16: Immunology Of Pregnancy Flashcards
What can occur with aberrant expression of cytokines IFN-y/a/B, TNF-a, IL-1/6/17?
Developmental failure in multiple organ systems
Three most crucial times for appropriate cytokine expression
- Attachment
- Implantation
- Establishing maternal blood supply to fetus
Six cytokines upregulated in first phase of pregnancy
IL: 1, 6, 8, 12
TNF, IFN-y
Types of immune cells and their percentages in first stage
- DNKs: 70%
- DMacrophages: 20-30%
- DDCs: 5-10%
What type of macrophage is most common during: pre-pregnancy, implantation, and second trimester
Pre-pregnancy: M1
Implantation: M1 = M2
Second trimester: M2
Four immune functions of trophoblasts generally
- Secrete cytokines and chemokines
- Express co-stimulatory ligands and receptors
- TLRs to sense local environment
- Unique HLA expression to regulate fetal/placental Ag expression
Two populations of trophoblast cells that play innate immune roles
Extravillous trophoblasts + syncytiotrophoblasts
Four major functions of IgG
Opsonization, classical complement activation, ADCC, neutralization
Only Ig that can cross placental barrier
IgG
What clinical role does IgG play?
In Rh issue
Function of EVs shed by syncytiotrophoblasts
Carry placental or ST proteins around body to extend immunomodulatory mechanisms locally and systemically
Clinical correlation of increased EVs in maternal blood
Seen in pts with pre-eclampsia, gestational DM, and pre-term births
When can soluble HLA-G be detected in maternal serum?
During pregnancy, and reduced levels are associated with pregnancy complications
Majority of DC type during first two trimesters vs at end
First two trimesters: mostly myeloid DCs
Late pregnancy: more plasmacytoid DCs, less myeloid
Majority of T cells in decidua + second most common
Most: Tregs
2nd most: Th2 cells
