Mechanism of Human Chorionic Gonadotrophinmediated Immunomodulation in Pregnancy

Amolak S Bansal; Shabana A Bora; Srdjan Saso; J Richard Smith; Mark R Johnson; Meen-Yau Thum


Expert Rev Clin Immunol. 2012;8(8):747-753. 

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Expert Commentary

hCG is of critical importance in the establishment of the early embryo in the harsh environment of the maternal endometrium. While the role of this hormone in promoting angiogenesis and placentation has been appreciated for some time, its role in recruiting and promoting maternal Treg cell function has only recently been recognized. The subsequent downregulation of maternal anti-trophoblastic T- and NK-cell immunity is critical in preventing rejection of the fetus. However, further work is required to delineate the precise molecular pathways by which hCG upregulates IDO activity, modulates DC function and alters the pattern of the cytokine secretion. More research is certainly required in checking for autoimmunity to hCG and/or the LH/hCG receptor in women with infertility and RM, and especially in women with evidence of thyroid autoimmunity. Downregulating this autoimmunity may reduce early miscarriage and RFIVF.