Abstract
Recurrent spontaneous abortion is a global problem, and unexplained recurrent abortion triggered by immunological factors is an important focus of current research. Helper T lymphocytes (Th cells) and regulatory T lymphocytes (Treg cells) are central in human immune regulation and play a complex role in pregnancy. Natural killer cells (NK cells) exist in the endometrium and cooperate with T lymphocytes to create immune tolerance at the maternal-fetal interface, which is essential for successful pregnancy. This review has analyzed studies on Th17 cell, Treg cell and NK cell dysfunction and cellular imbalances which may contribute to unexplained recurrent spontaneous abortion to suggest a possible direction for future immunotherapies.
Highlights
Recurrent spontaneous abortion (RSA) is defined as 3 or more clinically detectable pregnancy losses occurring in the first 20 weeks of pregnancy [1]
In addition to autoimmune diseases, the abnormal expression of human leukocyte antigens, Th1/Th2 imbalance [5], Fas ligand expression in embryonic trophoblast cells [6], and the inhibition of complement activation [7], abnormal immune functions of Th17 cells, Treg cells and decidual natural killer cells and imbalances in these three types of cells play a key role in unexplained recurrent spontaneous abortion (URSA)
Sasaki et al [65] found that increases in Natural killer cells (NK) cells increased CD4+ CD25bright Treg cells and that the expression of cytotoxic T lymphocyte antigen 4 (CTLA-4) was higher at the interface in women in the early stage of pregnancy compared to a group of non-pregnant women
Summary
Recurrent spontaneous abortion (RSA) is defined as 3 or more clinically detectable pregnancy losses occurring in the first 20 weeks of pregnancy [1]. Th1 and Th2 cell responses show a physiological imbalance, with Th2-type cells prevailing at the maternal-fetal interface and playing a role in the immune protection of embryo.
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