2015, Number 1
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Rev Cubana Invest Bioméd 2015; 34 (1)
Immune mechanisms and female infertility
León TEJ, Hernández DEB, Cubas DI, Rodríguez AJ, Cabrera-Rode E
Language: Spanish
References: 37
Page: 80-92
PDF size: 170.74 Kb.
ABSTRACT
Introduction: infertility is a growing worldwide health problem whose causal factors
are mostly associated to the female sex. A close relationship has recently been
suggested between fertility disorders and functional alterations of the immune system
contributing to and maintaining infertility.
Objective: review updated scientific literature about the subject to identify the role of
immune mechanisms in the development of female infertility.
Development: the very immune components ensuring the success of reproduction
may create a perpetuated inflammatory environment in the presence of an antigenic
stimulus, resulting in the development of a tissular lesion. Dysregulated inflammation
triggers autoimmune reactions against reproductive structures, affecting their
operation. The presence of autoantibodies and proinflammatory cytokines as
biological markers of these phenomena has been reported for conditions such as
endometriosis and polycystic ovary syndrome.
Conclusions: the immune system is known to play an important role in both normal
and pathological female reproduction. However, information about the subject
continues to be scant. Underestimation of the immune factors present in the clinical
environment often blocks the way for diagnostic and therapeutic alternatives which
could otherwise improve the quality of the care of infertile women. The complexity of
the immune and endocrine systems, as well as the limited reach of the available
diagnostic tools, are factors contributing to such insufficiency.
REFERENCES
Torres Y, Verdecia EE, Cedeño Y, Pérez Y, Santana M. Comportamiento clínico epidemiológico de las enfermedades tiroideas en mujeres con trastornos de la fertilidad. Correo Científico Médico de Holguín. 2011;15(4):4.
Urgellés SA, Reyes E, Figueroa M, Palazón A. Infertilidad en pacientes mayores de 35 años. Rev Cubana Obstet Ginecol. 2012 Dic;38(4):530-7.
Boivin J, Bunting L, Collins JA, Nygren KG. International estimates of infertility prevalence and treatment-seeking: potential need and demand for infertility medical care. Oxford J Medicine Human Reproduction. 2007;22(6):1506.
Díaz Z, García D. La perspectiva de género y la relación médico-paciente para el problema de la infertilidad. Rev Cubana Salud Pública [serie en Internet]. 2011 Mar [citado 8 de agosto de 2014];37(1). Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S0864- 34662011000100009&lng=es&nrm=iso&tlng=es
Carp HJ, Selmi C, Shoenfeld Y. The autoimmune bases of infertility and pregnancy loss. J Autoimmun. 2012;38:J266-J274.
Fernández H, Valle T, Fernández I, Ramírez N. Caracterización de la infertilidad en el municipio Pinar del Río. Rev Ciencias Médicas. 2013 sep-oct;17(5):64-73.
Hernández A, Padrón RS, Seuc A. Caracterización de la mujer infértil: resultados de un estudio estandarizado. Rev Cubana Endocrinol. 1999;10(1):16-24.
Oliva JA. Problemas de la Reproducción: Infertilidad. En: Temas de Obstetricia y Ginecología. La Habana: Editorial Ciencias Médicas; 2007. p. 1-32.
Jurado RA, Moreno-Rosset C, Río CJ, Espada AA. Principales trastornos psicológicos asociados a la infertilidad. Papeles del Psicólogo. 2008;29(2):167-75.
González I. La infertilidad, el maternaje frustrado. Rev Cubana Med Gen Integr. 2002;18:47-52.
Mande PV, Thomas S, Khan S, Jadhav S, Khole VV. Immunization with ovarian autoantigens leads to reduced fertility in mice following follicular dysfunction. Reproduction. 2012;143:309-23.
Veranes M. Evaluación de la pareja infértil. En: Ginecología y Obstetricia. Cap. 35. La Habana: Editorial Ciencias Médicas; 2004. p. 357-73.
Roy A, Matzuk MM. Reproductive tract function and dysfunction in women. Nature Reviews Endocrinology. 2011 September;7:517-25.
Yamamoto HS, Xu Q, Fichorova RN. Homeostatic properties of Lactobacillus jensenii engineered as a live vaginal anti-HIV microbicide. BMC Microbiol. 2013 Jan 8;13:4.
Anderson DJ, Marathe J, Pudney J. The structure of the human vaginal stratum corneum and its role in immune defense. Am J Reprod Immunol. 2014;71:618-23.
