摘要：
目的：妊娠被认为是一种典型的免疫耐受状态，但是母体对表达父源抗原的胎儿组织产生选择性免疫耐受的机制，迄今尚未完全阐明。近年来，关于母胎界面免疫调控的研究持续增多，逐步揭示了免疫细胞在构建局部免疫耐受微环境中的潜在作用；胎盘滋养层细胞也被认为在调控母体免疫应答中发挥重要功能。然而，目前关于母胎免疫耐受的细胞协同模式、分子调控网络及其在妊娠各阶段动态建立与维持的机制尚不清晰。本文拟在整合现有证据基础上，系统梳理母胎免疫耐受的主要细胞与分子机制，展望未来发展与转化方向。

关键词：母胎免疫耐受；调节性T细胞；免疫检查点；蜕膜自然杀伤细胞；妊娠相关免疫并发症

Abstract:

Pregnancy is widely regarded as a physiological state of immune tolerance; however, the mechanisms by which the maternal immune system selectively tolerates fetal tissues expressing paternal antigens remain incompletely understood. In recent years, a growing body of research has focused on the immunoregulatory processes at the maternal–fetal interface, gradually uncovering the pivotal roles of immune cells in shaping a localized immune-tolerant microenvironment. Placental trophoblasts have also been implicated as active participants in modulating maternal immune responses. Despite these advances, the cellular crosstalk, regulatory molecular networks, and dynamic mechanisms underlying the establishment and maintenance of maternal–fetal immune tolerance throughout gestation remain to be fully elucidated. This review aims to systematically summarize the current understanding of key cellular and molecular mechanisms involved in maternal–fetal immune tolerance and to discuss future directions and translational prospects in this emerging field.

Keywords: Maternal fetal immune tolerance; Regulatory T cells; Immune checkpoint; Decidual natural killer cells; Pregnancy related immune complications

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