Innate Immune System at the Maternal-Fetal Interface: Mechanisms of Disease and Targets of Therapy in Pregnancy Syndromes.
The maternal-fetal interface is an immunologically unique site that allows the tolerance to the allogenic fetus and maintains host defense against possible pathogens. Balanced immune responses are required for the maintenance of successful pregnancy. It has been demonstrated that innate immune disturbances may be responsible for some adverse pregnancy outcomes such as preeclampsia (PE); hemolysis, elevated liver enzymes, low platelets (HELLP) syndrome; intrauterine growth restriction (IUGR); and recurrent spontaneous abortion (RSA). Observational studies suggest that immunomodulatory treatments in pregnancy-specific complications may improve both the hematological/biochemical features in the mother and the perinatal outcomes. The following review will discuss how recent and relevant findings in the field of the innate immunity have advanced our understanding of the role of inflammation and innate immune system in the pathogenesis of pregnancy failure and will discuss the therapeutic outcomes of the existing studies and clinical trials in light of these new insights.
Rheumatology, Allergology and Clinical Immunology, Department of 'Medicina dei Sistemi', University of Rome Tor Vergata, Rome, Italy.
Paola
P
Triggianese
Reumatologia, Dipartimento di Medicina Interna e Specialità Mediche, Sapienza Università di Roma, Rome, Italy. carlo.perricone@gmail.com.
Carlo
C
Perricone
Rheumatology, Allergology and Clinical Immunology, Department of 'Medicina dei Sistemi', University of Rome Tor Vergata, Rome, Italy.
Maria Sole
MS
Chimenti
Past Head of Obstetrics and Gynecology II, San Giovanni Addolorata Hospital, Rome, Italy.
Caterina
C
De Carolis
Rheumatology, Allergology and Clinical Immunology, Department of 'Medicina dei Sistemi', University of Rome Tor Vergata, Rome, Italy.
Roberto
R
Perricone
D000818:Animals; D002986:Clinical Trials as Topic; D005260:Female; D006801:Humans; D007108:Immune Tolerance; D007113:Immunity, Innate; D056747:Immunomodulation; D008431:Maternal-Fetal Exchange; D058990:Molecular Targeted Therapy; D011247:Pregnancy / Q000276:immunology*; D011248:Pregnancy Complications / Q000276:immunology* / Q000628:therapy; D011256:Pregnancy Outcome
Complement system; eclampsia; innate immunity; natural killer cells; pregnancy