The role of dendritic cells in recurrent pregnancy loss.

IF 3.3 4区医学 Q3 IMMUNOLOGY

Immunologic Research Pub Date : 2025-07-21 DOI:10.1007/s12026-025-09664-z

Xingxing Yuan, Chaofan Li, Liuxin Yang, Xiaoyu Zhang, Xiaoling Feng

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引用次数: 0

Abstract

Recurrent pregnancy loss (RPL), defined as ≥ 2 consecutive losses, remains a significant clinical challenge with complex immunological underpinnings. While immune dysfunction underpins RPL, dendritic cells (DCs) emerge as central regulators of maternal-fetal tolerance. This review comprehensively explores the multifaceted roles of DC subsets at the maternal-fetal interface, including their contribution to immune tolerance, angiogenesis, placental development, and bidirectional interactions with trophoblasts and natural killer (NK) cells. We detail specific DC alterations in RPL, encompassing phenotypic shifts, functional defects, and disrupted DC-NK cell crosstalk, linking these changes to pregnancy loss risk. Emerging evidence highlights therapeutic strategies targeting DCs, such as tolerogenic DC vaccines and interventions modulating trophoblast MHC antigen presentation, alongside established immunomodulation, to restore immune balance. Underlying mechanisms like systemic inflammation impacting endometrial DCs are also discussed. By synthesizing current literature and controversies, this review elucidates the critical, yet complex, role of DC heterogeneity and function in RPL pathogenesis and discusses innovative interventions aimed at improving pregnancy outcomes.

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树突状细胞在复发性妊娠丢失中的作用。

复发性妊娠丢失（RPL），定义为连续2次以上的妊娠丢失，仍然是一个具有复杂免疫学基础的重大临床挑战。虽然免疫功能障碍是RPL的基础，但树突状细胞（dc）作为母胎耐受性的中枢调节因子出现。这篇综述全面探讨了DC亚群在母胎界面的多方面作用，包括它们对免疫耐受、血管生成、胎盘发育以及与滋养层细胞和自然杀伤细胞（NK）的双向相互作用的贡献。我们详细介绍了RPL中特定的DC改变，包括表型改变、功能缺陷和DC- nk细胞串扰中断，并将这些变化与妊娠丢失风险联系起来。新出现的证据强调了针对DC的治疗策略，如耐受性DC疫苗和调节滋养细胞MHC抗原呈递的干预措施，以及已建立的免疫调节，以恢复免疫平衡。潜在的机制，如全身性炎症影响子宫内膜DCs也进行了讨论。通过综合目前的文献和争议，本文阐述了DC异质性和功能在RPL发病机制中的重要而复杂的作用，并讨论了旨在改善妊娠结局的创新干预措施。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Immunologic Research 医学-免疫学

CiteScore

6.90

自引率

0.00%

发文量

审稿时长

6-12 weeks

期刊介绍： IMMUNOLOGIC RESEARCH represents a unique medium for the presentation, interpretation, and clarification of complex scientific data. Information is presented in the form of interpretive synthesis reviews, original research articles, symposia, editorials, and theoretical essays. The scope of coverage extends to cellular immunology, immunogenetics, molecular and structural immunology, immunoregulation and autoimmunity, immunopathology, tumor immunology, host defense and microbial immunity, including viral immunology, immunohematology, mucosal immunity, complement, transplantation immunology, clinical immunology, neuroimmunology, immunoendocrinology, immunotoxicology, translational immunology, and history of immunology.