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Review
. 2023 Sep;90(3):e13755.
doi: 10.1111/aji.13755.

The function of decidua natural killer cells in physiology and pathology of pregnancy

Fangfang Jin  1 , Wei Liu  2   3 , Guan Cheng  4 , Songchen Cai  2   3 , Tailang Yin  1 , Lianghui Diao  2   3
Affiliations
Review

The function of decidua natural killer cells in physiology and pathology of pregnancy

Fangfang Jin et al. Am J Reprod Immunol. 2023 Sep.

Abstract

The role of decidual natural killer (dNK) cells in maintaining immune tolerance at the maternal-fetal interface during pregnancy is a significant topic in reproductive health. Immune tolerance is essential for a successful pregnancy and involves a complex immune response involving various immune cells and molecules. DNK cells comprise the largest population of lymphocyte subsets found in the decidua and play important roles in maintaining immune tolerance. These cells exert multiple functions to maintain homeostasis of the decidual microenvironment, including modulation of trophoblast invasion, promotion of fetal development, regulation of endometrial decidualization and spiral artery remodeling. DNK cells can also be divided into different subsets based on their functions as NKtolerant , NKcytotoxic , and NKregulatory cells. However, the relationship between dNK cells function and pregnancy outcomes is complex and poorly understood. In this review, we will focus on the physiological role of dNK cells during pregnancy and highlight the potential role in pathological pregnancies and therapeutic approaches.

Keywords: decidua natural killer cells; decidualization; embryo implantation; spiral artery remodeling.

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