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November 27, 1987, Vol 258, No. 20 >
ARTICLE | November 27, 1987

Reproductive Immunology FREE

Gary Gurka, MD; Ross E. Rocklin, MD
JAMA. 1987;258(20):2983-2987. doi:10.1001/jama.1987.03400200189024
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References

ONE OF the greatest mysteries yet to be unraveled in biology is the mechanism by which the fetus, which is essentially an allograft, is able to survive the immunologic defenses of the mother without being rejected. That a successful pregnancy so often is the outcome seems even more remarkable, since it defies the basic tenets of the field of transplantation immunology.

Metchnikoff first noted in 1882 that starfish had an intrinsic ability to differentiate self from nonself and, in their identification of that which was foreign, mounted a vigorous reaction locally to eliminate the invader. One might wonder how an embryo, which receives 50% of its genetic code from the father, can be housed in a womb that may already be primed to destroy it. Medawar1 hypothesized in 1954 several mechanisms for the survival of the fetal allograft: (1) the fetus is not immunogenic and therefore cannot be detected;

REFERENCES

1 +
Medawar PB:  Some immunological problems raised by the evolution of viviparity . Symp Soc Exp Biol 1954;;7:320-328.
2 +
Ahrons S:  Leukocyte antibodies: Occurrence in primagravidae . Tissue Antigens 1971;;1:179.
3 +
Webb CG, Gall WE, Edelmann GM:  Synthesis and distribution of H2 antigens in pre-implantation mouse embryos . J Exp Med 1977;;146:923-932.
4 +
Searle RF, Johnson MH, Billington WD:  Investigation of antigens on the mouse blastocyst . Transplantation 1974;;18:136-141.
5 +
Heyner S:  Antigens of trophoblast and early embryo , in Dhindsa DS, Schumacher RS (eds): Immunological Aspects of Infertility and Fertility Regulation . New York, North Holland Biomedical Press, 1980;, pp 183-203.
6 +
Cohne J, Werrett DJ:  Antibodies and sperm survival in the female tract of the mouse and rabbit . J Reprod Fertil 1975;;42:301-310.
7 +
Bernard O, Bennett D, Ripoche M:  Distribution of maternal immunoglobulins in the mouse uterus and embryo in the days after implantation . J Exp Med 1977;;145:58-75.
8 +
Kirby DR:  The immunological consequences of extra uterine development of allogeneic mouse blastocysts . Transplantation 1968;;6:1005-1009.
9 +
Billington RE:  From transplantation biology to reproductive immunobiology . Obstet Gynecol Annu 1978;;7:1-14.
10 +
Weinberg ED:  Pregnancy-associated depression of cell-mediated immunity . Rev Infect Dis 1984;;6:814.
11 +
Weber RW, Nelson HS:  Immunologic and atopic aspects of pregnancy and lactation . Ann Allergy 1986;;57:159-166.
12 +
McIntyre JA, Faulk WP:  Trophoblast immunosuppressive factors . Proc Natl Acad Sci USA 1982;;76:4029.
13 +
Murgita RA, Tomasi TB:  Suppression of the immune response by alpha-fetoprotein . J Exp Med 1975;;141:440-452.
14 +
Rocklin RE, Kitzmiller JL, Kaye MD:  Immunobiology of the maternal fetal relationship . Annu Rev Med 1979;;30:375-404.
15 +
Muchmore AV, Decker JM:  Uromodulin: A unique immunosuppressive glycoprotein isolated from the urine of pregnant women . Science 1985;; 229:479-481.
16 +
Muchmore AV, Blaese R, Shifrin S, et al:  Uromodulin, affinity for recombinant IL-1 , abstracted. Am Fed Clin Res 1986;;34( (suppl 2) ): 671A.
17 +
Simmons RL, Price AL, Ozerkis AJ:  The effect of estrogen and progesterone on allograft survival . Am J Obstet Gynecol 1968;;100:908-911.
18 +
Pence H, Petty WM, Rocklin RE:  Inhibition of MIF production by maternal serum factor . J Immunol 1975;;114:525.
19 +
Rocklin RE, Kitzmiller JL, Garvoy MR:  Further characterization of an immunologic blocking factor that develops during pregnancy . Clin Immunol Immunopathol 1982;;22:305-315.
20 +
Winchester RF, Fu S, Jersild C, et al:  Recognition by pregnancy serums of non-HLA alloantigens . J Exp Med 1975;;141:924-929.
21 +
Beer AE, Head JR, Smith WG, et al:  Some immunoregulatory aspects of pregnancy in rats . Transplant Proc 1976;;8:267-273.
22 +
Stankova J, Rola-Pleszczynskin M:  Suppressor cells in the human maternal-fetal relationship . J Reprod Immunol 1984;;6:49.
23 +
Mathur S, Fudenburg HH, Keane M, et al:  Fetal cytotoxic antibodies to maternal T lymphocytes: A possible mechanism of maternal tolerance of the fetal allograft . Am J Reprod Immunol 1982;; 2:23-28.
24 +
Goldsobel A, Ank B, Stiehm ER:  Phenotypic and cytotoxic characteristics of the immune cells of the human placenta . Cell Immunol 1986;;97:335-343.
25 +
Mettler L, Gradl T:  The occurrence of sperm antibodies in human reproduction . Am J Obstet Gynecol 1980;;136:106-116.
26 +
Mettler L, Paul S, Seki M, et al:  Different factors influencing mice in vitro fertilization . Infertility 1980;;3:217-229.
27 +
Fiddes TM, O'Reilly DB, Rocklin RE, et al:  Phenotypic and functional evaluation of suppressor cells in normal pregnancy and in chronic abortors . Cell Immunol 1986;;97:407-418.

