Austgulen R, Arntzen K J
Institutt for kreftforskning og molekylaerbiologi Det medisinske fakultet Norges teknisk-naturvitenskapelige universitet, Trondheim.
Tidsskr Nor Laegeforen. 1999 Dec 10;119(30):4468-71.
The fetus may be regarded as an allograft in the maternal organism. This paper gives an overview of pregnancy-associated immune mechanisms, based on the literature and studies performed by the authors. During implantation, maternal tissues are invaded by fetal trophoblasts expressing HLA-G, a trophoblast-specific variant of HLA Class I antigens. Recognition of HLA-G stimulates uterine natural killer cells to cytokine production, by which an intrauterine immunosuppression is established. Development, growth and differentiation of placenta is regulated by the cytokines produced. Uterine leukocyte population and expression of cytokine receptors in placental tissues varies throughout gestation, and the complex interplay between trophoblasts and uterine cells, involving a number of cytokines, cytokine receptors, adhesion molecules, enzymes and hormones, changes with gestation. Some cytokines, such as tumour necrosis factor and interleukin-1, may threathen the reproductive process and fetal well-being in high doses. A tight regulation of cytokine activities is probably obtained by the observed upregulation of endogenous cytokine buffer mechanisms in pregnancy. The reproductive success and phenomenons like implantation, placental growth and development, maintenance of pregnancy and delivery, appear to rely on complex, gestational age related interplay between cells of fetal origin and the maternal immune system.
胎儿可被视为母体中的同种异体移植物。本文基于文献及作者开展的研究，对妊娠相关免疫机制进行了综述。在着床过程中，表达HLA - G（一种I类HLA抗原的滋养层特异性变体）的胎儿滋养层细胞侵入母体组织。对HLA - G的识别刺激子宫自然杀伤细胞产生细胞因子，由此建立子宫内免疫抑制。胎盘的发育、生长和分化受所产生的细胞因子调节。整个孕期，胎盘组织中子宫白细胞群体及细胞因子受体的表达会发生变化，滋养层细胞与子宫细胞之间复杂的相互作用（涉及多种细胞因子、细胞因子受体、黏附分子、酶和激素）也会随孕期而改变。某些细胞因子，如肿瘤坏死因子和白细胞介素 - 1，高剂量时可能会威胁生殖过程及胎儿健康。孕期内源性细胞因子缓冲机制的上调可能实现了对细胞因子活性的严格调控。生殖成功以及着床、胎盘生长发育、维持妊娠和分娩等现象，似乎依赖于胎儿来源细胞与母体免疫系统之间复杂的、与孕周相关的相互作用。
