An immune dependency of trophoblastic growth implied by the antithetic difference in immunology between spontaneous abortion and hydatidiform mole.

It may be difficult to demonstrate clearly an immune dependency of trophoblast growth in vivo. The author's standpoint, however, is that comparative study of the immunology of SpA and HM must attempt to demonstrate it. In this chapter, before entering the main topics, the genesis of HM in relation to early SpA, the dependency of trophoblastic cell growth on the presence of an embryo or fetus, as evidenced by animal experiments, and the pathology and cytogenetics of SpA were outlined in a summarized form. This summary was provided to stress that the comparative immunologic study of SpA and HM may be a very useful experimental model in the elucidation of an immune dependency of trophoblastic cell growth in vivo. Many immunologically antithetic differences between SpA and HM were found and the important role that BA plays in trophoblastic cell growth was strongly suggested by the considerations of immune injury to the trophoblast in SpA and of the immune survival of the trophoblast in HM. Thus, we have come to believe that our clinical and experimental model described here might illustrate a new aspect of reproductive immunology, while contributing to the elucidation of SpA and HM genesis. Further studies along these lines may be useful and, needless to say, should be performed.