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ILP2015 - Is there a role for Natural Killer cells in ectopic pregnancy?
Ectopic pregnancy (EP) is a life-threatening condition, in which a fertilised ovum abnormally implants outside the uterine cavity, most commonly in the fallopian tube (FT) (Parashi, Moukhah, & Ashrafi, 2014). Although EP is clinically well documented, much of its pathogenesis is still unknown. Because tubal (t)EP is associated with significant maternal mortality due to tubal rupture and intra-abdominal haemorrhage, greater understanding of this medical emergency is warranted (Kirk, Bottomley, & Bourne, 2014). Current literature on EP and research in the possible role of maternal Natural Killer (NK) cells in the FT interacting with the implanting embryo, aims to improve the potential of diagnostic markers, resulting in earlier EP management.
Uterine NK cells: active regulators at the maternal-fetal interface
J Clin Invest. 2014 May;124(5):1872-9. doi: 10.1172/JCI68107. Epub 2014 May 1.
Moffett A, Colucci F.
Abstract
Pregnancy presents an immunological conundrum because two genetically different individuals coexist. The maternal lymphocytes at the uterine maternal-fetal interface that can recognize mismatched placental cells are T cells and abundant distinctive uterine NK (uNK) cells. Multiple mechanisms exist that avoid damaging T cell responses to the fetus, whereas activation of uNK cells is probably physiological. Indeed, genetic epidemiological data suggest that the variability of NK cell receptors and their MHC ligands define pregnancy success; however, exactly how uNK cells function in normal and pathological pregnancy is still unclear, and any therapies aimed at suppressing NK cells must be viewed with caution. Allorecognition of fetal placental cells by uNK cells is emerging as the key maternal-fetal immune mechanism that regulates placentation.
PMID 24789879
