Endocrine Abstracts (2002) 4 S19

Immunology of implantation and pregnancy

IL Sargent1, GP Sacks2 & CWG Redman1

1Nuffield Department of Obstetrics and Gynaecology, University of Oxford,Oxford, UK; 2Divison of Women's and Children's Health, St George Hospital, Kogarah, Australia.

Recent advances in reproductive immunology have caused a fundamental shift in our appreciation of the nature of human pregnancy. For nearly 50 years, the subject has been dominated by Medawar's 'fetal allograft' hypothesis, in which an analogy is assumed between the fetus and a tissue transplant. In this framework, all maternal immune mechanisms are considered potentially harmful for the fetus and, therefore, must be overcome, bypassed or suppressed. Much progress has been made in elucidating the ways in which the implanting embryo evades specific immunological attack. However, it has also become clear that fetal-maternal interaction is much more complex. In particular, a hitherto relatively neglected area of interest is the non-specific, or innate, arm of the maternal immune system. An understanding of these widespread changes in the maternal immune system is relevant to many disorders of pregnancy

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