



 !
"#$%&!&
'()*
 !"#$%&'(#')*#(+!(,,(
A. La grossesse : un paradoxe immunologique.
)*****+,-" !')#',$+*!-(%.**/0,+%
+1*-*/+)****.*+*/'0(%" !','1"2 (%(/1/-+2(+*/3*
(&454%
(/1(**+6,+67**+)8+9:+/(),
/(9*/)66*$++),;%&66+6*1(+*)9*/(9%
*2*9/+9/++67****/*/6-<
:)/*,/.6-*;% +1*/-',$+*!-(%" !','1"2 (%
$"+&454++*/**=1/>2)*+*,-*
1-*+)(*+*-+++*/+.=%(+*-*=1--((9*+
**-)66/((/+.=%/-*/0+-,*
(+-%
$(//***6++*)**?++*--(/.)(++%*-/*
*/)66++),:++/*)9*(/(9;%&*/+
/+-+2=/+)66:/+;% +2/-/*-***(+-(/+)****
/*-***(+-/+/+-,*-+/66*%
<'
Plan
A. La grossesse : un paradoxe immunologique
B. Organisation de la réponse immunologique au cours de la grossesse
C. Les interfaces foeto-maternelle
D. Les cellules trophoblastiques
E. Les cellules immunitaires placentaires.
I. Les cellules natural killer (NK)
II. Les macrophages
III. Les cellules dendritiques
F. La tolérance foeto- maternelle
I. Anticorps cytotoxiques maternels
II. Les cellules T CD8+ cytotoxiques
III. Rôles des molécules HLA-G
IV.Les mécanismes d'immunosuppression
G. Conclusion

6+*(+**2(9**(**2/.1(+,-(9%*(9*2(9**
6+*****1-*
$(9/*,+**6+),%
$/19/*,.+2-+),/+9%
$&6+/9/,.+2*((2*,/**++6+:-.*(*+
61-1/12(9**(-/*;%
&++2-**-/67*(+.+%
*+*-*(+*2*9/+9*
*)9*(+*/67*
*)9*,*/+((/+/+((2%
*+*):)*6-1%%%;%
+-(**/-(*("1!'+*!-(/67*%
B. Organisation de la réponse immunologique au cours de la grossesse.
+2/->/--@*+*--**--.*+%.,*-(!#*?+/+0+-
:6-+**+6+;%
(/->+**67*?,.+/**(+-,.+/***
:(;+*=%.*/-+(+-,-+*-/*/+.+-%
C. les interfaces foeto-maternelles.
4/*9*,-*+(+-*+-/***61/***
+*-.*+/(-"/ *%3*4*,"4%.*-,+.+*-+++*/*2*9%*(*
6+9-*=*+*>*/--,*6+**6++/+>/
+,/,?/(+*/+/-/*+*%
<'

