4 immunology of pregnancy Flashcards
Maternal general adaptations
The LOCAL cytotoxic adaptive response is strongly suppressed in the uterus and near the fetus.
The regulator adaptive immunity is enhanced.
The innate immunity remains normal.
Mild leukocytosis occurs, and overall there is no significant change in the mothers general immune ability.
Certain infections are much worse in pregnant mothers: Hep E Influenza Varicella CMV Polio Listeria Streptococcus Gonorrhea Salmonella Leprosy Malaria Coccidiomycosis
Maternal specific adaptations
NK cell mediated inflammation is needed for embryo implantation.
Suppressor/Regulatory T cells suppress local responses and there are no B cells locally.
High progesterone levels inhibit TNF-alpha and alter Th1/Th2 balance.
Prostaglandin E2 inhibits lymphocyte proliferation.
Fetal adaptations
Fetal tissue expresses apecific HLA class 1 molecules that suppress maternal immune response.
The trophoblast cells express unique HLA 1b molecules with HLA-E HLA-F and HLA-G highly expressed.
HLA-G promotes release of IL-10 and other anti-inflammatory cytokines
The outermost syncitiotrophoblast cells do not express any HLA-1 antigens.
They also express the enzyme IDO which degrades and locally depletes trypophan levels, which is important for T cell function, suppressing T cells.
