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Abstract
The proper functioning of the monocyte–macrophage system, an important unit of innate immunity, ensures the normal course of pregnancy. In this review, we present the current data on the origin of the monocyte–macrophage system and its functioning in the female reproductive system during the ovarian cycle, and over the course of both normal and complicated pregnancy. Preeclampsia is a crucial gestation disorder characterized by pronounced inflammation in the maternal body that affects the work of the monocyte–macrophage system. The effects of inflammation at preeclampsia manifest in changes in monocyte counts and their subset composition, and changes in placental macrophage counts and their polarization. Here we summarize the recent data on this issue for both the maternal organism and the fetus. The influence of estrogen on macrophages and their altered levels in preeclampsia are also discussed.
Highlights
The prevalence, main symptoms, and classification of preeclampsia (PE) are well established and can be found in every article devoted to this multisystem pregnancy complication
Compared to other pregnancy complications, PE is the main cause of maternal morbidity and mortality
An important aspect of PE development is the response of maternal innate immunity to various proinflammatory stimuli from the placenta
Summary
The prevalence, main symptoms, and classification of preeclampsia (PE) are well established and can be found in every article devoted to this multisystem pregnancy complication. PE occurs in the second half of pregnancy (after the 20th week) and is characterized by arterial hypertension (depending on the severity of PE) in combination with proteinuria (≥0.3 g/L in daily urine) and/or manifestations of multi-organ or multisystem dysfunction/failure [1]. Tissue macrophages are usually divided into proinflammatory (M1) and anti-inflammatory (M2), the distinction between these types is currently being revised. It is known that polarization is triggered by local concentrations of certain cytokines It is not clear whether selective depletion of a particular monocyte population will affect the composition of tissue macrophage populations. The review is focused on studies published over the last few years in order to provide the most up-to-date information on the topic
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