PSYCHO-NEURO-CYTOKINE ENDOCRINE PATHWAYS IN IMMUNOREGULATION DURING PREGNANCY/

PROBLEM: Some mammalian pregnancy failure is thought to occur by immun ological or immunologically modifiable mechanisms. The original model wherein spontaneous abortion was proposed to represent rejection of th e conceptus as an allograft has been supplanted by a model of maternal paraimmunological natural effector cell toxicity to fetal trophoblast more closely related to tumor rejection. The problem is to integrate current information concerning the role of immunological, paraimmunolo gical, endocrinological, and stress-triggered neural factors that dete rmine whether or not abortion will occur. METHODS: Review of existing data. RESULTS: An integrated model is proposed. CONCLUSION: Immunologi cal factors play an important role in abortion processes and preventio n of abortions. The existence of abortogenic mechanisms and their regu lation appears to be based upon optimizing survival of the species. Tw o new conceptual models provide a useful framework for further investi gation of human pregnancy failure and its treatment.