Energy metabolism and maternal-fetal tolerance working in decidualization

Front Immunol. 2023 Jun 19:14:1203719. doi: 10.3389/fimmu.2023.1203719. eCollection 2023.

Abstract

One pivotal aspect of early pregnancy is decidualization. The decidualization process includes two components: the differentiation of endometrial stromal cells to decidual stromal cells (DSCs), as well as the recruitment and education of decidual immune cells (DICs). At the maternal-fetal interface, stromal cells undergo morphological and phenotypic changes and interact with trophoblasts and DICs to provide an appropriate decidual bed and tolerogenic immune environment to maintain the survival of the semi-allogeneic fetus without causing immunological rejection. Despite classic endocrine mechanism by 17 β-estradiol and progesterone, metabolic regulations do take part in this process according to recent studies. And based on our previous research in maternal-fetal crosstalk, in this review, we elaborate mechanisms of decidualization, with a special focus on DSC profiles from aspects of metabolism and maternal-fetal tolerance to provide some new insights into endometrial decidualization in early pregnancy.

Keywords: decidual immune cells; decidual stromal cells; decidualization; energy metabolism; maternal-fetal crosstalk; trophoblast cells.

Publication types

  • Review
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Decidua* / metabolism
  • Endometrium* / metabolism
  • Energy Metabolism
  • Estradiol / metabolism
  • Female
  • Fetus / metabolism
  • Humans
  • Pregnancy

Substances

  • Estradiol

Grants and funding

This work was supported by grant from the Special Youth Project for Clinical Research in Health Industry of Shanghai Municipal Health Commission (20224Y0005 to SW), National Nature Science Foundation of China (NSFC) (82201852 to LYC, 82201855 to CC), and the Nature Science Foundation of Shanghai (21ZR1410500 to SW).