Journal of perinatal medicine · 2025
Immunoediting in pregnancy: a new paradigm for understanding fetal tolerance and obstetric disease.
СтатьяОбзорНазвание и аннотация: Перевод в очереди
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Bachnas Muhammad Adrianes, Andonotopo Wiku, Dewantiningrum Julian, Pramono Mochammad Besari Adi, Akbar Muhammad Ilham Aldika, Darmawan Ernawati, Aldiansyah Dudy, Hariyasa Sanjaya I Nyoman, Sulistyowati Sri, Stanojevic Milan, Kurjak Asim
Аннотация
INTRODUCTION: Pregnancy poses an immunological paradox: the maternal immune system must tolerate a semi-allogeneic fetus while maintaining defense against infections. Rather than being an immunosuppressed state, gestation is now recognized as a dynamic, highly regulated immune condition.
CONTENT: This review applies the cancer-derived immunoediting framework - elimination, equilibrium, and escape - to maternal-fetal immune tolerance. We examine how immune checkpoints, regulatory T cells, non-classical MHC molecules, and placental exosomes coordinate to create a localized tolerant environment. Integrating knowledge from oncology and reproductive immunology, this perspective provides a unifying concept for pregnancy immune regulation.
SUMMARY: The immunoediting framework reinterprets obstetric disorders such as preeclampsia, recurrent pregnancy loss, and preterm birth as failures of distinct immune phases rather than isolated pathologies. This conceptual shift allows for a broader understanding of how immune balance influences implantation, placental development, and fetal growth.
OUTLOOK: Adopting an immunoediting perspective highlights potential clinical advances, including immune checkpoint modulation, regulatory T-cell therapies, and exosome-based biomarkers, paving the way for innovative diagnostic and therapeutic strategies in pregnancy care.
CONTENT: This review applies the cancer-derived immunoediting framework - elimination, equilibrium, and escape - to maternal-fetal immune tolerance. We examine how immune checkpoints, regulatory T cells, non-classical MHC molecules, and placental exosomes coordinate to create a localized tolerant environment. Integrating knowledge from oncology and reproductive immunology, this perspective provides a unifying concept for pregnancy immune regulation.
SUMMARY: The immunoediting framework reinterprets obstetric disorders such as preeclampsia, recurrent pregnancy loss, and preterm birth as failures of distinct immune phases rather than isolated pathologies. This conceptual shift allows for a broader understanding of how immune balance influences implantation, placental development, and fetal growth.
OUTLOOK: Adopting an immunoediting perspective highlights potential clinical advances, including immune checkpoint modulation, regulatory T-cell therapies, and exosome-based biomarkers, paving the way for innovative diagnostic and therapeutic strategies in pregnancy care.