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    Immunology of Pregnancy 
    2013 
     
    Editors; 
    Gérard Chaouat, Olivier Sandra and Nathalie Ledee 
    Since a 
    September, 1992, Nature article which read: “Can there be life without LIF?”, 
    researchers now realize that the maternal immune system is both a foe (it 
    can reject the conceptus) and a friend (immune cells and molecules are also 
    necessary for successful pregnancy). Leukemia Inhibitory Factor (LIF) when 
    absent, prevents embryo implantation in rodents. From fecundation to 
    parturition, immunity acts as a Janus, required but potentially dangerous. 
    However, the complexity and the diversity of immunity in pregnancy deter 
    many from entering the field. This book will try to give a complete overview 
    of immunity from gametes till parturition, in brief, but with complete 
    chapters and subsections, each written by leading specialists in the field. 
    The 
    importance of the topic relies not only on “the riddle of the fetal 
    allograft”, which is per se fascinating, but on its consequences, linked to 
    the development of IVF and in general, Assisted Reproductive Technologies 
    (ART) / Medicine. Since the discovery that there would not be (mammalian) 
    life without LIF, it has become clear that in general, Immune Molecules, and 
    most specifically a transient post mating inflammatory reaction are required 
    for successful implantation. Disruptions of this process can lead to 
    implantation failure / sterility. 
    In later 
    stages of pregnancy immunological cells, mostly of the innate immune system, 
    control formation of local spiral arteries. Finally, a state of tolerance 
    establishes itself, whose “break” leads to immune abortion. Also the 
    vascular bed is further transformed and enlarged, till delivery, and here 
    again “immunological cytokines” do play a major role and can eventually 
    cause immune mediated abortion. 
    Failure of, 
    not just, the cytokine and cell recognition mediated dialogue, but also of 
    the pre and peri-implantation “preparation of the uterus”, as stated, leads 
    to sterility, early pregnancy loss and recurrent abortions. There is also an 
    increasingly stronger series of argument to implicate immunology in pre-eclampsia. 
    Further still, immunology is also implicated in the control of local 
    infection, mother to child transmission of pathogens (notably, but not 
    limited to, HIV). Finally, pregnancy is the only known physiological 
    allorecognition phenomenon where the once named “suppressor T cells,” now 
    re-emerged as “regulatory T cells”, play a cardinal role. 
    This E-book 
    provides a complete compendium of gynecological immunology, spanning from 
    fecundation to delivery. Topics also include the role of various cell types 
    (such as T regs and NK cells) in implantation and uterine changes as well as 
    the genetic regulation of immunological processes. As such it will be of 
    interest not only to mainstream and reproductive immunologists, but more 
    importantly, clinicians in obstetrics and gynecology. 
    Contents 
    1. 
    Innate and Adaptive Immunity in the Human Female Reproductive 
    Tract: 
    Bridging the Menstrual Cycle with Pregnancy 
    Charles 
    R. Wira, Mickey V. Patel, Mimi Ghosh and Zheng Shen, 
    Marta 
    Rodríguez-García 
    2. 
    Immunity and Sperm: Auto- and Iso Immunization  
    Koji 
    Koyama 
    3. 
    Contraceptive Vaccines: Past, Present and Future 
    Satish 
    K. Gupta 
    4. 
    Immune Markers of Oocyte and Embryo Quality  
    Nathalie 
    Lédée 
    5. MHC 
    Antigens Expression/ Function at the Embryonic Interface 
    Part A: 
    Major Histocompatibility Complex Class I Unique Expression in Human 
    Trophoblast: Facts, Questions and Controversies  
    Philippe 
    Le Bouteiller 
    Part B: 
    Expression of MHC-I Proteins by the Placenta of Domestic and Laboratory 
    Animals  
    Heloisa 
    M. Rutigliano, Aaron J. Thomas and Christopher J. Davies 
    6. 
    Immunology of Implantation, Implantation Failure and Pregnancy 
    Part A: 
    Regulators of Early Invasion of Trophoblast Cells  
    Pankash 
    Shuman and Satish K. Gupta 
    Part B: 
    Dendritic Cells: New Insights in Reproduction  
    Sandra 
    M. Blois, Petra C. Arck and Gabriel Barrientos 
    Part C: 
    A Summary of Cytokine Networks and Embryo: A Short Overview  
    Gerard 
    Chaouat 
    Part D: 
    Human Implantation  
    Nathalie 
    Lédée and Mona Rahmati 
    Part E: 
    Interleukin-10: A Vascular and Anti-Inflammatory Cytokine Connecting the 
    Pieces of the Pregnancy Puzzle  
    Satyan 
    Kalkunte, Tania Nevers, Eliana Lippe and Surendra Sharma 
    Part F: 
    Functional Duality of Mouse Uterine Natural Killer Cell 
    in 
    Pregnancy  
    Patricia 
    D.A. Lima, Valdemar A. Paffaro Jr. and Aureo T. Yamada 
    Part G: 
    Human Uterine Natural Killer Cells. Friend or Foes of Pregnancy Outcomes
     
