ABSTRACT
The endometrium is remarkable in two respects-firstly, in its capacity to undergo regular and extensive tissue growth, breakdown and repair and secondly, as a mucosal tissue called upon to discriminate between and respond appropriately to foreign agents as disparate as semen, the conceptus, and sexually transmitted pathogens. As a subset of the growth factor family, cytokines have essential roles in mediating the intercellular communication events governing leukocyte trafficking and activation and the induction of immune responses, as well as participating in tissue restructuring through targeting somatic cell lineages and cells in the preimplantation embryo and placenta (Figure 28.1). Thus cytokines are now implicated as pivotal agents in immunobiological and other physiological processes essential for normal endometrial function. Disruption or imbalance in the endometrial cytokine-leukocyte axis is proving to be a principal factor in the etiology of infertility, endometriosis and uterine bleeding disorders, and in diseases of pregnancy related to “shallow” placentation (Bulmer, 1992; Raghupathy, 1997; Conrad and Benyo, 1997; Rier and Yeaman, 1997).
