PMID- 28501365
OWN - NLM
STAT- MEDLINE
DCOM- 20170818
LR  - 20180130
IS  - 1556-5653 (Electronic)
IS  - 0015-0282 (Linking)
VI  - 107
IP  - 6
DP  - 2017 Jun
TI  - Why natural killer cells are not enough: a further understanding of killer 
      immunoglobulin-like receptor and human leukocyte antigen.
PG  - 1273-1278
LID - S0015-0282(17)30351-5 [pii]
LID - 10.1016/j.fertnstert.2017.04.018 [doi]
AB  - The immune system's role in recurrent reproductive failure is a controversial 
      issue in assisted reproduction. Most studies into immune system implication in 
      reproduction have focused on finding markers of peripheral blood and less on the 
      uterine environment. Peripheral blood natural killer cells have become an "immune 
      study core" for women with recurrent miscarriage or recurrent implantation 
      failure, based on the mistaken notion that they cause reproductive failure by 
      killing or "rejecting" the embryo. Maternal-fetal tolerance begins at the uterine 
      level, so successful adaptation to the fetus occurs after a complicated process. 
      Insufficient uterine lining invasion by an invading extravillous trophoblast is 
      the primary defect in pregnancy disorders such as recurrent miscarriage. This 
      process is regulated by the interaction between maternal killer 
      immunoglobulin-like receptors (KIRs), expressed by uterine natural killer cells 
      (uNK), and their ligand human leukocyte antigen (HLA) C, expressed by the 
      extravillous trophoblast. Pregnancies are an increased risk of disorders in 
      mothers with KIR AA when the fetus has paternal HLA-C2. A recent report has 
      indicated that the expression of more than one paternal HLA-C by the extravillous 
      trophoblast in assisted reproduction may affect placentation in mothers with KIR 
      AA. This review provides insight into the immune system's role in assisted 
      reproductive treatments. These insights can have an impact on the selection of 
      single-embryo transfer and/or oocyte/sperm donor according to HLA-C in patients 
      with recurrent implantation failure and recurrent miscarriage depending on their 
      KIR haplotype.
CI  - Copyright (c) 2017 American Society for Reproductive Medicine. Published by 
      Elsevier Inc. All rights reserved.
FAU - Alecsandru, Diana
AU  - Alecsandru D
AD  - Department of Immunology and Department of Reproductive Endocrinology and 
      Infertility, Instituto Valenciano de Infertilidad-Madrid, Rey Juan Carlos 
      University, and Instituto de Investigacion Hospital Universitario La Paz, Madrid, 
      Spain. Electronic address: diana.alecsandru@ivi.es.
FAU - Garcia-Velasco, Juan A
AU  - Garcia-Velasco JA
AD  - Department of Immunology and Department of Reproductive Endocrinology and 
      Infertility, Instituto Valenciano de Infertilidad-Madrid, Rey Juan Carlos 
      University, and Instituto de Investigacion Hospital Universitario La Paz, Madrid, 
      Spain.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20170510
PL  - United States
TA  - Fertil Steril
JT  - Fertility and sterility
JID - 0372772
RN  - 0 (HLA-C Antigens)
RN  - 0 (Receptors, KIR)
SB  - IM
MH  - Abortion, Spontaneous/immunology
MH  - Embryo Implantation/immunology
MH  - Female
MH  - HLA-C Antigens/*immunology
MH  - Humans
MH  - Immune Tolerance/*immunology
MH  - Immunity, Maternally-Acquired/*immunology
MH  - Killer Cells, Natural/*immunology
MH  - Placentation/*immunology
MH  - Pregnancy
MH  - Receptors, KIR/*immunology
MH  - Uterus/*immunology
OTO - NOTNLM
OT  - human leukocyte antigen C (HLA-C)
OT  - killer immunoglobulin-like receptor (KIR)
OT  - maternofetal immune tolerance
OT  - natural killer cells
OT  - uterine natural killer cells
EDAT- 2017/05/16 06:00
MHDA- 2017/08/19 06:00
CRDT- 2017/05/15 06:00
PHST- 2017/01/31 00:00 [received]
PHST- 2017/04/21 00:00 [revised]
PHST- 2017/04/23 00:00 [accepted]
PHST- 2017/05/16 06:00 [pubmed]
PHST- 2017/08/19 06:00 [medline]
PHST- 2017/05/15 06:00 [entrez]
AID - S0015-0282(17)30351-5 [pii]
AID - 10.1016/j.fertnstert.2017.04.018 [doi]
PST - ppublish
SO  - Fertil Steril. 2017 Jun;107(6):1273-1278. doi: 10.1016/j.fertnstert.2017.04.018. 
      Epub 2017 May 10.