T Cell-Related Endometrial Gene Expression in Normal and Complicated Pregnancies

Abstract

T cell immunity is critical for implantation and maintenance of pregnancy. The balance between T helper (Th)1/Th2 and Th17/T regulatory cell (Treg) immunities determines the pregnancy outcome. The predominant expression of Th2 and Treg immunities at the maternal-fetal interface was related to normal pregnancy, while the balance biased to Th1 and Th17 immunities is associated with reproductive disorders, such as recurrent implantation failures, recurrent pregnancy losses, preeclampsia, and preterm labor. T cell immunity can be evaluated by investigating lymphocyte subsets, cytokines, transcription factors, and gene expressions in the tissue (endometrium/decidua) and peripheral blood. Interestingly, various endometrial gene expression patterns have been reported to be associated with specific gynecological and obstetrical disorders. Therefore, analysis of endometrial genes responsible for the T cell subsets and related cytokines and factors will help us to understand the underlying immunopathology of reproductive failures and obstetrical complications and develop an efficient therapeutic strategy. In this review, we aim to deliberate the role of T cell immunity, which is vital to sustaining an adequate maternal-fetal response, immune homeostasis, and maintenance of pregnancy by assessing changes in T cell subsets and endometrial/decidual gene expression patterns in normal and complicated pregnancies.