The role of innate immune factors in maintaining physiological pregnancy: a modern approach

Sorokina L.E., Krasnyi A.M., Fomochkina I.I., Kan N.E.

Order of the Red Banner of Labor Medical Institute named after S.I. Georgievsky, V.I. Vernadsky Crimean Federal University, Simferopol, Russia
Academician Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Health Ministry of Russian Federation, Moscow, Russia

In recent decades, the concept that innate immune factors play a central role in ensuring immunological tolerance in the mother-fetus system while maintaining effective anti-infective defenses of the mother has become increasingly popular. Fundamentally different from the responses of the adaptive immune system, nonspecific immune mechanisms not only contribute to the formation of a tolerogenic environment at the maternal-fetal interface but also ensure successful endometrial decidualization, embryo implantation, trophoblast invasion, spiral artery remodeling, placentation, fetal growth and development, and labor, as well as create the conditions for effective protection against infectious pathogens. It has been shown that disruptions in the number and functional activity of innate immune cells can lead to the development of various immune-mediated pregnancy pathologies, such as repeated implantation failures, recurrent miscarriage, and preterm birth. This review presents the results of studies examining the biology and functional role of the main cell populations of the innate immune system in regulating reproductive processes.