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CeIlularMolecularImmunology(2014)11．582—588
@2014CSlandUSTC．Allrightsreserved1672—7681／14$32．O0
www．naturecom／cm
REVIEW
F一ut-ured0I■rect一i0onsOt，Cl■I●nl●CaI■I■ab0orat一oryevaI■uat--ionot·
pregnancy
KennethDBeaman，MukeshKJa]swal，SveflanaDambaevaandAliceGilmna —Sachs
lnrecentyears，ourunderstandingofhowtheimmunesystem interactswiththedevelopingfetusandplacentahasgreatly
expanded．TherearemanyIaboratoriesthatprovidetestsfordiagnosisofpregnancyoutcomeinwomenwhohave
recurrentpregnancylOSS(RPL)orpre-eclampsia。Thesetestsarebasedonthepremisethatimmuneresponsetothefetus
isequivalenttotheadaptiveimmuneresponsetoatransplant．Newunderstandingleadstotheconceptthattheactivated
innateresponseisvitalforpregnancyandthiscanresultinmoree竹ectivetestingandtreatmenttopreventanabnormal
pregnancyinthefuture．Wedescribehereonlythreesuchareasforfuturetesting：oneareainvolvesspermandsemenand
factorsnecessaryforsuccessfuIfertilization；anotherareawoulddetermineconditionsforproductionofgrowthfactors
necessaryforimplantationintheuterus；finally．theIastareawouldbetodetermineconditionsnecessaryforthe
vascuIarizationoftheplacentaandgrowingfetusbyactivatednaturalkiller(NK)cells(combinationsofkillercell
immunoglobulin-likereceptor(KIR)familygeneswithHLA-Chaplotypes)thatleadtocapabilityofsecretingangiogenic
growthfactors．TheseareasarenovefbutunderstandingtheirroleinpregnancycanIeadtoinsightintohow tomaintain
andtreatpregnancieswithcomplicatingfactors．
Cellula，Molecular／mmunology(2014)11。582—588；doi：10．1038／cmi．2014．62：publishedonIiRe21July2014
Keywords：malefactor；preterm labor；recurrentpregnancyloss；seminalplasma；sperm
INTR0DUCTION butonemightconsiderthatwomen withhistoriesofRPL
Whan utilizingclinica1immunologicaltestingin recurrent shouldbetestedtodetermineifareasonofrtherepeatedmis—
pregnancyloss(RPL)orpreterm delivery，itshouldbeconsid— carriag
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