Inflammation and miscarriage.

Full Abstract

Most relevant studies in animals and humans indicate that some degree of systemic or uterine inflammation is necessary both for normal implantation and pregnancy. However, if inflammation becomes too excessive it might cause pregnancy complications such as fetal resorption/miscarriage. The main regulator of the correct level of inflammation at the feto-maternal interface seems to be the uterine CD16(-) CD56(bright) natural killer (NK) cells. Trophoblast debris, apoptotic cells and progesterone probably stimulate/regulate the production of inflammatory cytokines from these cells. Miscarriage of karyotypically normal embryos may occur when the level of inflammation at the feto-maternal interface falls outside the optimal range. This may be caused by an insufficient influx of CD56(bright) NK cells into the decidua, too little soluble histocompatibility leukocyte antigen (HLA)-G secretion from the trophoblast, hypersecretion of inflammatory cytokines due to the presence of high-production polymorphisms, presence of maternal HLA-DR alleles associated with high tumor necrosis factor (TNF)-alpha production, or maternal mannose-binding lectin deficiency.

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Author information

Author/s: Christiansen, Ole B (OB); Nielsen, Henriette S (HS); Kolte, Astrid M (AM);

Affiliation: Fertility Clinic 4071, Rigshospitalet, Blegdamsvej 9, DK-2100 Copenhagen, Denmark. obc(-atsign-)pregnancyloss.dk

Journal and publication information

Publication Type: Journal Article; Review

Journal: Seminars in fetal & neonatal medicine (Semin Fetal Neonatal Med), published in Netherlands. (Language: eng)

Reference: 2006-Oct; vol 11 (issue 5) : pp 302-8

Dates: Created 2006/07/18; Completed 2007/02/27;

PMID: 16682265, status: MEDLINE (last retrieval date: 12/26/2008)

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MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Abortion, Habitual - etiology; immunology; prevention & control
Abortion, Spontaneous - etiology; immunology; prevention & control
Animals
Anti-Inflammatory Agents - therapeutic use
Antigens, CD56 - physiology
Cytokines - physiology
Female
HLA Antigens - metabolism

HLA Antigens - metabolism
Histocompatibility Antigens Class I - metabolism
Humans
Inflammation - complications; therapy
Killer Cells, Natural - physiology
Mannose-Binding Lectin - physiology
Pregnancy
Pregnancy Complications - etiology; immunology; prevention & control

Associated Chemicals: Anti-Inflammatory Agents (0) ; Antigens, CD56 (0) ; Cytokines (0) ; HLA Antigens (0) ; HLA-G antigen (0) ; Histocompatibility Antigens Class I (0) ; Mannose-Binding Lectin (0)

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