Immunological mechanisms and immunotherapeutic strategies for the maternal-fetal interface diseases during pregnancy.

The immune environment at the maternal-fetal interface is reliant on the precise regulation of various immune cells and their secreted cytokines, resulting in a coordinated balance of immune nutrition, immune defense, and immune tolerance to meet the needs of different stages of pregnancy. Disruption in the immunological microenvironment can lead to several pregnancy problems. In recent years, immunotherapy medications have made substantial advances in the treatment of maternal-fetal interface diseases during pregnancy. This paper provides a cellular and molecular review of the immunological mechanisms behind various common maternal-fetal interface diseases (preterm birth, recurring spontaneous abortion, preeclampsia, and fetal growth restriction). It offers a novel analysis of the mechanisms of action, application strategies, current research status, and future challenges for distinct immunotherapeutic agents from three separate perspectives: targeting different phases of inflammatory pathways, targeting particular immune cells at the maternal-fetal interface, and targeting specific autoantibodies associated with autoimmunity. The aim is to provide new insights for medication discovery, as well as precision diagnosis and treatment of pregnancy-related illnesses. These advancements will provide vital evidence for precision treatment of maternal-fetal interface diseases throughout pregnancy.