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Die Physiologie des Implantationsprozesses

The physiology of the implantation process

  • Leitthema
  • Published:
Gynäkologische Endokrinologie Aims and scope

Zusammenfassung

Die Implantation der Blastozyste ist ein komplexer Prozess, auf den der Embryo und das Endometrium zum korrekten Zeitpunkt vorbereitet sein müssen. Die Implantation des menschlichen Embryos lässt sich aus ethischen Gründen in vivo kaum untersuchen. Erkenntnisse aus Tiermodellen sind aufgrund deutlicher speziesbezogener Unterschiede nur sehr eingeschränkt übertragbar. Aus diesen Gründen werden zunehmend 3‑dimensionale Modelle entwickelt, in denen Trophoblastsphäroide oder embryoide Strukturen mit einer deziduaähnlichen Matrix konfrontiert werden. Im vorliegenden Beitrag werden die aktuell bekannten Faktoren und Interaktionen mit Bedeutung für die Implantation zusammengefasst, sowohl auf zellulärer als auch auf molekularer Ebene. Zunächst werden vorbereitende Prozesse im Menstruationszyklus beschrieben. Daran schließt sich eine Beschreibung relevanter Komponenten des Immunsystems an, wobei ausführlich auf die Eigenschaften und Funktionen uteriner natürlicher Killerzellen eingegangen wird. Im Weiteren wird die Rolle verschiedener molekularer Faktoren in der Implantation diskutiert (Zytokine, Wachstumsfaktoren, Zelladhäsionsmoleküle, Hormone). Perspektivisch ist damit zu rechnen, dass Studien an den oben erwähnten 3‑dimensionalen Modellen trotz aller Limitationen neue Erkenntnisse zur Embryoimplantation beim Menschen liefern werden. Dies könnte sich letztlich positiv auf die reproduktionsmedizinische Praxis auswirken.

Abstract

The implantation of the blastocyst is a complex process for which the embryo and the endometrium must be prepared at the correct point in time. For ethical reasons it is nearly impossible to investigate the implantation of human embryos in vivo. Due to clear species-related differences the transfer of knowledge from animal models is very limited. For these reasons 3‑dimensional models are increasingly being developed in which spheroid trophoblast or embryoid structures are confronted with a decidua-like matrix. This article summarizes the currently known factors and interactions, which are important for implantation at both the cellular and also the molecular levels. At first the preparatory processes in the menstrual cycle are described. This is followed by a description of relevant components of the immune system, whereby the properties and functions of uterine natural killer cells are dealt with in detail. Furthermore, the role of various molecular factors in the implantation is discussed (cytokines, growth factors, cell adhesion molecules, hormones). In perspective, it is to be expected that despite all the limitations studies on the abovementioned 3‑dimensional models will provide new knowledge on human embryo implantation. This could ultimately have a positive effect on the practice of reproductive medicine.

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Förderung

Das Placenta-Labor koordiniert das vom Bundesministerium für Bildung und Forschung (BMBF) geförderte Center for Early Pregnancy and Reproductive Health (CEPRE). U.R. Markert wird von der Deutschen Forschungsgemeinschaft gefördert (Projektnummer: 537607142).

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Authors and Affiliations

  1. Klinik für Geburtsmedizin, Placenta-Labor, Forschungszentrum Lobeda, Universitätsklinikum Jena, Am Klinikum 1, 07747, Jena, Deutschland

    Maria T. Huber &  Udo R. Markert

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  1. Maria T. Huber
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  2. Udo R. Markert
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Correspondence to Udo R. Markert.

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Interessenkonflikt

M.T. Huber und U.R. Markert geben an, dass kein Interessenkonflikt besteht.

Für diesen Beitrag wurden von den Autor/-innen keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

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Georg Griesinger, Lübeck

Wolfgang Küpker, Baden-Baden

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Huber, M.T., Markert, U.R. Die Physiologie des Implantationsprozesses. Gynäkologische Endokrinologie 22, 95–101 (2024). https://doi.org/10.1007/s10304-024-00563-4

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