Flashcards in immunology of pregnancy Deck (20)
what challenges does the female reproductive tract face when it come to the immune system?
implantation and pregnancy
defence against microorganism
what part of the FRT is colonised and which part is non colonised?
upper = non colonised
lower = colonised by bacteria
5 cardinal signs of inflammation
loss of function
during pregnancy, the human decidua contains a high number of immune cells...
regulatory T cells
during the first trimester what cells infiltrate the decidua and accumulate around the invading trophoblast cells?
what happens if there is no immune cells during pregnancy?
what happens if there is an absence of NK cells?
trophoblast cells are not able to reach the endometrial vascularity leading to termination of pregnancy.
(NK cells are critical for trophoblast invasion)
what is the decidua?
a thick layer of modified mucous membrane which lines the uterus during pregnancy
what have studies suggested that dendritic cells are necessary for?
why are there immune cells at the implantation site?
to facilitate and protect the pregnancy
the immune system the implantation site is active, functional and carefully controlled.
what are the three stages of trophoblast-immune interaction?
1) attraction - trophoblast cells secrete chemokine that recruit immune cells to the implantation site.
2)education - trophoblast cells produce regulatory cytokines that modulate the differentiation process of immune cells
3) response) immune cells educated b trophoblast cells respond to signals of the local microenvironment in an unique way.
which parts of pregnancy resemble an open wound?
implantation, placentation, the first and early second trimester.
(they require a strong inflammatory response)
why is the first trimester a proinflammatory phase?
because during the first stage the blastocyst has to break through the epithelial lining of the uterus in order to implant, damage the endometrial tissue to invade; followed by the trophoblast replacement of the endothelium and vascular smooth muscle of the maternal blood vessels in order to secure an adequate placental-metal blood supply.
all these activities create a battleground of invading cells, dying cells and repairing cells.
an inflammatory environment is required in order to secure the adequate repair of the uterine epithelium and the removal of cellular debris.
what is the second immunological phase of pregnancy?
an anti-inflammatory state.
it is in many ways the optimal time for mother - period rapid fatal growth and development.
the woman no longer suffers from nausea and fever
what is the final immunological state of pregnancy?
the foetus has completed its development - all organs are functional and ready to deal with the external world. - now the mother needs to deliver the baby - achieved by the renewed inflammation
how does a pro inflammatory environment help deliver the baby?
the pro inflammatory environment promotes contraction of the uterus and expulsion of the baby and rejection of the placenta.
what is it thought that damaging the endometrium before implantation help success of IVF?
provokes a rapid growth of decimal cells
what are the role of NK in the human decidua?
they have a role in regulating trophoblast invasion.
they are potent secretors of an array of angiogenic factors that induce vascular growth that is essential for the establishment of an adequate decidua.
what is the role of dendritic cells in the female reproductive tract?
they initiate and coordinate the innate adaptive immune response.