Nguyen PV, Kafka JK, Ferreira VH, Roth K, Kaushic C. Innate and adaptive immune responses in male and female reproductive tracts in homeostasis and following HIV infection. Cell Mol Immunol. 2014 Sep;11(5):410-27.
Libert C, Dejager L, Pinheiro I. The X chromosome in immune functions: when a chromosome makes the difference. Nature Reviews Immunology. 2010;10:594-604.
Sakiani S, Olsen NJ, Kovacs WJ. Gonadal steroids and humoral immunity. Nat Rev Endocrinol. 2013;9:56-62.
Dunbar B, Patel M, Fahey J, Wira C. Endocrine control of mucosal immunity in the female reproductive tract: impact of environmental disruptors. Mol Cell Endocrinol. 2012 May 6;354(1-2):85-93.
Gregorczyk KP, Krzyżowska M. Innate immunity to infection in the lower female genital tract. Postepy Hig Med Dosw. 2013 May 10;67:388-401.
Wira CR, Fahey JV, Rodriguez-Garcia M, Shen Z, Patel MV. Regulation of mucosal immunity in the female reproductive tract: the role of sex hormones in immune protection against sexually transmitted pathogens. Am J Reprod Immunol. 2014;72(2):236-58.
Wira CR, Fahey JV, Sentman CL, Pioli PA, Shen L. Innate and adaptive immunity in female genital tract: Cellular responses and interactions. Immunol Rev. 2005;206:306-35.
Amjadi F, Salehi E, Mehdizadeh M, Aflatoonian R. Role of the innate immunity in female reproductive tract. Adv Biomed Res. 2014;3:1.
Jayaram A, Orfanelli T, Doulaveris G, Linhares IM, Ledger WJ, Witkin SS. Autophagy and female genital tract infections: new insights and research directions. BJOG. 2014 Jun;121(7):801-8.
Unuane D, Tournaye H, Velkeniers B, Poppe K. Endocrine disorders & female infertility. Best Pract Res Clin Endocrinol Metab. 2011;25:861-73.
Ojeda-Ojeda M, Murri M, Insenser M, Escobar-Morrealee HF. Mediators of lowgrade chronic inflammation in polycystic ovary syndrome (PCOS). Curr Pharm Des. 2013;19:5775-91.
Johnson NP, Hummelshoj L. World Endometriosis Society Montpellier Consortium. Consensus on current management of endometriosis. Hum Reprod. 2013;28:1552-68.
Capobianco A, Rovere-Querini P. Endometriosis, a disease of the macrophage. Front Immunol. 2013;4:1-13.
Vercellini P, Viganò P, Somigliana E, Fedele L. Endometriosis: pathogenesis and treatment. Nat Rev Endocrinol. 2014;10:261-75.
Pires E. Multiplicity of molecular and cellular targets in human ovarian autoimmunity: an update. J Assist Reprod Genet. 2010;27:519-24.
Sen A, Kushnir VA, Barad DH, Gleicher N. Endocrine autoimmune diseases and female infertility. Nat Rev Endocrinol. 2014 January;10:37-50.
Haller-Kikkatalo K, Salumets A, Uibo R. Review on Autoimmune Reactions in Female Infertility: Antibodies to Follicle Stimulating Hormone. Clin Dev Immunol. 2012;2012:762541.
Bedoya SK, Lam B, Lau K, Larkin J 3rd. Th17 cells in immunity and autoimmunity. Clin Dev Immunol. 2013;2013:986789.
Horne AW, Stock SJ, King AE. Innate immunity and disorders of the female reproductive tract. Reproduction. 2008;135:739-49.
Ortiz C, Hechavarría C, Ley M, Álvarez G, Hernández Y. Estudio de Chlamydia trachomatis, Ureaplasma urealyticum y Mycoplasma hominis en pacientes infértiles y abortadoras habituales. Rev Cubana Obstet Ginecol [serie en Internet]. 2010 Dic [citado 13 de agosto de 2014];36(4). Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S0138- 600X2010000400011&lng=es&nrm=iso&tlng=es
Naz RK. Female genital tract immunity: distinct immunological challenges for vaccine development. J Reprod Immunol. 2012 Jan;93(1):1-8.
Monach J. Developments in infertility counselling and its accreditation. Hum Fertil (Camb). 2013 Mar;16(1):68-72.