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Die Gynäkologie

Erschienen in:

23.08.2022 | Präeklampsie | Leitthema

Bedeutung natürlicher Killerzellen in der Frühschwangerschaft

verfasst von: Prof. Dr. Ruben-J. Kuon, Kilian Vomstein

Erschienen in: Die Gynäkologie | Ausgabe 9/2022

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Zusammenfassung

Hintergrund

Im Rahmen der Etablierung einer erfolgreichen Schwangerschaft nehmen natürliche Killerzellen (NK-Zellen) eine Schlüsselrolle ein. Sie kommen sowohl im peripheren Blut (periphere NK-Zellen) als auch im Endometrium und in der Dezidua (uterine NK-Zellen) vor.

Ziel

Der Beitrag soll einen Überblick über Herkunft, Funktion und Diagnostik von NK-Zellen geben sowie mögliche Therapieoptionen aufzeigen.

Ergebnisse

NK-Zellen unterscheiden sich maßgeblich in ihrer Zytotoxizität. Etwa 90 % der uterinen NK-Zellen zeigen eine niedrige Zytotoxizität bei hoher Zytokinproduktion, periphere NK-Zellen hingegen weisen eine hohe Zytotoxizität und eine niedrige Zytokinproduktion auf. Erhöhte uterine und periphere NK-Zellen werden mit Fehlgeburten, Hypertonie, Präeklampsie und fetaler Wachstumsrestriktion assoziiert.

Diskussion

Ein detailliertes Verständnis der einzelnen Mechanismen für Implantation und (Früh‑)Schwangerschaft ist von größter Bedeutung, um die Erfolgsraten reproduktionsmedizinischer Maßnahmen zu verbessern und Schwangerschaftskomplikationen zu verhindern. Es gibt eine zunehmende Anzahl an Studien zu immunmodulatorischen Therapien bei NK-Zellveränderungen, die v. a. den Einsatz von Kortikosteroiden, Lipidinfusionen und Immunglobulinen untersuchen. Jedoch sind die Studien in Design, Methodik, Intervention und Population sehr heterogen, was die Vergleichbarkeit und Interpretation, aber auch die Entwicklung evidenzbasierter Therapiestrategien erschwert.

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Titel: Bedeutung natürlicher Killerzellen in der Frühschwangerschaft
verfasst von: Prof. Dr. Ruben-J. Kuon
Kilian Vomstein
Publikationsdatum: 23.08.2022
Verlag: Springer Medizin
Schlagwort: Präeklampsie
Erschienen in: Die Gynäkologie / Ausgabe 9/2022
Print ISSN: 2731-7102
Elektronische ISSN: 2731-7110
DOI: https://doi.org/10.1007/s00129-022-04974-x

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Bedeutung natürlicher Killerzellen in der Frühschwangerschaft

Zusammenfassung

Hintergrund

Ziel

Ergebnisse

Diskussion

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