Journal of International Reproductive Health/Family Planning ›› 2022, Vol. 41 ›› Issue (3): 219-224.doi: 10.12280/gjszjk.20210615

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The Role of Decidual Natural Killer Cells in Recurrent Pregnancy Loss and Related Treatment

WANG Lu, LI Yang, DU Bo-tao()   

  1. Reproductive Center, The Second Affiliated Hospital of Harbin Medical University, Harbin 150086, China
  • Received:2021-12-22 Published:2022-05-15 Online:2022-05-30
  • Contact: DU Bo-tao E-mail:botaodu34@sina.com

Abstract:

The incidence of recurrent pregnancy loss (RPL) is about 1%-5%. The immune microenvironment at the maternal-fetal interface has a vital impact on the pregnancy outcomes. Decidual natural killer (dNK) cells, as important immune cells at the maternal-fetal interface, can produce a variety of cytokines, regulate trophoblast cells invasion, promote uterine spiral arteries remodeling, and participate in the establishment of immune tolerance at the maternal-fetal interface in early pregnancy, so as to maintain pregnancy. However, the dNK cells are highly activated in RPL patients. The increased activity and changed function of dNK cells may affect the immune environment of pregnancy, thereby leading to pregnancy failure. At present, the therapeutic regimens that affects the microenvironment of the maternal-fetal interface by improving the activity and function of dNK cells, including intravenous immunoglobulin G and lipid emulsion, granulocyte colony-stimulating factor, glucocorticoid, mesenchymal stem cells, sildenafil citrate and Sirolimus have become new research directions in the treatment of RPL.

Key words: Embryo Loss, Autoimmunity, Decidua, Killer cells,natural, Immune tolerance, Immunotherapy