Uterine leukocytes: key players in pregnancy

In species with hemochorial placentation, which includes humans, mice and rats, antigen-specific T and B lymphocytes which are responsible for acquired immunity are virtually absent from the maternal-fetal interface. In contrast, non-antigen specific natural killer cells and macrophages which provide innate immunity are abundant and highly specialized. Autocrine/paracrine factors such as steroid and polypeptide hormones, prostaglandins and anti-inflammatory cytokines that are present in the uterine environment during pregnancy re-program their secretory profiles. Recent studies using transgenic mice and other approaches indicate that these environmentally modified leukocytes have major pregnancy-associated functions that include facilitation of implantation, modulation of the maternal uterine vasculature, supply of growth factors to the placenta, promotion of trophoblast differentiation and facilitation of parturition.