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normal & abnormal foetal development > Maternal Immune System in Pregnancy Success and Placental Development > Flashcards

Maternal Immune System in Pregnancy Success and Placental Development Flashcards

1
Q

what is the immune paradox of pregnancy

A
  • foetus and placenta contains 50% of father’s genes
  • so developing foetus and placenta are foreign to female body
  • but maternal immune system does not reject foetus and placenta
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2
Q

what does immune system use to recognise self from non-self

A

major histocompatibility complex (MHC)

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3
Q

what is MHC

A

a set of cell surface proteins that help to recognise foreign molecules

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4
Q

in pregnancy, what from the father is recognised by maternal immune system as foreign

A

MHC from father

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5
Q

is the uterus an immune privileged site

A

no

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6
Q

is the conceptus immunologically invisible

A

no

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7
Q

what molecules can mothers immune system recognise as being foreign

A

MHC molecules

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8
Q

are MHC molecules expressed by conceptus

A

yes but attenuated

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9
Q

is maternal immune response compromised

A

no

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10
Q

maternal immunity recognises (?) but does not (?)

A
  • recognises foetus is there
  • does not reject
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11
Q

what does the maternal immune system recognise

A
  • recognises paternal and foetal antigens
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12
Q

what does maternal immune system respond with

A

tolerogenic immune response

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13
Q

what is immune systems job other than discriminating self from non self

A

discriminating dangerous from benign

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14
Q

which immune responses (out of 2) are important for responding well in terms of pregnancy success

A

adaptive and innate immune response

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15
Q

name a subtype of cells in adaptive immune system

A

T lymphocytes

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16
Q

what can T lymphocytes do depending on how they’re programmed

A

elicit either tolerance or rejection

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17
Q

what do T helper 1 (Th1) elicit

A

rejection

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18
Q

what do Th17 illicit

A

rejection

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19
Q

what do Th2 elicit

A

either rejection or tolerance

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20
Q

what do regulatory T cells (Treg) elicit

A

tolerance

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21
Q

which T lymphocyte plays a crucial role in immune system function in pregnancy

A

Treg

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22
Q

how do Treg cells work

A
  • regulate the immune system (including other than T lymphocytes)
  • aka police officers of immune system
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23
Q

what do Treg cells act to promote

A

anti-inflammatory and tolerogenic phenotype

24
Q

which T lymphocytes can Treg cells regulate

A

Th1, Th17

25
Q

if we can get an appropriate response with these tolerogenic Th2 and Treg cells, they are able to do what

A

constrain / block pro-rejection response from Th1 and Th17 cells

26
Q

if we don’t get right response - due to not having right amount of Treg cells OR if their function impaired - it can impact what

A

capacity to control the immune response

27
Q

if the capacity to control the immune response is impacted, not having an appropriate response can mean the difference between

A
  • tolerance and therefore birth of a healthy baby
  • or infertility or pregnancy complications (eg/ preterm birth, preeclampsia)
28
Q

what does tolerance lead to in pregnancy regarding the foetus

A

birth of a healthy foetus

29
Q

there is an expansion of Treg cells when?

A

early pregnancy in 1st and 2nd trimester

30
Q

in cases of recurrent miscarriage, Treg cells are…

A

reduced

31
Q

are Treg cells disrupted in pregnancy complications in women

A

yes

32
Q

in preeclampsia, Treg cells are….

A

decreased

33
Q

in pre-eclampsia what cells in immune system are increased

A

Th1 and Th17

34
Q

what 2 factors are critical for Treg cells to determine whether going to have tolerogenic immune response & healthy pregnancy OR pro-rejection response & no pregnancy / pregnancy complications

A
  • number of Treg cells
  • function of Treg cells
35
Q

when is maternal immune system first exposed to foreign paternal antigen (& responds)

A

ejaculation - seminal fluid at coitus

36
Q

what is the maternal immune response to first exposure of foreign paternal antigen

A
  • exposure to seminal fluid at coitus
  • activates an inflammatory cascade that results in education and expansion of Treg cells
37
Q

education and expansion of Treg cells is important for pregnancy why (2)

A
  • Treg cells important in tolerance to pregnancy
  • they have a role in placenta development and maternal vascular adaptations
38
Q

limited duration of cohabitation (lack of prior partner semen exposure - usually thru natural coitus) is linked with increased risk of (2)?

A
  • preeclampsia
  • low birth weight
38
Q

exposure to a conceiving partner’s semen is linked with healthy pregnancy in women because?

A

it helps to expand that population of Treg cells in a partner (woman’s Treg cells immunologically responding to foreign antigens in semen)

39
Q

coitus prior to IVF embryo transfer improves what (2) and why

A
  • improves implantation
  • improves live birth rates
  • since exposure to conceiving partner’s semen is linked with healthy pregnancy
40
Q

based on exposure to conceiving partner’s semen, what would cause risk of pregnancy complications

A
  • limited duration of cohabitation (implies through natural coitus)
  • IVF embryo transfer
  • use of donor sperm or oocytes
41
Q

remodeling of _____ arteries are an important facet of placental development

A

spinal

42
Q

how do spinal arteries change in pregnant vs non-pregnant women

A

non-pregnant: tightly coiled vessels
pregnant: spinal arteries converted to wide bore conduits

43
Q

how does conversion of spinal arteries to wide bore conduits in pregnant women occur (2steps)

A
  • invasion of extra villous trophoblast from developing placenta
  • in coordination with maternal immune cells including uterine natural killer cells
    => help to remodel spinal arteries & displace endothelial cells that would normally line the artery and smooth muscle cells
44
Q

endothelial cells and smooth muscle cells get replaced by trophoblast cells so that the vessel is no longer what

A

under maternal vascular control

45
Q

regarding local vascular adaptations, preeclampsia is characterised by what (2)

A
  • incomplete transformation of spinal arteries
  • shallower invasion of extra villus trophoblast
46
Q

in preeclampsia, what does shallower invasion of extra villus trophoblast lead to

A
  • leads to high resistance, high velocity, turbulent flow that can damage delicate villus structures of placenta
47
Q

does deficit in Treg cells affect maternal vascular adaptations to pregnancy and placental development

A

yes

48
Q

what are some exposures to our environment that impact the immune response and can impact receptivity for pregnancy

A

nutrition, obesity, stress, infection, alcohol, environmental toxins

49
Q

why are exposures in the environment also important in men

A
  • health of male affects quality of his semen and seminal fluid
50
Q

how does the health of male contributing to quality of his semen and seminal fluid affect pregnancy likelihood

A

affects semen and seminal fluid ability to prime an appropriate immune response by the maternal immune system

51
Q

pregnancy tolerance requires balance in T cell response, with enough _____ cells w/ the right ____ to block type __ cells

A

Treg
functional capacity
type 1

52
Q

when does immune response to conceptus (embryo) antigens begin

A

conception

53
Q

insufficient Treg cells are associated with which 2 pregnancy complications

A
  • miscarriage
  • preeclampsia
54
Q

immune system promotes ____________ required for _____ development to support optimal ________

A
  • vascular adaptations
  • placental
  • foetal growth

normal & abnormal foetal development (7 decks)

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