The importance of the topic reliesnot only on 'the riddle of the fetal allograft'which is per se fascinatingbut on its consequenceslinked to the development ofIVF and in generalAssisted Reproductive Technologies (ART) / Medicine. Since the discovery that there would not be (mammalian) life without LIFit has become clear that Immune Moleculesand in generaltransient post mating inflammatory reactions are required for successful implantation. Disruptions of this process can lead to implantation failure / sterility.
In later stages of pregnancy immunological cellsmostly of the innate immune systemcontrol formation of local spiral arteries. Finallya state of tolerance establishes itselfwhose 'break' leads to immune abortion and the vascular bed is further transformed and enlargedtill deliveryand here again 'immunological cytokines' do play a major role and can eventually cause immune mediated abortion.
Failure ofnot justthe cytokine and cell recognition mediated dialoguebut also the pre and peri-implantation 'preparation of the uterus'as statedleads to sterilityearly pregnancy loss and recurrent abortions. There is also an increasingly stronger argument to implicate immunology in pre-eclampsia. Further stillimmunology is also implicated in the control of local infectionmother to child transmission of pathogens (notablybut not limited toHIV). Finallypregnancy is the only known physiological phenomenon where the once named 'suppressor T cells ' re-emerge as 'regulatory T cells'and play a cardinal role.
This E-book provides a complete compendium of gynecological immunologyspanning from fecundation to delivery. Topics also include the role of various cell types (such as T regs ad 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 fundamental and reproductive immunologistsbut more importantlyclinicians in obstetrics and gynecology.
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