Immunological analogy between allograft rejection, recurrent abortion and pre-eclampsia - the same basic mechanism?

Hum Immunol. 2006 Jul;67(7):492-511. doi: 10.1016/j.humimm.2006.04.007. Epub 2006 May 4.

Abstract

There are still controversies concerning the role of immunological mechanisms engaged both in recurrent abortions (RA) and pre-eclampsia (PE). According to some opinions, recurrent miscarriage is comparable to organ-specific autoimmune disease. Analysis of immune reactions shows that graft rejection shares many similar mechanisms with RA and PE. This fact allows us to conclude that rejection of transplanted alloantigenic organs and pregnancy loss have probably the same evolutionary origin. Subsets and functions of immunocompetent cells (T CD4, suppressor gammadeltaT, cytotoxic T CD8, Treg, Tr1, uterine NK cells), over-activation of innate immunity (activation of NK cytotoxic cells, macrophages, neutrophils and complement), changes of Th1/Th2 cytokine balance (IL-2, IL-12, IL-15, IL-18, IFNgamma, TNFalpha vs. IL-4, IL-10, TGFbeta), importance of HLA-G molecule, CD200/CD200R interaction, over-expression of adhesion molecules, fgl2 prothrombinase activation and stimulation of IDO and HO expression, all suggest that RA and PE are syndromes of fetal allograft rejection, and not organ-specific autoimmune diseases. According to that supposition, an analogy might exist between acute graft rejection and recurrent abortion, and between chronic graft rejection and pre-eclampsia.

Publication types

  • Review

MeSH terms

  • Abortion, Habitual / enzymology
  • Abortion, Habitual / immunology*
  • Animals
  • Cytokines / metabolism
  • Female
  • Graft Rejection / enzymology
  • Graft Rejection / immunology*
  • HLA Antigens / immunology
  • HLA Antigens / metabolism
  • HLA-G Antigens
  • Heme Oxygenase-1 / metabolism
  • Histocompatibility Antigens Class I / immunology
  • Histocompatibility Antigens Class I / metabolism
  • Humans
  • Indoleamine-Pyrrole 2,3,-Dioxygenase / metabolism
  • Killer Cells, Natural / enzymology
  • Killer Cells, Natural / immunology
  • Models, Animal
  • Pre-Eclampsia / enzymology
  • Pre-Eclampsia / immunology*
  • Pregnancy
  • Th1 Cells / enzymology
  • Th1 Cells / immunology
  • Th2 Cells / enzymology
  • Th2 Cells / immunology

Substances

  • Cytokines
  • HLA Antigens
  • HLA-G Antigens
  • Histocompatibility Antigens Class I
  • Indoleamine-Pyrrole 2,3,-Dioxygenase
  • Heme Oxygenase-1