Antiphospholipid syndrome (APS) is a systemic autoimmune condition characterized by the persistent presence of antiphospholipid antibodies (aPL), and is commonly associated with thrombosis and pregnancy-related complications. To date, relatively little is known about the potential of NK cells in mediating the pathological effects of APS. While the role of NK cells in controlling immune responses and maintaining tissue homeostasis is relatively clear, the fact that they are also linked to various autoimmune conditions is now being highlighted. Given the impact of NK cells on immune regulation, vascular function, and pregnancy outcomes, the unifying message of a critical role for NK cells in APS emerges. As innate immune cells, NK cells might be activated in an antibody dependent manner and exert antibody-dependent cellular cytotoxicity (ADCC). In this process, NK cells recognize and bind to the Fc portion of antibodies that have attached to target cells. With their immunoregulatory properties in the uterus, NK cells play a crucial role in facilitating endometrial tissue remodeling, supporting vascular function, and contributing to placental formation, all of which are essential for a successful pregnancy. In APS, the presence of aPL may disrupt the delicate balance of NK cell-mediated immune regulation leading to alterations in cell activation, cytokine production, and cytotoxic functions. Given the multifactorial nature of NK cells in peripheral blood and uterus, the review provides insight into the potential underlying mechanisms through which NK cells may contribute to thrombosis and pregnancy complications in APS.

• Klíčová slova
• NK cells, antiphospholipid antibodies, antiphospholipid syndrome, peripheral blood, placenta,
• MeSH
• antifosfolipidové protilátky imunologie   MeSH
• antifosfolipidový syndrom * imunologie   metabolismus   MeSH
• buněčná cytotoxicita závislá na protilátkách MeSH
• buňky NK * imunologie   metabolismus   MeSH
• komplikace těhotenství imunologie   MeSH
• lidé MeSH
• těhotenství MeSH
• trombóza imunologie   MeSH
• zvířata MeSH
• Check Tag
• lidé MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH
• Názvy látek
• antifosfolipidové protilátky MeSH

Recurrent pregnancy loss (RPL) is defined as the occurrence of two or more consecutive pregnancy losses before 24 weeks of gestation. It affects 3-5% of women who are attempting to conceive. RPL can stem from a variety of causes and is frequently associated with psychological distress and a diminished quality of life. By contrast, recurrent implantation failure (RIF) refers to the inability to achieve a successful pregnancy after three or more high-quality embryo transfers or at least two instances of egg donation. RIF shares several causative factors with RPL. The immunological underpinnings of these conditions involve alterations in uterine NK cells, reductions in M2 macrophages and myeloid-derived suppressor cells, an increased Th1/Th2 ratio, a decreased Treg/Th17 ratio, the presence of shared ≥3 HLA alleles between partners, and autoimmune disorders. Various therapeutic approaches have been employed to address these immunological concerns, achieving varying degrees of success, although some therapies remain contentious within the medical community. This review intends to explore the immunological factors implicated in RPL and RIF and to analyze the immunological treatments employed for these conditions, which may include steroids, intravenous immunoglobulins, calcineurin inhibitors, anti-TNF antibodies, intralipid infusions, granulocyte colony-stimulating factor, and lymphocyte immunotherapy.

• Klíčová slova
• HLA, NK cells, T regulatory cells, Th1, Th17, Th2, cytokines, macrophages, recurrent implantation failure, recurrent pregnancy loss,
• MeSH
• habituální potrat * imunologie   terapie   MeSH
• implantace embrya * imunologie   MeSH
• imunoterapie metody   MeSH
• lidé MeSH
• těhotenství MeSH
• Check Tag
• lidé MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH