IMUNOLOGI REPRODUKSI

REPRODUKSI

PUTRI NELLY SYOFIAH 1520332009

FETAL FET AL ALLOGRAFT Mediator seller Mediator !" da#at lart  $ari res#o% #ada ra%" a%tar i& da% 'a%i%(

IMUNOENDOKRINOLOGI IMPLANTASI NORMAL  

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Setela) *ertilisasi &era+)ir( Per,laa%-a.al #e,&ela)a% ,itosis &er)asil( /o%se#ts !" ter&%"+s o%a #elsida ,e,erl+a% .a+t  )ari %t+ ,eli%tasi t&a *alo#ii  sa,#ai +e ters dala, &e%t+ &lastosis #rai,#la%tasi( lastosis 4 ,assa sel e,&rio%i+ !" +isti+ da% ato%o,(

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1 15

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22

Haid tera+)ir

O6lasi Fertilisasi

Mas+ +a6(te ri

Nidasi

25

H78 :; <10 ,IU-,l

29

32

US8 :; <00 ,IU-,l

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< 1=00 ,IU-,l

Pe%!s+a%i,#la%tasi; &lastosis diatr ole) i%tera+si r,it a%tara #e#tida )or,o% steroid !a%" ,e%!elaras+a% #ersia#a% e%do,etri, de%"a% #er+e,&a%"a% e,&rio( Se+resi #ro"estero% ole) +or#s lte, ,er#a+a% +o,#o%e% ta,a &a"i i%tera+si i%i> !a%" di#erl+a% %t+ #e,eli)araa% da% #er+e,&a%"a% desida(

EARLY PLACENTATION

8o%adotro#i% +orio%i+ ,a%sia (human chorionic gonadotropin,hCG ) dise+resi+a% ole) 'ari%"a% e,&rio%i+ ,e%'ela%" )ari #erta,a setela) i,#la%tasi da% &erta%""%" 'a.a& &a"i #e%"&a)a% +or#s lte, si+ls )aid ,e%'adi +or#s lte, +e)a,ila%( /o%se#ts di%i &ert"as ,e%d+%" se+resi progesteron ovarium !a%" di#erl+a% &a"i +eta)a%a% )id#%!a se%diri(

Lanjutan … Pro"estero% @ 1; Perta,a di)asil+a% ole) o6ari, +e,dia% ole) #lase%ta( 2; U +eta)a%a% )id# +o%se#ts 3; Me,eli)ara e%do,etri, +e)a,ila% !" dise&t desida( ; I,%os#resi* 4 #ada #er,+aa% #e,isa) (interface) ,ater%al*etal  sat ,e+a%is,e di,a%a #ro"estero% ,e%d+%" +e)a,ila% ,elali +e,a,#a%%!a ,e%"atr sito+i%( 

5)

Lanjutan … Pada saat i,#la%tasi desida &erisi &a%!a+ lekosit ter,as+ sel!T da% "ak#o$a% iolo"i selT +lasi+ ter*o+s #ada sel%Ta& !a%" sa%"at ada#ti*( Selsel it terda#at #ada desida ,ater%al> ta#i ',la) sel sel T sa%"at re%da) da% e%dr%" &er,i"rasi dari ters #ada a.al +e)a,ila%( Pada desida ,ater%al tela) diatat ars ,as+ i%B+s; sel sel T !a%" relati* &ar !ait sel sel T"d i%i e%dr%" le&i) re%da) dari #ada sel sel Ta& se)i%""a ,e%'adi &arisa% !a%" le&i) #ri,iti* dari #ada sel sel Ta&( F%"si sel sel T terse&t &el, di+eta)i> did"a ,e%e"a) #e%"ar) #e%"ar) si,#a%" i%*e+si 6irs ter)ada# sel sel desida ,ater%al( Pera% sel sel T dala, ,e%d+%" +e)a,ila% &el, 'elas(

Prod+#rod+ sito+i% ,er#a+a% #era%tara &a"i &a%!a+ i%tera+si i%i#roses +e)a,ila%;( Mis( Fa+tor #ert,&)a% epidermal(epidermal growth factor,EGF ) da% rese#tor%!a !a%" ta,#ila%%!a &er"a%t%" estro"e% #ada ters ti+s( Rese#tor E8F tela) di+e%ali #ada &lasto+is #ra i,#la%tasi da% #ada &ia+a% e,&rio in vitro. EGF ,era%sa%" #er+e,&a%"a% &lasto+is se)i%""a ter+esa% ada%!a i%tera+si li"a% rese#tor *%"sio%al &a"i E8F sela,a #eristi.a #rai,#la%tasi

