Abstract
The human embryo and subsequent fetus is a semi-allograft and immunologically foreign to the mother. Successful embryonic implantation and maintenance of normal pregnancy depends on intricate interactions between the invading embryo, maternal endometrium and maternal immune response. Cytokines are pivotal in determining the type of maternal T-helper immune response, which can be divided into T-helper 1 (TH1)-mediated delayed hypersensitivity and T-helper 2 (TH2)-mediated humoral immunity. We examined the pattern of TH1 [interleukin (IL)-2, IL-12 and interferon-gamma] and TH2 (IL-4 and IL-6) cytokine expression in the peri-implantation endometrium of 10 fertile, multiparous women. Endometrial samples were timed to the mid-cycle luteinizing hormone (LH) surge, with collection on days LH+7 to LH+9. Analysis for cytokine mRNA was by mRNA extraction and reverse transcription-polymerase chain reaction. The results show a lack of TH1 and predominant TH2 cytokine expression. We postulate that endometrial cytokines may contribute to the local modulation of maternal adaptive immune response in peri-implantation endometrium, to facilitate successful embryonic implantation and maintenance of pregnancy.
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