ABSTRACT
The most widely recognized clinical manifestation of failures in development of maternal immune tolerance for conceptuses is idiopathic recurrent pregnancy loss. Immunological testing is equally justified in cases where diagnosed or strongly suspected inflammatory or autoimmune conditions are present, which may lead to a failure in the proper generation of maternal immune tolerance for paternal antigens and are known to be associated with various forms of reproductive failure. Several mechanisms may lead to failure of one or more of the steps involved in immune tolerance and result in an inability of the maternal immune system to properly develop or maintain tolerance for paternal antigens present on a conceptus. Genetic predispositions have been identified for almost all known autoimmune conditions which largely cluster within the major histocompatibility/human leukocyte antigens region of chromosome 6. Elevated serum levels of proinflammatory cytokines are found in patients with autoimmune and inflammatory conditions and are also found in patients with a history of recurrent miscarriage.
