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母-胎免疫耐受作为免疫学原理的唯一例外,一直是生殖免疫学界备受关注的焦点问题。一个世纪以来,人们对于母-胎免疫耐受建立和维持的机制有了越来越深入的认识。妊娠早期胎儿绒毛外滋养细胞(EVT)侵入蜕膜组织,与母体蜕膜免疫细胞(DIC)及蜕膜基质细胞(DSC)直接接触,建立精细的母-胎交互对话。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,基于母-胎交互对话阐明母-胎免疫耐受的建立和维持机制。其中,对以滋养细胞为中心的母-胎界面固有免疫应答、母-胎界面适应性免疫应答及穿插于其中的协同刺激信号和趋化因子等方面进行概述,以解析人早孕母-胎免疫耐受与胎盘形成机制,为反复自然流产、子痫前期、胎儿宫内生长受限等疾患的防治提供新的思路。还将为移植免疫学、肿瘤免疫学的研究提供借鉴,因此,具有重要的理论意义和实际应用价值。
As the only exception to the immunological principle, mother-fetal immune tolerance has been the focus of much attention in the field of reproductive immunology. For more than a century, people have become more and more aware of the mechanism for the establishment and maintenance of maternal-fetal immune tolerance. In early gestation, fetal extravillous trophoblast cells (EVT) invade the decidua and directly contact with decidual immune cells (DIC) and decidual stromal cells (DSC) to establish a fine mother-to-child interaction. On the basis of summarizing the previous research findings, the establishment and maintenance mechanism of maternal-fetal immune tolerance was elucidated on the basis of maternal-fetal interaction based on the functional cells critical to the maternal-fetal interface. Among them, the trophoblast-centered immune response at the maternal-fetal interface, maternal-fetal interface adaptive immune response and interspersed among the co-stimulatory signals and chemokines and other aspects are summarized to analyze the human early pregnancy maternal-fetal immunity Tolerance and placenta formation mechanism for the prevention and treatment of recurrent spontaneous abortion, preeclampsia, fetal growth restriction and other diseases provide new ideas. It will also provide reference for the study of transplantation immunology and tumor immunology. Therefore, it has important theoretical significance and practical value.