Chaturvedi Vandana, Ertelt James M, Jiang Tony T, Kinder Jeremy M, Xin Lijun, Owens Kathryn J, Jones Helen N, Way Sing Sing
J Clin Invest. 2015 Apr;125(4):1713-25. doi: 10.1172/JCI78578. Epub 2015 Mar 9.
Mammalian pregnancy requires protection against immunological rejection of the developing fetus bearing discordant paternal antigens. Immune evasion in this developmental context entails silenced expression of chemoattractant proteins (chemokines), thereby preventing harmful immune cells from penetrating the maternal-fetal interface. Here, we demonstrate that fetal wastage triggered by prenatal Listeria monocytogenes infection is driven by placental recruitment of CXCL9-producing inflammatory neutrophils and macrophages that promote infiltration of fetal-specific T cells into the decidua. Maternal CD8+ T cells with fetal specificity upregulated expression of the chemokine receptor CXCR3 and, together with neutrophils and macrophages, were essential for L. monocytogenes-induced fetal resorption. Conversely, decidual accumulation of maternal T cells with fetal specificity and fetal wastage were extinguished by CXCR3 blockade or in CXCR3-deficient mice. Remarkably, protection against fetal wastage and in utero L. monocytogenes invasion was maintained even when CXCR3 neutralization was initiated after infection, and this protective effect extended to fetal resorption triggered by partial ablation of immune-suppressive maternal Tregs, which expand during pregnancy to sustain fetal tolerance. Together, our results indicate that functionally overriding chemokine silencing at the maternal-fetal interface promotes the pathogenesis of prenatal infection and suggest that therapeutically reinforcing this pathway represents a universal approach for mitigating immune-mediated pregnancy complications.
哺乳动物怀孕需要防止对携带父源抗原的发育中的胎儿进行免疫排斥。在这种发育背景下的免疫逃逸需要趋化蛋白(趋化因子)的表达沉默,从而防止有害免疫细胞穿透母胎界面。在此,我们证明产前单核细胞增生李斯特菌感染引发的胎儿流失是由产生CXCL9的炎性中性粒细胞和巨噬细胞向胎盘募集所驱动,这些细胞促进胎儿特异性T细胞浸润到蜕膜中。具有胎儿特异性的母体CD8 + T细胞上调趋化因子受体CXCR3的表达,并且与中性粒细胞和巨噬细胞一起,对于单核细胞增生李斯特菌诱导的胎儿吸收至关重要。相反,通过CXCR3阻断或在CXCR3缺陷小鼠中,具有胎儿特异性的母体T细胞在蜕膜中的积累和胎儿流失得以消除。值得注意的是,即使在感染后开始CXCR3中和,对胎儿流失和子宫内单核细胞增生李斯特菌入侵的保护作用仍然得以维持,并且这种保护作用扩展到由免疫抑制性母体调节性T细胞部分消融引发的胎儿吸收,这些调节性T细胞在怀孕期间会扩张以维持胎儿耐受性。总之,我们的结果表明,在母胎界面功能性地克服趋化因子沉默会促进产前感染的发病机制,并表明通过治疗加强这一途径代表了一种减轻免疫介导妊娠并发症的通用方法。