Female reproductive immunology

Half the chromosome complement of the foetus is derived from the father and molecules encoded by paternal genes theoretically could be recognised as foreign by the maternal immune system. Importantly, the maternal and foetal immune systems coexist for a period of time and so the potential exists for either to reject the other. However, the mother and foetus appear to have a symbiotic relationship. This mutual state of tolerance is critical for a healthy delivery. Several mechanisms exist that may explain this mutual acceptance. Foetal tissues may lack MHC Class I antigens (trophoblast cells) or express non-classical members of this family (extravillous trophoblast cells), the maternal immune system may be non-specifically suppressed, blocking antibodies may be produced and/or complement regulatory protein expression may be altered.

Decidua vera

Figure 7.1 Structure of the human decidua

The first exposure of the female to paternal antigens (that may be expressed by the foetus) occurs after sexual intercourse. Although sperm bear foreign antigens, they are not recognised by the female's immune system and so are not destroyed. This may be due to non-specific suppressor factors in the semen. Indeed, high molecular weight substances found in seminal plasma have been shown to inhibit antigen-, mitogen- and alloantigen-stimulated lymphopro-liferation. This inhibition may influence subsequent responses after implantation of the foetus.

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