    Eliana M 
    O Lippe, Aureo T Yamada and Surendra Sharma 
    Part H: 
    Factors Elevated during Sexual Intercourse Act to Assist Pregnancy Outcome
     
    Mukesh 
    K. Jaiswal, Timothy M. Millers, Alice Gilman-Sachs and 
    Kenneth 
    D. Beaman 
    Part I: 
    Substances Secreted by the Preimplantation Human Embryo  
    Georgi 
    Georgiev, Jana Pastuschek, Stefan Neubeck and Udo R. Markert 
    Part J: 
    Placental Interferons, Implantation and Pregnancy  
    Fuller 
    W. Bazer 
    Part K: 
    Pathophysiology of the Complement System at Feto-Maternal Interface 
    Roberta 
    Bulla, Chiara Agostinis and Francesco Tedesco 
    Part L: 
    Toll-like Receptors and Nod-Like Receptors in Gestational Tissues 
     
    Vikki M. 
    Abrahams 
    7. 
    Tolerance to the Fetal Allograft 
    Part A: 
    Is the Fetus an Allograft and is it Object of Immunological Tolerance? 
    Gérard 
    Chaouat 
    Part B: 
    Immunoregulation at the Interface by Placental Suppressor Factors 
    Gérard 
    Chaouat 
    Part C: 
    Decidual Transforming Growth Factors and Tolerance Signalling Molecules
     
    David A. 
    Clark and Reginald M. Gorczynski 
    Part D: 
    Role of Regulatory T Cells in Human Reproduction  
    Leonardo 
    Fainboim 
    Part E: 
    the Role of Cytotoxic Natural Killer (NK) Cells and Regulatory NK Cells in 
    Pregnancy 
    Shigeru 
    Saito, Tomoko Shima, Akitoshi Nakashima and Yi Lin 
    Part F: 
    Pathways for Activating Implantation Tolerance in Early Pregnancy 
    Sarah A. 
    Robertson, David J. Sharkey, John E. Schjenken, Alison S. 
    Care and 
    Lachlan M. Moldenhauer 
    8. 
    Immuno Endocrine Interactions: An Example 
    
    Progestagen Treatment for Threatened and Recurrent Abortion; Molecular 
    
    Mechanisms 
    Julia 
    Szekeres-Bartho, Melinda Halasz, Beata Polgar and Agnes 
    Bogdan 
    9. The 
    Maternal Inflammatory Response to Pregnancy  
    Jennifer 
    H. Southcombe and Ian L. Sargent 
    10. Are 
    there Abortions of Immunological Origin? 
    Part A: 
    Animal Models of Spontaneous Immunological 
    
    Abortions  
    Gérard 
    Chaouat 
    Part B: 
    Immunology and Recurrent Pregnancy Loss. Epidemiological Aspects in Humans
     
    Ole B. 
    Christiansen 
    Part C: 
    Immune Treatments Recent Developments 
    Edward 
    E. Winger and Jane L. Reed 
    Part D: 
    Debates on Immunotherapy for Recurrent Pregnancy 
    Failure
     
    David A. 
    Clark   
    Part E: 
    Debates on Immunotherapy for Recurrent Pregnancy 
    Failure
     
    Gérard 
    Chaouat 
    11. 
    Impact of the Immune System on Trophoblast Invasion and 
    
    Uteroplacental Blood Flow  
    Raj 
    Raghupathy 
    12. 
    Epidemiology and Immunology of Preeclampsia 
    Part A: 
    Preeclampsia, Plague of Human Reproduction. The Role of Paternity and 
    Immunological Implications  
    
    Pierre-Yves Robillard and Gustaaf Dekker 
    Part B: 
    Animal Models for a Cure for Preeclampsia  
    
    Guillermina Girardi 
    13. 
    Autoimmunity in Association with Pregnancy  
    Nobert 
    Gleicher 
    14. The 
    Control of HIV-1 In Utero Transmission at the Materno-Foetal Interface by 
    Immunological Determinants  
    Héloïse 
    Quillay, Romain Marlin, Marion Duriez, Marie-Thérèse 
    Nugeyre 
    and Elisabeth Menu 
    Annex 1: 
    Immunology for Assisted Reproductive Medicine 
    
    Practitioners: A Comprehensive Overview 
    Ae-Ra 
    Han, Alice Gilman-Sachs, Joon W. Kim and Joanne Kwak- 
    Kim.Annex 2: 
    Glossary
 Conclusion
 Gérard Chaouat
 
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