Current Insights and Future Perspectives on Neuro-Endocrine-Immune Circuity Challenging Pregnancy Maintenance and Fetal Health

Journal für Reproduktionsmedizin und Endokrinologie - Journal of Reproductive Medicine and Endocrinology 2006; 3 (2): 98-102

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Keywords: Dendriten,  Entzündung,  Schwangerschaft,  Stress,  dendritic cells,  HPA axis,  inflammation,  pregnancy,  Stress

Maternal stress perception has long been suspected as a possible cause of infertility, implantation failure, late pregnancy complications, and impaired fetal development, notions that exist since ancient times and across all cultures. In view of the enormous complexity of the regulatory nervous, endocrine, and immune mechanisms involved in pregnancy maintenance, it is evident that pregnancy failure is not a single entity condition, but most likely the result of complex dysregulation. This dysregulation can be initiated or aggravated by stress. Here, we review the effects of stress on the equilibrium of the nervous, endocrine, and immune systems and summarise relevant general principles of neuro-immune and endocrine-immune cross talk in the context of pregnancy and fetal tolerance. While there are still more questions than answers, the neuroendocrine- immune circuitry of the stress response during pregnancy is becoming increasingly defined, e. g. due to the development of particularly instructive rodent models and prospectively designed human cohort trials. Our goal is to prompt clinicians to become far more attentive to the effect of psychological stress on pregnancy complications. Together with basic science research elucidating hierarchical, temporal, and spatial interactions of key parameters during central and peripheral responses to psychological stress, a list of candidate molecular targets for clinically useful therapeutic intervention can then be created.