Abstract

This prospective longitudinal study aimed at comparing maternal immune response among naturally conceived (NC; n = 25), in vitro fertilization (IVF; n = 25), and egg donation (ED; n = 25) pregnancies. The main outcome measures were, firstly, to follow up plasma levels of interleukin (IL) 1beta, IL2, IL4, IL5, IL6, IL8, IL10, IL17, interferon gamma, tumor necrosis factor-alpha (TNFα), transforming growth factor-beta (TGFβ), regulated upon activation normal T-cell expressed and secreted (RANTES), stromal cell-derived factor 1 alpha (SDF1α), and decidual granulocyte-macrophage colony-stimulating factor (GM-CSF) during the three trimesters of pregnancy during the three trimesters of pregnancy; secondly, to evaluate if the cytokine and chemokine pattern of ED pregnant women differs from that of those with autologous oocytes and, thirdly, to assess if women with preeclampsia show different cytokine and chemokine profile throughout pregnancy versus women with uneventful pregnancies. Pregnant women in the three study groups displayed similar cytokine and chemokine pattern throughout pregnancy. The levels of all quantified cytokines and chemokines, except RANTES, TNFα, IL8, TGFβ, and SDF1α, rose in the second trimester compared with the first, and these higher values remained in the third trimester. ED pregnancies showed lower SDF1α levels in the third trimester compared with NC and IVF pregnancies. Patients who developed preeclampsia displayed higher SDF1α plasma levels in the third trimester.

Highlights

  • Maternal immunological tolerance is essential for successfully establishing and maintaining pregnancy [1, 2]

  • Type 1 inflammatory T-cells significantly decrease, whereas both type 2 cells and CD56bright CD16− cytokine-secreting uterine natural killer cells significantly increase compared with the nonpregnant endometrium [3]

  • We studied 75 consecutive women whose pregnancy was achieved by three different modes of conception: naturally conceived (NC) (n = 25), in vitro fertilization (IVF) (n = 25), and egg donation (ED) (n = 25)

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Summary

Introduction

Maternal immunological tolerance is essential for successfully establishing and maintaining pregnancy [1, 2]. Type 1 inflammatory T-cells significantly decrease, whereas both type 2 cells and CD56bright CD16− cytokine-secreting uterine natural killer (uNK) cells significantly increase compared with the nonpregnant endometrium [3]. UNK cells (70%), macrophages (15%), and T-cells (10%) are the most abundant decidual leukocyte populations in early pregnancy [4,5,6,7]. A high CD4+CD25bright T regulatory/T helper (Th) 17 cells ratio is found in decidua in early human pregnancy [8]. Women with uncomplicated early pregnancies systemically display high serum Th2/Th1 cytokine [9] and CD4+CD25+Foxp3+ T regulatory (Treg)/Th17 cells ratios [10]. A shift toward peripheral Th1/Th2 augmentation [11] and Th17/Treg cells imbalance has been

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