Fa+tor #era%sa%" +olo%i  colony-stimulating factor,CSF; dari sito+i%( Fa+tor #era%sa%" +olo%i "ra%losit,a+ro*a" granulocyte-macrophage colonystimulating factor, GM-CSF ; ( I%terle+i%3IL-3; serta rese#tor *,s &a"i 7SF1 tela) di+e%ali #ada #lase%ta da% desida ti+s serta dereta% selsel desida #lase%ta ,a%sia( Se,a sito+i% terse&t ,e%"&a) si*atsi*at ,e,&ra% &lasto+is dala, #ersia#a%%!a %t+ i,#la%tasi

Se&el, i,#la%tasi > o%a #elsida )ars dilr)+a% ( el, 'elas a#a+a) e%i, &a"i de"radasi o%a #elsida &erasal dari e,&rio ata e%do,etri, ( Fa+tor #e%")a,&at le+i,ia sitokin&leukimia inhibitory factor,LIF; ters di&t)+a% %t+ #erle+ata% da% i,#la%tasi &lasto+is +e dala, e%do,etri,(  Ti+s &eti%a ta,#a "e% LIF !a%" &er*%"si ter%!ata teta# *ertil> teta#i &lasto+is%!a "a"al i,#la%tasi da% &er+e,&a%"( Na,% de,i+ia% +o%se#ts it sa%"at ,a,# )id#> da#at dita%drali)+a% +e&eti%a +o%trol> da% da#at &eri,#la%tasi serta &er+e,&a%" seara %or,al(

Sito+i%sito+i% lai% !a%" dise+resi+a% ole) sel selT desida da% ,a+ro*a" da#at ,e,da)+a% ata ,e%")ala%"i #eristi.a i,#la%tasi( /a'ia%+a'ia% i% 6itro 4 ,e,#erli)at+a% &a).a IL!'( ,e%")a,&at #erle+ata% &lasto+is ti+s teta#i ,e,#er+at #ert,&)a% +elar tro*o&las(

I%ter*ero% "a,,a  IF-! )* ,e%")a,&at #ert,&)a% +elar tro*o&las da% ,e%!e&a&+a% #er&a)a% de"e%erati* #ada selsel i%i /eadaa% terse&t ,e,#erli)at+a% &a).a i,#la%tasi da% #er+e,&a%"a% e,&rio diatr ole) 4 1('e%is'e%is sito+i%( 2( Saat se+resi%!a 3( C,la) relati*%!a(

Plasenta Se+a%ai O#%an I"unoen,ok#in  

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2( 3(

Plase%ta4 or"a% !" %i+ da% &er,r #e%de+ /er'a4 ,e%")asil+a% )or,o% steroid> #rotei% ,e%"atr a+tiDtas Dsiolo"is +e)a,ila%( Se&a"ai4 #ar> "i%'al> ss> )ati &a"i 'a%i%(  Cari%"a% +o,#le+s !" &er*%"si se&a"ai i,%olo"is( 

T#o$o+las 

La#isa% si%sitiotro*o&las ,lti%+lear #lase%ta &e+er'a se&a"ai  &%"+s  &a"i 'a%i%  &erti%da+ se&a"ai sa.ar t)d ,e+a%is,e e*e+tor i,% ,ater%al( Me%se+resi+a% sito+i% !" terta,a ter+ait d" *a"osit ,o%o%+lear> s#t4 7SF1 da% rese#tor%!a *,s> IL3 da% 8M 7SF( Se+a%ai "ak#o$a%> tro*o&las ,e%a,#il+a% rese#tor LIF dala, +adar ti%""i  &er+e,a,#a% @ *a"ositosis> si%sitialisasi> ,e%a,#il+a%4FR>7$ da% 7$1( Res#o%si* ter)ada#4 TNF> IL1> TGF-ß(transforming growth factor eta; da% IL  $" te,a% i%i se,a ,a+a tro*o&las ,e.a+ili se&a"aia%  'ali%a% 'ari%"a% ,iri# ,a+ro*a" !" terse&ar diselr) t&) !" &er&a"i 'alr sito+i% ,,( 

