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GIGU Exam 2 > Immunological Implications Of Pregnancy > Flashcards

Immunological Implications Of Pregnancy Flashcards

1
Q

How is the mom tolerant to the fetus

A

Mom is exposed to some of fetus H and Igs and gets tolerant

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2
Q

What cytokines are part of early phase pregnancy

A

IL1, 6, 17, TNF, LIF, PGE, Neutrophils, Macrophage, DC,ILC3

*acute inflammatory response

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3
Q

Reason we have acute inflammatory response

A
  1. NK, macrophage, Neutrophils: make the endometrium rough
    = exposed adhesion molecules on the endometrium for blastocyst
  2. Also priming of foreign semen proteins starts
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4
Q

What are some acute phase cytokines

A

IL 1, 6, 8, 12, TNF, INF-g

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5
Q

What macrophage and cytokines is in pre-pregnancy
What macrophage is in implantation
their function

A

M1 and IL-1
M1+M2, and IL-10, TGF-B
* to clean up debris around spiral arteries , when trophoblast invade
* sustain CL

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6
Q

Decidual Dendritic Cells

A

Maintain dTreg cells, promote Th2 cells

IL15 —> NK

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7
Q

dNK and uNK cells

Implantation

A

Support development of trophoblasts after its implanted

  • help spiral arteries develop
  • most important
  • inhibitory receptor to HLA C,E,G
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8
Q

Trophoblasts are part of what immune system

A

Innate

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9
Q

How does the trophoblast function as part of the immune system

A
  1. Recruits immune cells, Tregs, M2, uNK cells
  2. Trains them
  3. Has TLR receptors to see PAMPS, DAMPS, -> tissues damage, infection
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10
Q

What cytokines is needed to train
uNK cells
Tregs
M2

A

IL15, TGF-B
TGF-B
IL10, M-CSF

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11
Q

Syncytiotrophoblasts in innate immunity

A

Have firm layer, secrete cytokines to bring immune cells to train then

  • have Fc receptors to bring in Ig from mom to fetus
  • TLR receptors
  • secretion of IFN= anti-viral
  • dense actin cytoskeleton to keep bacteria out
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12
Q

Fc Receptors do what

A

Transport IgG into fetus through endocytosis

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13
Q

Rh - and Rh +

A

TX : rhogam
Type 2 hypersensitivity
Father is + , Rh - females

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14
Q

What does the Syncytiotrophoblasts give off to the maternal circulation

A

Sheds off vesicles with proteins that allow ST to regulate local and systemic mechanisms

  1. Downregulate adaptive, upregulate innate
  2. Vascular response, metabolism regulation
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15
Q

Syncytiotrophoblasts vesicles/exosomes can lead to what

A

Since they regulate metabolism, there is drastically more vesicles in patients with
- pre-eclampsia, gestational diabetes, pre-term birth

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16
Q

What do the syncytiotrophoblasts exosomes have as receptors on their surface

A
  1. FasL
  2. TRA/L
    * suppress active immune, apoptosis
  3. HLA-G
    * downregulate Ag presentation
17
Q

Immune function of Extravillous Trophoblasts

A

Secrete IL15, CCL2, TGF-B (Treg) , IL10(M2), IFN Type1, HLA -G

  • vascular remodeling ,
  • reduce dNK (IL15) + (HLA-G)
  • express PD-1 : —I T cell to bind to CD28
  • M2 secretes IDO : —I T-cells, debris
  • IL8 receptors (Neutrophils)
18
Q

HLA -G

A

Class 1,
*——I active immune response (TOLERANCE)
+ maintain peripheral fetal tolerance
- preeclampsia have low HLA-G

19
Q

Acute phase cytokines

Needed for

A
  • implantation (blastocyst to attach)
  • villi and spiral artery development (mom supply to fetus)
  • Also in delivery and labor
20
Q

Some acute phase cytokines

A

IFN-g/a (Brian), TNF-a, IL-6, IL-17, IL1B

21
Q

During Pregnancy Week 13-27, which immune cells

A

M2, dNK, dM, dDC

22
Q

dNK during pregnancy

A

Helper cells, not cytotoxic
Around the extravillous trophoblast to help invade and angiogenesis
promotes Treg (IL10, INF-g) can still attack if needed

23
Q

dM (macrophage) in during pregnancy

A 
Primarily M2 (second trimester)
Suppressor cell : 
IL 10 (Treg)
IL15 (dNK)
HLA-G —I t-cell presentation
24
Q

dDC during pregnancy

A

From myeloid line
1st 2 trimesters
Self tolerance + immune response to foreign
IL10, TGF-B
HLA _G
*low during late preg. (HIGH plasmacytoid DCs)

25
Q

Tregs are induced by

A

EVTs (HLA-C, HLA-G) and dM
——I immune responses
* other similar cell is PD-1 and TIGHT

26
Q

Tregs have what receptors

A

CTLA-4 —> B7 (CD80) to anergy of APC:

  1. M2 ——> IDO —I Tcells
  2. DC ——> IDO —I Tcells
27
Q

When fo Tregs increase dramatically

A

After implantation

28
Q

Which T-cells does the decidua have

A
  1. Th2 : IL4,5,10,13
  2. g/d Tcells : recognize Ag with no APC (IL10, TGF-B, IFN-g)

Th1/Th17 + CD8+ are VERY LOW

29
Q

Which immune cells are present during the delivery/parturition phase

A

Th17, T-cells, Neutrophils, M1, IL1,6,17,8

DAMPS, prostaglandins

30
Q

What causes the increase immune system response during delivery phase (3rd trimester)

A

trophoblasts release DAMPS and damages DNA

31
Q

What does the increased immune response cause

A

Ripen cervix and initiate labor

32
Q

Which cytokines is there within 12hrs before delivery

A

pro-inflammatory cytokines peak here
(IL1,6,8) (IFN-g, TNF-a)
Also prostaglandins and lipid modulators

33
Q

What Ig is in the breast milk

And function

A

IgA

*GI and Upper respiratory immune protection

GIGU Exam 2 (13 decks)

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