[fr] Les troubles hypertensifs de la grossesse (THG) représentent globalement 10 % des naissances humaines, et leur complication majeure, la prééclampsie, 3 à 5 %. L’étiologie de ces THG reste toujours controversée ; cependant des avancées majeures ont eu lieu ces dernieres 25 années. Le « sixième colloque international d’immunologie de la reproduction, de l’immunotolérance et de l’immunologie de la prééclampsie » 2008 a fêté cette année son dixième anniversaire. Durant cette décennie, ces six colloques bisannuels ont largement contribué à nourrir le débat entre immunologistes, cliniciens, anthropologues et spécialistes des maladies cardiovasculaires. Le défaut de l’invasion trophoblastique profonde obligatoire chez les humains rencontrée dans la prééclampsie, le retard de croissance intra-utérin, et dans une certaine mesure dans la menace d’accouchement prématuré n’ont été compris qu’à la fin des années 1970. Dans le même temps, des études cliniques et épidémiologiques à la fin du xxe siècle ont permis de réaliser que la prééclampsie « maladie des primipares » pouvait en fait être une maladie de la première grossesse au niveau d’un couple. Parmi les avancées significatives, l’immunologie de la reproduction a fait des bonds de géant dans la dernière décennie. Ce papier relate les étapes majeures franchies dans la compréhension de cette pathologie et met en lumière l’intérêt de ces travaux immunologiques et des nouveaux concepts afférents. Il semble, en ce début de xxie siècle que nous soyons plus près que jamais de comprendre l’étiologie de cette énigme obstétricale. Dans ce domaine, l’immunologie de la reproduction sera sans doute un des interlocuteurs majeurs. [en] Hypertensive disorders of pregnancy (HDP) represent globally 10% of human births and their major complication, preeclampsia, 3 to 5%. The etiology of these HDP remains still uncertain, however major advances have been made these last 25 years. The Sixth International Workshop on Reproductive Immunology, Immunological Tolerance and Immunology of Preeclampsia 2008 celebrated its 10th Anniversary in Reunion-island (French overseas Department in the Indian Ocean). Over this decade, these six workshops have contributed extensively to immunological, epidemiological, anthropological and even vascular debates. The defect of trophoblastic invasion encountered in preeclampsia, intra-uterine growth retardation and to some extend also preterm labour has been understood only at the end of the 1970's. On the other hand, clinical and epidemiological findings at the end of the 20th century permitted to apprehend that “preeclampsia disease of primiparae” may in fact well be the disease of first pregnancies at the level of human couples. Among the important advances, immunology of reproduction is certainly the topic where knowledge has literally exploded in the last decade. This paper relates some major steps in comprehension of this disease and focuses on the interest to follow these immunological works and their new concepts. It seems, at the beginning of the 21st century, that we are possibly closer than ever to understand the etiology of this obstetrical enigma. In this quest, the immunology of reproduction will certainly come out as one of the main players.
Disciplines :
Reproductive medicine (gynecology, andrology, obstetrics)
Author, co-author :
Robillard, P. Y.
Chaouat, G.
Le Bouteiller, P.
Fournier, T.
Barau, G.
Roman, h
Heisert, M.
Dekker, G.
Hulsey, T. C.
Vaiman, D.
Foidart, Jean-Michel ; Université de Liège - ULiège > Département des sciences cliniques > Gynécologie - Obstétrique - Labo de biologie des tumeurs et du développement
Boukerrou, M.
Language :
French
Title :
Débats actuels sur l'immunologie de la prééclampsie. Comptes rendus du sixième colloque international de La Réunion (décembre 2008)
Alternative titles :
[en] Current debates on immunology of preeclampsia. Report of the sixth international workshop of Reunion Island (Indian Ocean, December 2008)
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