Pregnancy Represents an Allograft

Cases of recurrent abortions, preeclampsia or babies born with hemolytic diseases of the newborn still puzzle us with the of the question "Why did your mother reject you?" Although, after looking at the complexity of the maternal-fetal immune interaction and the cases of successful pregnancies, with surprise and admiration the question now becomes: "Why didn't your mother reject you?"

Medawar, in the early 1950s, recognized for the first time the unique immunology of the maternal-fetal interface and its potential relevance for transplantation. In his original work, he described the "fetal allograft analogy" where the fetus is viewed as a semiallogeneic conceptus that evaded rejection. The approaches over the next 50 years have followed the methodology and development of transplantation immunity or more recently tumor immunity, unveiling new hypotheses and redefining old concepts.

The objective of this book is to review some of the significant events involved in human implantation related to the interaction between the maternal immune system and the fetus. The volume focuses on the main aspects of reproductive immunology, both from basic sciences and clinical points of view. Although there are still gaps in our knowledge, the advances accomplished in the last five years have proved the importance of understanding the role of the immune system during pregnancy. This not only represents a fascinating field for research, but it has the potential for new areas of treatment and diagnosis.

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