/-(+**6-*67$++*
A.6-*2-(+*$*(-++1*)++
A.6--:-2(+*1++1;$*(-++1*)++
ABCDEFGHIJKGLKMFNFHNOPNQRJSFGLGTFHJUDRRGVTLWGEXNUJSKVRJDHGYLZLSJE[LXGSLJHF\HGSLSODHJR]GSL^JFGHEGRRGSL
ABCDEFGHIJKGLKMFNFHNOPNQRJSFGLGTFHJUDRRGVTLWKGRRVRGSL[]JEFGS_LKGRRVRGSLORJKGEFJDHGSL[]JEFGSYL`LXGKDXVJL
QJSJRDSLWKCGSFLRGL^DRDGVLNaLDRLMLJLRGLSMSF\^GLD^^VEDFJDHGLORJKGEFJDHGYL
(NB : Le prof n'a pas énuméré l'ensemble de ces interfaces en cours, elles étaient sur la diapo donc je les ai
mises, mais l'essentiel à mon avis et de retenir qu'il y a des zones de contact entre le fœtus et la mère au niveau
du placenta)
D.Les cellules trophoblastiques.
*-+++*(+*,*b+=/*+6/(+-:b+(,c)*
/(+-?*(+-/*9**(+*%%%;%
&++***b+/*+%+$.'!4(%" !"#*"+(d*++**(**(-+**/*+
(*%.*)+-,.-+*-+++*(++*,(b+
//6*-/*)*()9+*,.++**(**(-+**/*+(*%
&++*1(8+*6-/*-(**:(-e+*)*1*;***
/*-(*-+++*:,**+-**-/.-/*-+,*;%*-(*
*(-+*+*567+**)+**/*-+++*/*2-2(+*
:*2-2(+*c*+/-+++*(+*,**,***+(6/*-++*
+-+*?+**2?6+*2-2(+*;//)****-*.+2/
-**-((//)****+2*,//.%
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-**-;%*,6-1*(**(*%
02(9*,6+(-(/-(9*,+*-+++*(+*,(**9/
/*%+$-(.#( +4%"!#+*-(,, ,*"+(4,6+/*-**+.2(*/-(*
*8-+8%
&668+*6-/*+*+1+26+=:6+-*+;,/*6-*/
/6**-+*-$)**+*%-*+*(+**1(/*-(*(*
+*-*:-(**;+****-**-*%
(+-(/*)+*-)**()9*/*-$)**-*1%
*-*-*+*0--9/(*(+*+*,+*-*()9*(9/*+
(+**-*(+*-+++*-/*/-+-/.(*
6+6-*%(*-+.)6-1+.)6-1*
)+-(+)****%
f<'

*,+*(+****++-*()6-1?+*(/*/*((/*$-*
:--+++(++;*,/*6-*-*-/*-8""'9"!(4(-+*
-+++*/*2*9:-+++*g?-()*;%*-+++*/-+b+/
*++%
:; Les cellules immunitaires placentaires.
/*-+++**(+-8+0/(*+*/.)**/.*-+++**
-*8+//%*+/-/*+*
)-(,, ,(4%<=%>?@AB
)-(,, ,(4%*-+'.8*1"2 (4%>C@AB
$-+++*//,*:h;
$-+++*:h;
$*:ih;
/*-*/+)****%*-+++*g(*jh//)****(*
/+)/+)****%
I. Les cellules natural killer.
:,,(4%4'!#%.+$4(!#(4%/*!4%,(%4*!1%.$+".8$+"2 (%* %!"D(* %/(4% 2 ( 4(4%> 2 ( 4(% #$+"!(B;%E %'(!#%
/(%,F".,*!#*#"'!%,(%!'3+(%/(4%-(,, ,(4%<=%D*%* 1(!#(+%+*."/((!#%.' +%*##("!/+(%?@A;%G(4%-(,, ,(4%
<=%/(%,*%/(-"/ *%3*4","4%'!#%/(4%4.$-"&"-"#$4%2 "%,(4%/"4#"!1 (!#%/(4%* #+(4%-(,, ,(4%<=%H
):,,(4%(0.+"(!#%&'+#((!#%,*%',$- ,(%GIJK;
-:,,(4%!(%4'!#%.*4%' %.( %-L#'#'0"2 (4%-'!#+*"+((!#%* 0%<=%-"+- ,*!#(4;
):,,(4%'!#% !(%&'+#(%*-#"D"#$%/(%.+'/ -#"'!%/(%-L#'9"!(4;
*-+++*g-/-(*,**-***% +*-**
-*/+-+*/k %*+-+**+*M6E):?M6E)NM6E)G;
BGSLKGRRVRGSLlmLVF]HDEGSLOGVUGEFLJUNDHLVELHnRGLONSDFDILJVLKNVHSLXGLRJL[HNSSGSSGoLpELGIIGF_LJVLKNVHSLXGLRJL
[HNSSGSSG_LGRRGSLOGH^GFFGEFLRGLX]UGRNOOG^GEFLXGLRJLUJSKVRJHDSJFDNELXVLORJKGEFJLWXCNaLRGVHLJOOJHDFDNELOH]KNKGLRNHS
XVLX]UGRNOOG^GEFLORJKGEFJDHGY_LGELOJHFDKDOJEFLqLRJLKH]JFDNELXGLUJDSSGJVTLSODHJR]SLrVDLINH^GEFLRCJTGLOHDEKDOJRLXGL
+*-+*(+-:))9*;%
-))9**+/*(+)*(+-*%.*(-+,+*g*6
(**//)****/+.(++*,+.))9*/(-
(+%
+1*-*)2(*/**(/*+*/*-(*/*-+++*g/*
-(* ,-**+*kk4$%+**,/.+$)(-,*.4"(*/*(
+/+*-+*/(+--(-*,-2(*(6+
(;%
s<'

