Biologic Markers in Reproductive Toxicology (1989) / Chapter Skim
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19. Reproductive Immunology: Biologic Markers of Compromised Pregnancies
19. Reproductive Immunology: Biologic Markers of Compromised Pregnancies
Pages 215-222
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From page 215... ...
MATERNAL IMMUNOLOGIC RECOGNITION AND REACTION DURING NORMAL PREGNANCY Efforts to understand the immunology of human pregnancy have focused on extraembryonic membranes, because the point of contact between maternal tissues and the conceptus is the trophoblast. Cells of the inner cell mass differentiate to become the embryo, and extraembryonic components form an interface with maternal blood and uterine cells (Faulk and McIntyre, 1983~.
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From page 216... ...
Studies of human serum taken during pregnancy have revealed the presence of circulating immune complexes (i.e., antigen in combination with its antibody) comprising five biochemically identifiable trophoblast and antitrophoblast components, two of which also can be identified at significantly lower concentrations in serum of nulliparous, nonpregnant women (Davies, 1985~.
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From page 217... ...
that are heat-labile, sensitive to calcium concentrations, destroyed by Russell's viper venom, and absent from the plasma of patients with deficiency in clotting factor V Some cytotrophoblasts in placental villi react with antibodies to factor V; factor V might play a role in modulating maternal antigenantibody interactions within the placental bed.
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From page 218... ...
That clearly is not the case in secondary spontaneous abortion, inasmuch as cytotoxicity is removed from serum by absorption with hLA-negative trophoblast or platelets unrelated to hLAs (Faulk and McIntyre, 1986~. During the last several years, investigators have theorized that normal pregnancy requires maternal immunologic recognition of the TLX antigens inherited by the conceptus (Faulk and McIntyre, 1981 )
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From page 219... ...
Controversy involving association of hLAs and reproductive performance could be resolved in part by properly classifying recurrent spontaneous aborters and inexplicably infertile couples. Immunologists often liken pregnancy to an allogeneic graft, inasmuch as the developing conceptus expresses paternal genes that are foreign to the mother.
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From page 220... ...
. One TLX antigen in the fertilized egg must be incompatible with the mother and be capable of signaling allogeneic recognition and immunologic protection through the generation of maternal blocking antibodies and suppressor cells (McIntyre and Faulk, 1985~.
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From page 221... ...
This approach might make it possible to harvest fetal cells for cytogenetic investigations without resorting to the more invasive techniques of amniocentesis or chorionic villus biopsy. Immunotherapy to Prevent Spontaneous Abortion Immunotherapy to prevent primary spontaneous abortions was begun in 1979 (Taylor and Faulk, 1981~.
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From page 222... ...
Type II immunopathologic reactions are caused by direct interaction of antibody and complement to cause cell lysis, usually with the collaboration of blood complement. An example of such antibodies in pregnancy is the maternal antipaternal lymphocytotoxin seen in secondary sponTOXICI7~YDURING PREGNANCY taneous aborters (McConnachie and McIntyre, 1984~.
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