The immune checkpoint protein PD-1: Its emerging regulatory role in memory T cells.

Immunological memory helps the body rapidly develop immune defense when it re-encounters a bacterial or viral strain or encounters a similar mutation in healthy cells. The immune checkpoint molecule programmed cell death 1 (PD-1) influences memory T cell differentiation. However, the mechanism by which PD-1 regulates the development and maintenance of memory T cells and its impact on memory T cells function remain unclear. In this review, we first discuss the structure and function of PD-1 and then summarize the roles of PD-1 as a marker of tumor memory T cells and in tumor immunotherapy. We also discuss the potential mechanisms through which PD-1 regulates memory T cells development and maintenance during immune diseases such as viral infection-mediated diseases, psoriasis, and rheumatoid arthritis, and list the effects of PD-1 on memory T cells in pregnancy and their function in maternal-fetal immune balance. A complete understanding of how PD-1 influences the development, maintenance, and function of memory T cells will provide new insights into the prevention and treatment of immune-related diseases.

Anti-Ro/SSA and/or anti-La/SSB antibodies are associated with adverse endometrial status.

PROBLEM: Anti-Ro/SSA and/or anti-La/SSB (anti-SSA/SSB) antibodies impair pregnancy outcomes, including embryo implantation and pregnancy maintenance. Optimal endometrial immune status is essential for successful pregnancy. However, whether these antibodies affect endometrial immune status is still unclear. Menstrual blood can be collected non-invasively, differs from peripheral blood, and can reflect the endometrial immune status. We herein focused on changes in subsets of natural killer (NK) cells and T cells in menstrual blood. METHODS OF STUDY: Menstrual blood samples from anti-SSA/SSB antibody-positive (n = 18) and anti-SSA/SSB antibody-negative control (n = 8) women were collected, and the profile of lymphocyte subsets was analyzed. The phenotypes of menstrual blood CD49a- and CD49a+ NK cells were compared, and the abundance of NK and CD49a+ NK cells in menstrual blood of the two groups was assessed. Additionally, CD4+T and CD8+T cells were investigated for their ability to secret functional cytokines. RESULTS: Menstrual blood contains a large number of (mostly CD49a+) NK cells, which exhibited a more exhausted phenotype with greater expression of the immune checkpoint molecules programmed cell death protein 1 and Tim-3 compared to CD49a- conventional NK cells. CD8+T cells in menstrual blood from anti-SSA/SSB antibody-positive women produced a stronger response after stimulation, accompanied by increased interferon-γ, tumor necrosis factor-α, and granzyme B secretion (P < 0.05, separately). CONCLUSION: Menstrual blood cell composition differs between anti-SSA/SSB antibody-positive women and normal controls, especially in terms of CD49a+ NK cells and CD8+T cells, unbalancing the immune cell composition and inflammatory uterine microenvironment and possibly contributing to adverse pregnancy outcomes.

Anti-Ro/SSA and/or anti-La/SSB antibodies are associated with adverse IVF and pregnancy outcomes.

Anti-Ro/SSA and/or anti-La/SSB antibodies (anti-SSA/SSB) were reported to increase the risk of recurrent pregnancy loss. However, the effects of anti-SSA/SSB antibodies on in-vitro fertilization (IVF) and pregnancy outcomes were still unclear. The purpose of the study was to determine whether anti-SSA/SSB antibodies were detrimental to IVF and pregnancy outcomes. This study included 55 anti-SSA/SSB antibodies-positive women and 61 anti-SSA/SSB antibodies-negative control women receiving gonadotropin-releasing hormone (GnRH) agonist long protocol (n = 30 and 39, respectively) or GnRH antagonist protocol (n = 25 and 22, respectively) for in-vitro fertilization and embryo transfer (IVF-ET). The impact of anti-SSA/SSB antibodies on immune-related indicators, fertilization, embryo development and pregnancy outcomes were analyzed. With either GnRH agonist or antagonist protocol, women with anti-SSA/SSB had higher levels of peripheral blood cytokines, including TNF-α and IL-17A, lower levels of peripheral blood Th and NK cells, and poor IVF outcomes, including lower number of retrieved oocytes and embryos, lower M II oocytes rate, blastocyst formation rate, and perfect and available embryo rates. Moreover, clinical pregnancy rate, implantation rate, take-home baby rate, and birth weight were significantly lower in the study group as compared with those of the control group. In conclusion, women with anti-SSA/SSB are associated with adverse IVF and pregnancy outcomes. Screening for these antibodies and proper counselling of couples undergoing IVF-ET should be considered. Underlying immunopathology associated with SSA/SSB antibodies and reproduction should be explored further.

Insulin Resistance Adversely Affect IVF Outcomes in Lean Women Without PCOS.

Objective: To investigate the effects of insulin resistance (IR) on IVF outcomes and a potential underlying mechanism in lean women without PCOS. Design: A prospective cohort study at the University Clinic. Setting: IVF center at the University setting. Patients: A total of 155 lean women (body mass index <25) without PCOS undergoing IVF cycle. Intervention: Patients were allocated to IR and non-IR groups based on HOMA-M120. Main Outcome Measures: IVF outcomes, including egg quality, the percentage of mature oocytes, fertilization rate, blastocyst formation rate, advanced embryo rate, and cumulative live birth rate were investigated. Auto-immune parameters, peripheral blood immunophenotypes, thyroid hormone, homocysteine, and 25-OH-vitamin D3 (25-OH-VD3) levels were analyzed. Results: The percentage of mature oocytes and blastocyst formation rate were significantly lower in the IR group as compared with those of the non-IR group (p<0.05, respectively). The proportion of peripheral blood CD19+ B cells was significantly higher in the IR group than those of the non-IR group (p<0.05). Homocysteine, 25-OH-VD3, and auto-immune parameters were the same between the two groups. Conclusion: In lean infertile women without PCOS, IR is associated with the decreased percentage of mature eggs and poor embryo quality in which B cell immunity may play a role.

NLRP3 Inflammasome and Its Critical Role in Gynecological Disorders and Obstetrical Complications.

Inflammasomes, intracellular, multimeric protein complexes, are assembled when damage signals stimulate nucleotide-binding oligomerization domain receptors (NLRs). Several inflammasomes have been reported, including the NOD-, LRR- and pyrin domain-containing protein 3 (NLRP3), NLRP1, NLRP7, ice protease-activating factor (IPAF), absent in melanoma 2 (AIM2) and NLR family CARD domain-containing protein 4 (NLRC4). Among these inflammasomes, the NLRP3 inflammasome is the most well-studied in terms of structure and function. Unlike other inflammasomes that can only be activated by a finite number of pathogenic microorganisms, the NLRP3 inflammasome can be activated by the imbalance of the internal environment and a large number of metabolites. The biochemical function of NLRP3 inflammasome is to activate cysteine-requiring aspartate proteinase-1 (caspase-1), which converts pro-IL-1ß and pro-IL-18 into their active forms, namely, IL-1ß and IL-18, which are then released into the extracellular space. The well-established, classic role of NLRP3 inflammasome has been implicated in many disorders. In this review, we discuss the current understanding of NLRP3 inflammasome and its critical role in gynecological disorders and obstetrical complications.