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    Is childbirth equivalent to a graft rejection?

    A study by Céline Méhats, team of Daniel Vaiman

    coverA study by Céline Méhats (Genomics, Epigenetics and Pathophysiology of Reproduction team), published in Journal of Immunology, shows that childbirth is preceded by a maternal immune response in the uterus similar to a mother-fetal rejection.

    figureChildbirth is characterized by strong uterine contractions, cervical dilation and membranes rupture. The trigger of the delivery remains unknown in humans. Yet, understanding the determinisms of parturition would bring light both in normal term delivery but also in many pathologies of the pregnancy, e.g. embryo implantation failures, spontaneous miscarriages, or preterm deliveries. The study led by Céline Méhats (team of Genomics, Epigenetics and Reproductive Physiopathology, Cochin Institute (Inserm U1016/CNRS UMR8104/University Paris Descartes)) with Louis Marcellin (Department of Obstetrics & Gynecology, Maternité Port Royal/Cochin, PhD research project), published in Journal of Immunology in February 2017, attempted to decipher the change in maternal-fetal tolerance at the time of delivery. They showed that there is an unambiguous molecular signature of processes involved in graft rejection and immune activation within the fetal membranes (the “water bag”) overlying the cervix. Maternal-fetal tolerance that is required for the development of the semi-allogenic embryo is therefore locally disrupted. These data suggest the existence of an immune trigger of the onset of parturition in humans. Céline Méhats is continuing this study to identify relevant vaginal markers of the onset of this immune response that could help for a better management of women presenting preterm labor.



    Marcellin L, Schmitz T, Messaoudene M, Chader D, Parizot C, Jacques S, Delaire J, Gogusev J, Schmitt A, Lesaffre C, Breuiller-Fouché M, Caignard A, Vaiman D, Goffinet F, Cabrol D, Gorochov G, Méhats C. Immune Modifications in Fetal Membranes Overlying the Cervix Precede Parturition in Humans. J Immunol. 2017 Feb 1;198(3):1345-1356. doi: 10.4049/jimmunol.1601482. PMID:28031337


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    Figure: In humans, fetal membranes, « the waterbag » line the uterine cavity. Trophoblasts within these membranes are the only fetal cells in contact with maternal uterine cells and interact with maternal resident immune cells to ensure pregnancy. Ultimately, activation of these maternal cells precedes childbirth.

    Cover: Electron microscopy image of enlarged vacuolated macrophages in human choriodecidua overlying the cervix at full-term pregnancy before labor. Prior to term parturition, the fetal membranes located over the cervix present physical weaknesses that are related to a local activation of leukocytes and the destruction of trophoblasts and extracellular matrix.