Aspects of Immunological Control, Novel Concepts, Challenges, and Clinical Perspectives
The physiological task of innate immunity seems to be substantially involved in diverse events of the ovary. Follicular atresia and the ovulatory process with rupture and tissue healing depend on pro- and anti-inflammatory actions finally initiated by oxidative stress. The changing structures require a great plasticity of the interstitial cortical stroma and a permanent tissue turnover without an inflammatory reaction, thus without a danger signal. The same holds true for rapid bulk tissue removal through herniation of cortical and luteal tissue into microvessels. The focus is on microvascular cytokeratin-positive cells, which are part of a luteovascular unit and seen as the first to sense danger at the onset of luteolysis. Future efforts to understand ways of immunoregulation in each of the ovarian events will provide far-reaching clinical perspectives on novel treatments of ovarian failures.