Cytokines, NK cells and regulatory T cell functions in normal pregnancy and reproductive failures

Am J Reprod Immunol. 2023 Feb;89(2):e13667. doi: 10.1111/aji.13667. Epub 2022 Dec 21.

Abstract

Purpose of the review: Pregnancy brings about an intricate assortment of dynamic changes, which causes proper connection of genetically discordant maternal and foetal tissues. Uterine NK cells are immune cells populating the endometrium and play a major role in implantation and also regulate placentation. This review mainly aims explore the role of uterine NK cells in implantation and how it is affecting in adverse pregnancy outcomes.

Recent findings: Though the functions of uterine NK (uNK) cells are not clearly understood, NK cell activity plays a vital role during immunomodulation which is the main step in implantation and sustaining the early pregnancy. Cytokines, cell surface receptors of NK cells and hormones such as progesterone modulate the NK cell activity in turn affect the implantation of the embryo. Altered NK cell activity (number and functionality) would be an important attributing factor in adverse pregnancy outcomes. Furthermore, T regulatory cells and cytokines also modulate the immune responses in the decidua which in turn contributes to successful implantation of embryos.

Summary: Immunological responses and interactions in the Foetus-maternal interface is crucial in the successful implantation of allogenic foetus resulting in a healthy pregnancy. NK cells, Treg cells and cytokines play a major role in successful implantation which remains an enigma. Comprehending pregnancy-induced immunological changes at the foetus-maternal interface will allow newer therapeutic strategies to improve pregnancy outcomes.

Keywords: decidua; implantation; recurrent miscarriages; uterine natural killer cells.

Publication types

  • Review

MeSH terms

  • Cytokines* / metabolism
  • Embryo Implantation
  • Female
  • Humans
  • Killer Cells, Natural
  • Pregnancy
  • T-Lymphocytes, Regulatory* / metabolism
  • Uterus

Substances

  • Cytokines