Recurrent pregnancy loss (RPL), commonly defined as three or more spontaneous pregnancy losses before 20 weeks of gestation, is as frequent as in 1–2% of reproductive couples.[2] The expected prevalence of pregnancy loss following three or more episodes is one in 300 pregnancies, 0.3%.[3] The etiology of RPL is multifactorial, STA-9090 solubility dmso and sometimes women with RPL showed multiple causative factors following thorough evaluation.[4] In general, more than half of women

with RPL have autoimmune or alloimmune abnormalities. Antiphospholipid syndrome is a well-known autoimmune factor, which causes thrombosis in the uterine vessels and decrease in blood supply to the fetomaternal interface. Alloimmune abnormalities seem to significantly contribute to the pathogenesis of RPL, even though the exact extent of these abnormalities remains to be defined. Natural killer cells have been extensively studied in RPL. High proportion and high cytotoxicity of NK cells have been reported as poor prognostic factors.[5-7] In addition, an increased population of CD4+ Th1 cells is also thought to be harmful in early pregnancy.[8-10] Recent advances in immunologic studies have widened our knowledge of how the immune response is regulated.

Regulatory T cells are considered the most important immune regulator, especially in the peripheral immune system.[11, learn more 12] Recently, a new T-cell subset was introduced as another key effector T cell. These Th17 cells, which secrete IL-17, are thought to play a role in chronic inflammation and protection from fungal infection.[13, 14] There is growing evidence that regulatory T and Th17 cells are involved in establishment and maintenance of pregnancy as regulator and effector cells, respectively.

Many researchers suggest that an immune imbalance between effectors Terminal deoxynucleotidyl transferase and regulatory cells may lead implantation failure and many other pregnancy disorders. This review will discuss recent and review recent studies concerning regulatory T and Th17 cells in RPL and infertility. For immune homeostasis, the balance between effector cells and regulator cells is necessary. Some conditions such as microbial infection trigger immune activation to defend against microorganisms or repair tissue damage. However, this activated immune response should be downregulated and return to the same normal state as prior to activation. The idea of immune regulation by thymic lymphocytes was introduced by Gershon and Kondo in 1970,[15] and T lymphocytes that were capable of suppressing an immune response were named as suppressor T cells.[16] Even though there were many efforts to identify these cells, the search for the elusive suppressor T cells was not successful for a few decades. In 1995, CD4+ CD25+ T cells were reported as a particular T-cell subset with regulatory function in mice.