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Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

1 +
Medawar PB:  Some immunological problems raised by the evolution of viviparity . Symp Soc Exp Biol 1954;;7:320-328.
2 +
Ahrons S:  Leukocyte antibodies: Occurrence in primagravidae . Tissue Antigens 1971;;1:179.
3 +
Webb CG, Gall WE, Edelmann GM:  Synthesis and distribution of H2 antigens in pre-implantation mouse embryos . J Exp Med 1977;;146:923-932.
4 +
Searle RF, Johnson MH, Billington WD:  Investigation of antigens on the mouse blastocyst . Transplantation 1974;;18:136-141.
5 +
Heyner S:  Antigens of trophoblast and early embryo , in Dhindsa DS, Schumacher RS (eds): Immunological Aspects of Infertility and Fertility Regulation . New York, North Holland Biomedical Press, 1980;, pp 183-203.
6 +
Cohne J, Werrett DJ:  Antibodies and sperm survival in the female tract of the mouse and rabbit . J Reprod Fertil 1975;;42:301-310.
7 +
Bernard O, Bennett D, Ripoche M:  Distribution of maternal immunoglobulins in the mouse uterus and embryo in the days after implantation . J Exp Med 1977;;145:58-75.
8 +
Kirby DR:  The immunological consequences of extra uterine development of allogeneic mouse blastocysts . Transplantation 1968;;6:1005-1009.
9 +
Billington RE:  From transplantation biology to reproductive immunobiology . Obstet Gynecol Annu 1978;;7:1-14.
10 +
Weinberg ED:  Pregnancy-associated depression of cell-mediated immunity . Rev Infect Dis 1984;;6:814.
11 +
Weber RW, Nelson HS:  Immunologic and atopic aspects of pregnancy and lactation . Ann Allergy 1986;;57:159-166.
12 +
McIntyre JA, Faulk WP:  Trophoblast immunosuppressive factors . Proc Natl Acad Sci USA 1982;;76:4029.
13 +
Murgita RA, Tomasi TB:  Suppression of the immune response by alpha-fetoprotein . J Exp Med 1975;;141:440-452.
14 +
Rocklin RE, Kitzmiller JL, Kaye MD:  Immunobiology of the maternal fetal relationship . Annu Rev Med 1979;;30:375-404.
15 +
Muchmore AV, Decker JM:  Uromodulin: A unique immunosuppressive glycoprotein isolated from the urine of pregnant women . Science 1985;; 229:479-481.
16 +
Muchmore AV, Blaese R, Shifrin S, et al:  Uromodulin, affinity for recombinant IL-1 , abstracted. Am Fed Clin Res 1986;;34( (suppl 2) ): 671A.
17 +
Simmons RL, Price AL, Ozerkis AJ:  The effect of estrogen and progesterone on allograft survival . Am J Obstet Gynecol 1968;;100:908-911.
18 +
Pence H, Petty WM, Rocklin RE:  Inhibition of MIF production by maternal serum factor . J Immunol 1975;;114:525.
19 +
Rocklin RE, Kitzmiller JL, Garvoy MR:  Further characterization of an immunologic blocking factor that develops during pregnancy . Clin Immunol Immunopathol 1982;;22:305-315.
20 +
Winchester RF, Fu S, Jersild C, et al:  Recognition by pregnancy serums of non-HLA alloantigens . J Exp Med 1975;;141:924-929.
21 +
Beer AE, Head JR, Smith WG, et al:  Some immunoregulatory aspects of pregnancy in rats . Transplant Proc 1976;;8:267-273.
22 +
Stankova J, Rola-Pleszczynskin M:  Suppressor cells in the human maternal-fetal relationship . J Reprod Immunol 1984;;6:49.
23 +
Mathur S, Fudenburg HH, Keane M, et al:  Fetal cytotoxic antibodies to maternal T lymphocytes: A possible mechanism of maternal tolerance of the fetal allograft . Am J Reprod Immunol 1982;; 2:23-28.
24 +
Goldsobel A, Ank B, Stiehm ER:  Phenotypic and cytotoxic characteristics of the immune cells of the human placenta . Cell Immunol 1986;;97:335-343.
25 +
Mettler L, Gradl T:  The occurrence of sperm antibodies in human reproduction . Am J Obstet Gynecol 1980;;136:106-116.
26 +
Mettler L, Paul S, Seki M, et al:  Different factors influencing mice in vitro fertilization . Infertility 1980;;3:217-229.
27 +
Fiddes TM, O'Reilly DB, Rocklin RE, et al:  Phenotypic and functional evaluation of suppressor cells in normal pregnancy and in chronic abortors . Cell Immunol 1986;;97:407-418.

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