Pregnancy has fascinated immunologists ever since Peter Medawar's observation that reproduction runs contrary to the founding tenets of immunology. During healthy pregnancy, maternal B cells interact with antigens of the foreign conceptus (placenta and fetus) yet do not elicit rejection. Instead, robust, and redundant fetomaternal tolerance pathways generally prevent maternal B cells and antibodies from harming the placenta and fetus. Fetomaternal tolerance is not absolute, and unfortunately there exist several pregnancy complications that arise from breaks therein. Here, important historic and recent developments in the field of fetomaternal tolerance pertaining to maternal B cells and antibodies are reviewed. General rules from which to conceptualize humoral tolerance to the placenta and fetus are proposed. Significant but underexplored ideas are highlighted and topics for future research are suggested, findings from which are predicted to provide insight into the fundamental nature of tolerance and bolster efforts to combat immune-mediated pregnancy complications.

中文翻译：

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B 细胞对胎盘和胎儿的反应


自从 Peter Medawar 观察到生殖与免疫学的基本原则背道而驰以来，怀孕就一直让免疫学家着迷。在健康妊娠期间，母体 B 细胞与外来概念（胎盘和胎儿）的抗原相互作用，但不引起排斥反应。相反，稳健且冗余的胎母耐受通路通常会阻止母体 B 细胞和抗体伤害胎盘和胎儿。胎母耐受性不是绝对的，不幸的是，胎胎耐受性的破裂会导致几种妊娠并发症。在这里，回顾了与母体 B 细胞和抗体有关的胎母耐受性领域的重要历史和最新发展。提出了概念化体液对胎盘和胎儿耐受性的一般规则。强调了重要但未被充分探索的想法，并提出了未来研究的主题，预计其结果将提供对耐受性基本性质的见解，并加强对抗免疫介导的妊娠并发症的努力。