Immunobiology of pregnancy: from basic science to translational medicine

Abstract

Embryo implantation failure and spontaneous abortions represent the main causes of infertility in developed countries. Unfortunately, incomplete knowledge of the multiple factors involved in implantation and fetal development keeps the success rate of medically assisted procreation techniques relatively low. According to recent literature, cellular and molecular mechanisms of ‘immunogenic tolerance' towards the embryo are crucial to establish an ‘anti-inflammatory' state permissive of a healthy pregnancy. In this review we dissect the role played by the immune system in the endometrial–embryo crosstalk, with a particular emphasis towards the fork-head-box-p3 (Foxp3⁺) CD4⁺CD25⁺ regulatory T (Treg) cells and discuss the most recent therapeutic advances in the context of early immune-mediated pregnancy loss.