Uterine natural killer cells

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SEM Lymphocyte

Uterine Natural Killer (uNK) cells are a type of immune cell found predominantly within the uterus. These cells play a crucial role in the early stages of pregnancy, particularly in the process of placenta formation and the establishment of the maternal-fetal interface. Unlike their counterparts in the blood, uNK cells are characterized by their unique ability to support rather than attack the developing fetus, making them an essential component of reproductive immunology.

Function[edit | edit source]

The primary function of uNK cells is to facilitate the remodeling of the uterine spiral arteries, which is critical for establishing adequate blood flow to the placenta. This process ensures that the fetus receives sufficient nutrients and oxygen necessary for growth. uNK cells achieve this by secreting a variety of cytokines and growth factors that promote blood vessel growth and modification. Additionally, uNK cells play a role in immune tolerance, helping the maternal immune system to recognize and accept the fetus, which carries paternal antigens.

Characteristics[edit | edit source]

Uterine Natural Killer cells are the most abundant leukocytes in the endometrium (the lining of the uterus) during the first trimester of pregnancy. They are distinct from peripheral blood NK cells in both their phenotype and function. uNK cells express a unique set of surface markers, including CD56bright and CD16-, which distinguishes them from the more cytotoxic CD56dimCD16+ NK cells found in the blood. Their reduced cytotoxicity is beneficial for the fetus, as it prevents damage to fetal cells and tissues.

Development and Regulation[edit | edit source]

The recruitment and proliferation of uNK cells in the uterus are regulated by hormonal changes associated with the menstrual cycle and early pregnancy, particularly by estrogen and progesterone. These hormones, along with signals from the developing placenta, influence the transformation of the endometrium to a state that is conducive to implantation and support of the pregnancy.

Clinical Significance[edit | edit source]

Abnormalities in the number or function of uNK cells have been associated with various reproductive complications, such as recurrent pregnancy loss, preeclampsia, and fetal growth restriction. Understanding the role of uNK cells in pregnancy has led to the exploration of new diagnostic and therapeutic approaches for these conditions. For instance, therapies aimed at modulating the activity of uNK cells are being investigated as potential treatments for women with a history of recurrent pregnancy loss.

Research Directions[edit | edit source]

Research on uNK cells continues to uncover their complex roles in pregnancy and their interactions with other cells at the maternal-fetal interface. Studies are also exploring the potential of uNK cells in regenerative medicine, given their ability to promote blood vessel growth and tissue repair.


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Contributors: Prab R. Tumpati, MD