Zusammenfassung
Bei der Implantation wandern, immunlogisch betrachtet, semi-allogene kindliche Trophoblastzellen der Plazenta tief ins mütterliche Gewebe des Uterus ein. Der Umstand, dass dieser Invasionsprozess nicht zu einer Abstoßung durch das mütterliche Immunsystem führt, wurde als immunologisches Paradaxon bezeichnet. Neben diversen anderen Mechanismen, die für diese Immuntoleranz der Mutter gegenüber dem Fetus von Bedeutung sind, scheint auch das besondere HLA Expressionsmuster der Plazenta eine wichtige Rolle zu spielen. Die besondere HLA Ausstattung der unterschiedlichen Trophoblastzellen erklärt, neben diversen zusätzlichen Besonderheiten der utero-plazentaren Wechselwirkung, warum ein direkter Vergleich der Einnistung mit der Situation bei der Organtransplantation eigentlich nicht zulässig ist. Die Schwangerschaft ist daher weniger als immunologisches Paradoxon, sondern vielmehr als besondere Herausforderung für das mütterliche Abwehrsystem zu betrachten.
Summary
Placental trophoblast cells of the semi-allogenic human conceptus invade deeply into maternal uterine tissue. From a classical immunoiogic point of view this invasion and the following growth and development of the fetus in the uterus have to be tolerated by a pregnant woman's immune system. Among the various possible protective mechanisms that may be involved, the unique expression pattern of HLA class I molecules seems to be relevant. Besides many other differences between placentation and organ transplantation, this extraordinary HLA class I expression on trophoblast explains why pregnancy should not be considered an immunologic paradox but rather a fascinating example of a very special challenge for the female immune system.
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Juch, H., Blaschitz, A., Dohr, G. et al. HLA class I expression in the human placenta. Wien Med Wochenschr 162, 196–200 (2012). https://doi.org/10.1007/s10354-012-0070-7
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DOI: https://doi.org/10.1007/s10354-012-0070-7