II. Les macrophages.
.*+/19((+/-+++*(+-% +**-*-*/+)****% +**
(**/*+/-/*+*%
+*1(+GIKO%,*,/*-()*% +*1(**+GIPQ,*,*
/-2%*/-/*-+++*((2/%&++*(/**/-2t*6+
,+**-()*%
&++*(/*/*+-+**((***%6)P@?5NR)S?TN:C%:(*)+/*;?IU%:/+
/*12)*;%
b+*/-e+*+*)*%&++***b+/*+.))9*%&6+(+*
(++*b+/*,V$,""!*#"'!%/(4%-(,, ,(4%*.'.#'#"2 (4%
&66***/***@+29*1/++-+++/-**
-(/*-+++*%*-+++*((,*/-d2*(+*-()*%.+2
*/-()?*,/($-+(*%
&-*.+**(-*?+2*,/.%
III. Les cellules dendritiques.
*/*-+++*6+(**%/(+-?++**9*)9*%
&++**9*+)6+-(+%/*)
$+++*//,**:1(GIOW;
$+++*//,**1($ !g:+-;(CR : elle permet de produire de l'IL-10)
$+++*//,**1($:+(+*;
*-+++*+*,.++***(b+/.+$4(!#(+%,F*!#"1X!(%1+*%
uNVHLrVCDRLMLJDFLFNR]HJEKG_LDRLIJVFLrVGLRJL^JFVHJFDNELXGSLKGRRVRGSLXGEXHDFDrVGSLSNDFL+*,(!#"((/*-2t*
KN^^GLRCvBZwx_LRGLyz{Z|LNVLRGSLOHNSFJ[RJEXDEGSLp}oL~GSL^]XDJFGVHSLSNEFLHGFHNVU]SLGELJQNEXJEKGLXJESLRJL
/-/*+*%
F. la tolérance foeto-maternelle.
BNHSLXGLRJL[HNSSGSSG_LRGLI•FVSLWGFLRGSLKGRRVRGSLFHNOPNQRJSFDrVGSYLXNDFLIJDHGLIJKGLqL€LH]ONESGSLD^^VEDFJDHGSLXDHD[]GS
KNEFHGLRGSLJEFD[\EGSLOJFGHEGRSL•L
$6(4%*!#"-'+.4%-L#'#'0"2 (4%IDTJEFLRGLKN^OR]^GEFL
$6(4%-(,, ,(4%5%-L#'#'0"2 (4%
$6(4%-(,, ,(4%<=%
pELR‚JQSGEKGLXGLFNVFGLOJFPNRN[DGLNVLDEIGKFDNE_LRGLI•FVSLX]ƒNVGLRGSLXDII]HGEFGSL^GEJKGSLOJHLRJL^DSGLGELORJKGLXGL
XDII]HGEFSL^]KJEDS^GSL^NR]KVRJDHGSLOHNFGKFGVHS_LSO]KDIDrVGSLGFLFHJESDFNDHGS%
<'
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