Gs. Vince et Pm. Johnson, MATERNO-FETAL IMMUNOBIOLOGY IN NORMAL-PREGNANCY AND ITS POSSIBLE FAILURE IN RECURRENT SPONTANEOUS-ABORTION, Human reproduction, 10, 1995, pp. 107-113
Many features contributing to the success of pregnancy in humans have
been identified over the last 20 years, Trophoblast cells (which form
the interface of fetal tissue with the mother) have specialized immuno
logical features which may confer unique transplantation protection fo
r the fetus throughout pregnancy, Both syncytiotrophoblast and cytotro
phoblast cells do not express classical class I [human leucocyte antig
en (HLA)-A or -B] or II (HLA-DP, -DQ or -DR) major histocompatibility
complex (MHC) alloantigens, and the regulation of these cell surface g
lycoproteins appears to be at the transcriptional level, In contrast,
extravillous cytotrophoblast cells express the non-classical class I M
HC molecule HLA-G, One form of HLA-G (HLA-G1) is potentially capable o
f presenting a variety of peptide antigens to T cells, Alternatively,
HLA-G may act as a cell surface class I MHC molecule, protecting cytot
rophoblast from maternal MHC non-restricted natural killer (NK) cell a
ttack; the expression of HLA-G by otherwise HLA-null cell transfectant
s has been shown to decrease their sensitivity to NK cell-mediated cyt
olysis, All fetal trophoblast populations throughout gestation express
high levels of cell surface complement regulatory proteins, providing
protection from complement-mediated damage at the materno-fetal inter
face, Analyses of trials with allogeneic leucocytes for the treatment
of recurrent spontaneous abortion show little evidence of an improved
success rate in immunized patients.