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Normal Immune Function: Journey of the Fetus

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Recurrent Pregnancy Loss

Abstract

During pregnancy, maternal immune system has to be modulated without suppression, so as to avoid rejection of the semi-allogenic fetus but at the same time permitting placental invasion and also preserving maternal defense against infections. The immune processes occurring at maternal fetal interface are highly dynamic with both maternal and fetal contributions. Development of maternal tolerance depends on unique embryo-derived signaling between the embryo and mother, and this signaling must take place prior to implantation and prior to the activation of embryo genome. Various factors affecting maternal tolerance include selective HLA-G expression in trophoblast cells, preimplantation factor, progesterone, altered Th1-Th2 ratio with Th2 dominance, synthesis of immunosuppressive molecules, regulatory T cells, complement system, uterine natural killer cells, phosphocholination, programmed death ligand 1, tryptophan catabolism mediated by indoleamine 2,3-dioxygenase, corticotropin-releasing hormone, and regulation of FasL expression. However, association of recurrent pregnancy loss with these factors has been inconsistent and non-reproducible.

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Author information

Authors and Affiliations

  1. Department of Obstetrics and Gynaecology, AIIMS, New Delhi, India

    Vidushi Kulshrestha

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  1. Vidushi Kulshrestha
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Correspondence to Vidushi Kulshrestha .

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Editors and Affiliations

  1. Department of Obstetrics & Gynecology, Babu Jagjivan Ram Memorial Hospital, New Delhi, India

    Sumita Mehta

  2. Department of Obstetrics and Gynecology, UCMS & GTB Hospital, New Delhi, India

    Bindiya Gupta

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Kulshrestha, V. (2018). Normal Immune Function: Journey of the Fetus. In: Mehta, S., Gupta, B. (eds) Recurrent Pregnancy Loss. Springer, Singapore. https://doi.org/10.1007/978-981-10-7338-0_3

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  • DOI: https://doi.org/10.1007/978-981-10-7338-0_3

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  • Publisher Name: Springer, Singapore

  • Print ISBN: 978-981-10-7337-3

  • Online ISBN: 978-981-10-7338-0

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