Decidual NR2F2-Expressing CD4+ T Cells Promote TH2 Transcriptional Program During Early Pregnancy

Characteristics in patients with unexplained recurrent spontaneous abortion and the impact on immune, coagulation, and inflammatory profiles

OBJECTIVE

Unexplained Recurrent Spontaneous Abortion (RSA) impacts the physical and psychological well-being of women of reproductive age. This study aimed to reveal the potential mechanisms behind unexplained RSA from the perspective of glucose and lipid metabolic profiles before conception and their relationship with immune, coagulation, and inflammatory markers.

METHODS

A retrospective analysis was conducted on 100 patients with unexplained recurrent spontaneous abortion at our gynecology department from June 2022 to June 2023. According to whether abnormal glucose and lipid metabolism exist, patients were grouped into normal group and abnormal group. The study compared the glucose and lipid metabolic characteristics, immune status, coagulation, and inflammatory parameters between two groups.

RESULTS

The Abnormal Group exhibited higher fasting blood glucose, 2-hour oral glucose tolerance test, homeostatic model assessment of insulin resistance, total cholesterol, and LDL cholesterol, along with lower levels of HDL cholesterol. Additionally, alterations in immune profile parameters, including lower levels of CD4+ T cells, CD8+ T cells, B cells, NK cells, and elevated IL-6, were observed in the Abnormal Group. Regarding coagulation and inflammatory profile parameters, the Abnormal Group demonstrated prolonged prothrombin time, activated partial thromboplastin time, elevated fibrinogen and D-dimer levels, and increased platelet count, along with elevated C-reactive protein, TNF-α, and IL-1β levels. Correlation analysis revealed significant associations between the pre-pregnancy metabolic characteristics and immune, coagulation, and inflammatory profile parameters.

CONCLUSION

Abnormal glucose and lipid metabolism may lead to or exacerbate unexplained RSA in some patients, and therapeutic interventions targeting glucose and lipid metabolism hold promise for improving pregnancy outcomes in this population.

Anti-angiogenesis and anti-immunosuppression gene therapy through targeting COUP-TFII in an in situ glioblastoma mouse model

Glioblastoma (GBM) is the most common and aggressive primary brain cancer; angiogenesis and immunosuppression exacerbate GBM progression. COUP-TFII demonstrates pro-angiogenesis activity; however, its role in glioma progression remains unclear. This study revealed that COUP-TFII promotes angiogenesis in gliomas by inducing transdifferentiation of glioma cells into endothelial-like cells. Mechanistic investigation suggested that COUP-TFII as a transcription factor exerts its function via binding to the promoter of TXNIP. Interestingly, COUP-TFII knockdown attenuated tumorigenesis and tumor progression in an immunocompetent mouse model but promoted tumor progression in an immuno-deficient mouse model. As an explanation, repression of COUP-TFII induces cellular senescence and activates immune surveillance in glioma cells in vitro and in vivo. In addition, we used heparin-polyethyleneimine (HPEI) nanoparticles to deliver COUP-TFII shRNA, which regulated tumor angiogenesis and immunosuppression in an in situ GBM mouse model. This study provides a novel strategy and potential therapeutic targets to treat GBM.

Recurrent implantation failure: A comprehensive summary from etiology to treatment

Implantation is the first step in human reproduction. Successful implantation depends on the crosstalk between embryo and endometrium. Recurrent implantation failure (RIF) is a clinical phenomenon characterized by a lack of implantation after the transfer of several embryos and disturbs approximately 10% couples undergoing in vitro fertilization and embryo transfer. Despite increasing literature on RIF, there is still no widely accepted definition or standard protocol for the diagnosis and treatment of RIF. Progress in predicting and preventing RIF has been hampered by a lack of widely accepted definitions. Most couples with RIF can become pregnant after clinical intervention. The prognosis for couples with RIF is related to maternal age. RIF can be caused by immunology, thrombophilias, endometrial receptivity, microbiome, anatomical abnormalities, male factors, and embryo aneuploidy. It is important to determine the most possible etiologies, and individualized treatment aimed at the primary cause seems to be an effective method for increasing the implantation rate. Couples with RIF require psychological support and appropriate clinical intervention. Further studies are required to evaluate diagnostic method and he effectiveness of each therapy, and guide clinical treatment.

HLA-G: An Important Mediator of Maternal-Fetal Immune-Tolerance

Maternal-fetal immune-tolerance occurs throughout the whole gestational trimester, thus a mother can accept a genetically distinct fetus without immunological aggressive behavior. HLA-G, one of the non-classical HLA class I molecules, is restricted-expression at extravillous trophoblast. It can concordantly interact with various kinds of receptors mounted on maternally immune cells residing in the uterus (e.g. CD4+ T cells, CD8+ T cells, natural killer cells, macrophages, and dendritic cells) for maintaining immune homeostasis of the maternal-fetus interface. HLA-G is widely regarded as the pivotal protective factor for successful pregnancies. In the past 20 years, researches associated with HLA-G have been continually published. Indeed, HLA-G plays a mysterious role in the mechanism of maternal-fetal immune-tolerance. It can also be ectopically expressed on tumor cells, infected sites and other pathologic microenvironments to confer a significant local tolerance. Understanding the characteristics of HLA-G in immunologic tolerance is not only beneficial for pathological pregnancy, but also helpful to the therapy of other immune-related diseases, such as organ transplant rejection, tumor migration, and autoimmune disease. In this review, we describe the biological properties of HLA-G, then summarize our understanding of the mechanisms of fetomaternal immunologic tolerance and the difference from transplant tolerance. Furthermore, we will discuss how HLA-G contributes to the tolerogenic microenvironment during pregnancy. Finally, we hope to find some new aspects of HLA-G in fundamental research or clinical application for the future.