Rizzuto Gabrielle
Immunology and Microbial Pathogenesis Program, Weill Cornell Medicine Graduate School of Medical Sciences, New York, NY, USA.
Department of Anatomic Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
Annu Rev Pathol. 2025 Jan;20(1):33-58. doi: 10.1146/annurev-pathmechdis-111523-023459. Epub 2025 Jan 2.
Pregnancy has fascinated immunologists ever since Peter Medawar's observation that reproduction runs contrary to the founding tenets of immunology. During healthy pregnancy, maternal B cells interact with antigens of the foreign conceptus (placenta and fetus) yet do not elicit rejection. Instead, robust and redundant fetomaternal tolerance pathways generally prevent maternal B cells and antibodies from harming the placenta and fetus. Fetomaternal tolerance is not absolute, and unfortunately there exist several pregnancy complications that arise from breaks therein. Here, important historic and recent developments in the field of fetomaternal tolerance pertaining to maternal B cells and antibodies are reviewed. General rules from which to conceptualize humoral tolerance to the placenta and fetus are proposed. Significant but underexplored ideas are highlighted and topics for future research are suggested, findings from which are predicted to provide insight into the fundamental nature of tolerance and bolster efforts to combat immune-mediated pregnancy complications.
自从彼得·梅达沃观察到生殖与免疫学的基本原理相悖以来，怀孕一直吸引着免疫学家。在健康怀孕过程中，母体B细胞与外来胚胎（胎盘和胎儿）的抗原相互作用，但不会引发排斥反应。相反，强大且冗余的母胎耐受途径通常可防止母体B细胞和抗体伤害胎盘和胎儿。母胎耐受并非绝对，不幸的是，其中的破坏会引发多种妊娠并发症。在此，我们回顾了母胎耐受领域中与母体B细胞和抗体相关的重要历史及近期进展。提出了用于概念化对胎盘和胎儿体液耐受的一般规则。强调了重要但未充分探索的观点，并提出了未来研究的主题，预计这些研究结果将为耐受的基本性质提供见解，并加强对抗免疫介导的妊娠并发症的努力。
