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Regular Article |
a Institut für Immunologie und Transfusionsmedizin, Universität zu Lübeck, 23538 Lübeck, Germany
b Lehrstuhl für Experimentelle Medizin I, Universität Erlangen-Nürnberg, 91054 Erlangen, Germany
c Laboratory of Immunology and Vascular Biology, Department of Pathology, Stanford University School of Medicine, Stanford, California 94305
One of the most fascinating immunologic questions is how the genetically distinct fetus is able to survive and develop within the mother without provoking an immune rejection response. The pregnant uterus undergoes rapid morphological and functional changes, and these changes may influence the nature of local immune responses at the maternal/fetal interface at different stages of gestation. We hypothesized that specialized mechanisms exist to control access of maternal leukocyte subsets to the decidua and that these mechanisms are modulated during the course of pregnancy. At the critical period of initial placenta development, the maternal/fetal interface displays an unparalleled compartmentalization of microenvironmental domains associated with highly differentiated vessels expressing vascular addressins in nonoverlapping patterns and with recruitment of specialized leukocyte subsets (monocytes, granulated metrial gland cells, and granulocytes) thought to support, modulate, and regulate trophoblast invasion. One of the most striking observations at this time of gestation is the almost complete exclusion of lymphocytes from the maternal/fetal interface. The second half of pregnancy is characterized by a partial loss of microenvironmental specialization and different switches in vascular specificity within the decidua basalis, paralleling dramatic changes in the populations of recruited leukocytes (e.g., a striking influx of lymphocytes, especially T cells). In the term pregnant uterus, the expression of all vascular addressins decreased dramatically; only weakly staining maternal vascular segments remained. These segments may define sites of extremely low residual traffic in the term decidua, which contains remarkably few maternal leukocytes overall. Our results suggest that the maternal/fetal interface represents a situation in which leukocyte trafficking is exquisitely regulated to allow entry of specialized leukocyte subsets that may play a fundamental role in immune regulation during pregnancy.
1 This work was supported in part by NIH grants GM37734 and AI37832, by the FACS Core and the Molecular Biology and Cell Imaging Core Facilities of the Stanford Digestive Disease Center under grant DK38707, and by an award from the Department of Veterans Affairs. A.K. was a recipient of a fellowship from the Deutsche Forschungsgemeinschaft.
2 Correspondence: Andrea Kruse, Institute of Immunology and Transfusion Medicine, School of Medicine, University of Lübeck, Ratzeburger Allee 160, 23538 Lübeck, Germany. FAX: 49 451 5003069; kruse{at}immu.mu-luebeck.de
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