Why natural killer cells are not enough: a further understanding of killer immunoglobulin-like receptor and human leukocyte antigen

Fertility and Sterility
Diana Alecsandru, J A García-Velasco

Abstract

The immune system's role in recurrent reproductive failure is a controversial issue in assisted reproduction. Most studies into immune system implication in reproduction have focused on finding markers of peripheral blood and less on the uterine environment. Peripheral blood natural killer cells have become an "immune study core" for women with recurrent miscarriage or recurrent implantation failure, based on the mistaken notion that they cause reproductive failure by killing or "rejecting" the embryo. Maternal-fetal tolerance begins at the uterine level, so successful adaptation to the fetus occurs after a complicated process. Insufficient uterine lining invasion by an invading extravillous trophoblast is the primary defect in pregnancy disorders such as recurrent miscarriage. This process is regulated by the interaction between maternal killer immunoglobulin-like receptors (KIRs), expressed by uterine natural killer cells (uNK), and their ligand human leukocyte antigen (HLA) C, expressed by the extravillous trophoblast. Pregnancies are an increased risk of disorders in mothers with KIR AA when the fetus has paternal HLA-C2. A recent report has indicated that the expression of more than one paternal HLA-C by the extravillous t...Continue Reading

Citations

Apr 7, 2020·Current Opinion in Obstetrics & Gynecology·Yigit Cakiroglu, Bulent Tiras
Apr 1, 2020·Experimental and Therapeutic Medicine·Yubin LeeNam Keun Kim
Sep 9, 2018·Journal of Assisted Reproduction and Genetics·Kevin MarronConor Harrity
Mar 9, 2019·Journal of Assisted Reproduction and Genetics·Kevin Marron, Conor Harrity
Feb 3, 2021·Human Reproduction Update·Indra Díaz-HernándezFrancisco Domínguez
Mar 28, 2021·American Journal of Reproductive Immunology : AJRI·Kamila KolanskaArsène Mekinian
Jun 24, 2021·Seminars in Reproductive Medicine·Joshua Odendaal, Siobhan Quenby
Nov 9, 2021·Frontiers in Immunology·Karolina PiekarskaIzabela Nowak

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