Department of Pediatrics and Cell Transplantation, Mie University Graduate School of Medicine, Tsu, Mie, Japan.
Front Immunol. 2012 May 25;3:135. doi: 10.3389/fimmu.2012.00135. eCollection 2012.
Major histocompatibility complex antigens that provoke severe transplant reactions are referred to as the human leukocyte antigen (HLA) in human and as the H-2 in mice. Even if the donor and recipient are HLA-identical siblings, graft-versus-host reactions have been linked to differences in the minor histocompatibility antigen. As the chance of finding an HLA-identical sibling donor is only 25%, attention has been focused on using alternative donors. An HLA-mismatched donor with non-inherited maternal antigens (NIMA) is less immunogenic than that with non-inherited paternal antigens, because the contact between the immune systems of the mother and child during pregnancy affects the immune response of the child against NIMA. However, the immunologic effects of developmental exposure to NIMA are heterogeneous, and can be either tolerogenic or immunogenic. We recently have devised a novel method for predicting the tolerogenic effect of NIMA. In this review, we overview the evidence for the existence of the NIMA tolerogenic effect, the possible cellular and molecular basis of the phenomenon, and its utilization in hematopoietic stem cell transplantation. We suggest a future direction for the safe clinical use of this phenomenon, fetomaternal tolerance, in the transplantation field.
主要组织相容性复合体抗原引发严重的移植反应，在人类中被称为人类白细胞抗原（HLA），在小鼠中被称为 H-2。即使供体和受体是 HLA 完全匹配的兄弟姐妹，移植物抗宿主反应也与次要组织相容性抗原的差异有关。由于找到 HLA 完全匹配的兄弟姐妹供体的机会只有 25%，因此人们一直关注使用替代供体。与非遗传父系抗原（NIMA）相比，具有 HLA 不匹配的供体的免疫原性较低，因为妊娠期间母亲和孩子的免疫系统之间的接触会影响孩子对 NIMA 的免疫反应。然而，对 NIMA 的发育性暴露的免疫效应是异质的，既可以是耐受原性的，也可以是免疫原性的。我们最近设计了一种预测 NIMA 耐受原性效应的新方法。在这篇综述中，我们概述了 NIMA 耐受原性效应的存在证据、该现象的可能细胞和分子基础，以及其在造血干细胞移植中的应用。我们建议在移植领域中为这种现象（胎母耐受）的安全临床应用开辟未来的方向。
