immunology of pregnancy Flashcards
what challenges does the female reproductive tract face when it come to the immune system?
mestruation fertilisation implantation and pregnancy defence against microorganism parturition
what part of the FRT is colonised and which part is non colonised?
upper = non colonised lower = colonised by bacteria
5 cardinal signs of inflammation
heat redness swelling pain loss of function
during pregnancy, the human decidua contains a high number of immune cells…
such as:
macrophages
NK cells
regulatory T cells
during the first trimester what cells infiltrate the decidua and accumulate around the invading trophoblast cells?
NK cells
dendritic cells
macrophages
what happens if there is no immune cells during pregnancy?
pregnancy terminates
what happens if there is an absence of NK cells?
trophoblast cells are not able to reach the endometrial vascularity leading to termination of pregnancy.
(NK cells are critical for trophoblast invasion)
what is the decidua?
a thick layer of modified mucous membrane which lines the uterus during pregnancy
what have studies suggested that dendritic cells are necessary for?
decidual formation
why are there immune cells at the implantation site?
to facilitate and protect the pregnancy
the immune system the implantation site is active, functional and carefully controlled.
what are the three stages of trophoblast-immune interaction?
1) attraction - trophoblast cells secrete chemokine that recruit immune cells to the implantation site.
2) education - trophoblast cells produce regulatory cytokines that modulate the differentiation process of immune cells
3) response) immune cells educated b trophoblast cells respond to signals of the local microenvironment in an unique way.
which parts of pregnancy resemble an open wound?
implantation, placentation, the first and early second trimester.
(they require a strong inflammatory response)
why is the first trimester a proinflammatory phase?
because during the first stage the blastocyst has to break through the epithelial lining of the uterus in order to implant, damage the endometrial tissue to invade; followed by the trophoblast replacement of the endothelium and vascular smooth muscle of the maternal blood vessels in order to secure an adequate placental-metal blood supply.
all these activities create a battleground of invading cells, dying cells and repairing cells.
an inflammatory environment is required in order to secure the adequate repair of the uterine epithelium and the removal of cellular debris.
what is the second immunological phase of pregnancy?
an anti-inflammatory state.
it is in many ways the optimal time for mother - period rapid fatal growth and development.
the woman no longer suffers from nausea and fever
what is the final immunological state of pregnancy?
renewed inflammation
the foetus has completed its development - all organs are functional and ready to deal with the external world. - now the mother needs to deliver the baby - achieved by the renewed inflammation
