Brami C
Presse Med. 1985 Feb 23;14(8):479-83.
An immunological response from mother to foetus is known to exist during pregnancy. Multiple mechanism ensure that this response is not one of rejection but of "tolerance" of the foetus, and the placenta, as the site of maternal-foetal exchanges, plays a prominent role in this respect: (1) the placenta cell bears foetal antigens, half of which are of paternal origin; it constitutes therefore the antigenic stimulus of maternal immune response; (2) this response can be modulated quantitatively through placental hormones and glycoproteins - an action which has been demonstrated in vitro but which may well take place at utero-placental level; (3) finally, the placenta can act qualitatively on the maternal response itself by reducing cytotoxic reactions responsible for graft rejection and by stimulating immunosuppressor cell populations. The therapeutic applications of some of these properties of the placenta are being investigated in the fields of rheumatology and renal transplantation. They will be considered in obstetrics only when more precise data are available concerning the immunopathological mechanisms involved in spontaneous abortion, preeclampsia and foetal growth retardation.
众所周知,孕期存在母体对胎儿的免疫反应。多种机制确保这种反应不是排斥反应,而是对胎儿的“耐受”,作为母胎物质交换场所的胎盘在这方面发挥着重要作用:(1)胎盘细胞携带胎儿抗原,其中一半来自父方;因此它构成了母体免疫反应的抗原刺激;(2)这种反应可通过胎盘激素和糖蛋白进行定量调节——这一作用已在体外得到证实,但很可能发生在子宫胎盘水平;(3)最后,胎盘可通过减少负责移植排斥的细胞毒性反应并刺激免疫抑制细胞群体,在质量上作用于母体反应本身。胎盘这些特性的一些治疗应用正在风湿病学和肾移植领域进行研究。只有在获得有关自然流产、先兆子痫和胎儿生长受限所涉及的免疫病理机制的更精确数据后,才会在产科中考虑这些应用。