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Pa,a Ke-a"ilan No#"al…

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1(

Prod+si sito+i% T)2 &ert+ar d" se',la) +esa# IL!'.( Pada A&orts s#o%ta% &erla%" @ sel sel T desida ,ater%al da% sel sel ,o%osit dara) tera+ti*+a% ,ito"e%,ito"e% ati6ated &lood ,o%o%lear ellPM7; "enu#unkan ta"/ilan IL! '.0 Res#o% i,% T)2 +e a%ti"e% #lase%ta da% tro*o&las &er+ra%"( 

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IL10 ser,@ 3(  '"a &er+ra%" #ada PE ( Sito+i% a%tirada%" #e%ti%" !" &er#era%a% #ada lara% +e)a,ila%(

IL!'. /a,a ke-a"ilan… 

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$i)asil+a% seara lo+al #ada %it *eto#lase%ta ole) tro*o&las( Me%"atr ta,#ila% a%ti"e% le+osit ,a%sia HLA;8 dari sitotro*o&last #ada sa.ar *eto,ater%al se)i%""a ,eli%d%"i 'a%i% dari #e%ola+a%( er+)asiat ,odlatori+ !" #e%ti%" t)d sito+i% #rorada%"> +)ss%!a4 IFN!1 ,an TNF!2  "+% "e#u%ikan +a%i unit $eto/lasenta /, tikus0 $a% TNF! 1 !" ti%""i dite,+a% #d  AS( "anusia0 

Prod+si IL10 ,a%sia &erada di&a.a) +e%dali "e%eti+( Pada IL10 !" ti%""i  Ade%i% A; #d sisi 10=2 dire"io #e%"a' dari "e% IL10 ter+ait de%"a% 8a%i%8; !a%" re%da)( 

I"unosu/#esi Lokal ,i Plasenta ,an  3a#in%an Te#,ekatn4a  

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I,%itas !" di#era%tai ole) sel #ada +e)a,ila%( Sela,a +e)a,ila% res#o% i,% ,ater%al di)ati da% li,#a tida+ di"a%""> ,es+i ada i%*e+si #lase%ta !" )e&at( Pada #lase%ta dite,+a% i%Dltrat rada%" !" &esar #d desida ,ater%al> seda%"+a% #d s#o%"iotro*o&last 'a%i% da% la#isa% la&iri% #lase%ta ti+s tida+ ada res#o% rada%"> ,es+i ada se',la) &esar &a+teri(  Cadi #eristi.a lo+al #d #er,+aa% #e,isa) ,ater%al*etal ,e%e"a) res#o% i,% !" e*e+ti* da% le&i) 'a) #lase%ta !" teri%*e+si it da#at ,e%i,&l+a% +)asiat &r+  o+ ,e%!edia+a% li%"+%"a% !" terli%d%" &a"i #arasit i%traseller> +e,dia% da#at ,e%!a,ai or"a%2 ,ater%al da% 'a%i% lai%%!a( /e+ra%"a% lo+al %!ata lai% #ada *%"si ,a+ro*a" di#lase%ta> !" tida+ &erta%""%" 'a.a& atas +e+ra%"a% re"io%al #ada sito+i% #e%"a+ti* ,a+ro*a" da% '"a tida+ atas #rod+sii,%os#resi* tro*o&last( 

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Reakti$asi Li"$osit 4an% "enu#un se5a#a Int#insik ,ala" Ke-a"ilan0 

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+ti +li%is i,%itas seller !" ,e%r%-terte+a% sela,a +e)a,ila% ,asi) di#erde&at+a% ( Per&edaa% #e%da#at te%ta%" @ ',la)> se&ara% da% rea+tiDtas sel T(  Terda#at @ #e%r%a% selsel 7$ da% #e%i%"+ata% sel sel 7$=> terda#at aat sitoto+si+ dari sel sel #e,&%) ala,i (!"-cell). Res#o% li,*osit ter)ada# ,ito"e% i%6itro +# &era"a,@ dari seda%"> terte+a% seara &er,a"%a> ta+ &er&a)( Pada +eadaa% +o%disi !" ,e%r% se#erti4 ,al%trisi>> i%*e+si  i%6olsi ti,s da% #e%i%"+ata% +adar +orti+osteroid #las,a  I,%itas sel  tida+ &er&a) seara &er,a+%a sela,a +e)a,ila%( 

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R'+a% @ 7arol!% (7ola,>M($ I,%olo"! O&stetri