joon Woo
authors.initials: JW
authors.lastname: Kim
authors.forename: Alice
authors.initials: A
authors.lastname: Gilman-Sachs
mesh_terms: D000026:Abortion, Habitual / Q000276:immunology* / Q000473:pathology; D016207:Cytokines / Q000096:biosynthesis / Q000276:immunology; D020964:Embryo Loss / Q000276:immunology* / Q000473:pathology; D005260:Female; D006801:Humans; D007249:Inflammation / Q000276:immunology / Q000473:pathology; D007694:Killer Cells, Natural / Q000276:immunology* / Q000473:pathology; D009389:Neovascularization, Pathologic; D018384:Oxidative Stress; D011247:Pregnancy; D013601:T-Lymphocytes / Q000276:immunology* / Q000473:pathology; D014327:Trophoblasts / Q000276:immunology / Q000473:pathology; D014599:Uterus / Q000098:blood supply / Q000276:immunology* / Q000473:pathology
chemical_list: D016207:Cytokines
keywords: Angiogenesis; multiple implantation failure; natural killer cell; recurrent pregnancy loss; stress; uterine blood flow