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正常妊娠是一个复杂的生理过程.胎儿虽携有遗传自父系的HLA抗原,但却并未引发母体产生针对胎儿这种特殊半同种“天然移植物”的排斥.妊娠期母-胎间必然存在着复杂的分子对话机制,以维持胎儿胎盘正常发育.母-胎交互对话异常,将引起母体对胚胎的免疫排斥(母-胎免疫调节紊乱),导致妊娠失败或妊娠并发症如自然流产、子痫前期等.母—胎对话的关键是母-胎免疫适应,而母—胎免疫适应的本质在于母体免疫系统对胚胎抗原的免疫耐受,其核心部位在母—胎界面;妊娠早期蜕膜局部出现免疫细胞亚群的富集和重分布,母体免疫系统不仅不排斥携有父系抗原的胚胎,反而形成母—胎免疫耐受,至今免疫生物学仍无法解释母—胎免疫相容的生理性机制.本文在总结既往研究成果的基础上,围绕母-胎界面关键的功能细胞,阐明基于母-胎交互对话的母-胎免疫耐受的建立和维持机制.
Normal pregnancy is a complex physiological process, although the fetus carries an HLA antigen inherited from the paternal line, but does not cause the mother to produce rejection of the fetus, a special semi-homogeneous “natural graft.” There must be a complex mechanism of molecular dialogue in order to maintain the normal development of fetal placenta. Abnormal mother-child interaction dialogue, will lead to maternal immune rejection of the embryo (maternal-fetal immunomodulatory disorders), resulting in pregnancy failure or pregnancy complications such as natural Miscarriage, preeclampsia, etc. The key to mother-fetus conversation is maternal-fetal immune adaptation, while the essence of maternal-fetal immune adaptation lies in the immune tolerance of the maternal immune system to embryonic antigens with the core part in the maternal-fetal interface; pregnancy Early deciduals appear immune cell subsets enrichment and redistribution, the maternal immune system not only does not exclude embryos with paternal antigens, but the formation of mother-fetus immune tolerance, immune biology so far still can not explain the mother-fetus immune phase Physiological mechanism of tolerance.This paper, based on the summary of past research results, around the mother-fetus-based interface of the key functional cells to clarify the mother-child interactive dialogue based on the establishment of the mother-child immune tolerance and Holding mechanism.