A Review on the Potential Therapeutic Application of Macrophage Polarization in Recurrent Spontaneous Abortion; With an Emphasis on Natural Components

Abstract

Three or more consecutive spontaneous pregnancy losses are the hallmark of recurrent spontaneous abortion (RSA) as a complex challenge in reproductive health, requiring a comprehensive understanding of contributing factors. Since balanced immune responses are essential for a successful pregnancy. Disruptions in immune responses may be the cause of unfavorable pregnancy outcomes like RSA. Of Note, Following RSA, immunopathological assessment of the placental implantation site markedly showed decidual inflammation, leading to hypothesize that RSA is a pregnancy disorder with an inflammatory etiology. Thus, an in-depth knowledge of how immune cells contribute to inflammation, may lead to the discovery of the novel therapeutic approaches for the prevention and/or treatment of RSA. Numerous studies have investigated the relationships between RSA and different immune cells, including B cells, T cells, decidual dendritic cells, and macrophages. Macrophages are present at the fetomaternal interface throughout pregnancy, and they are beneficial to the processes of embryonic development, placental formation, embryo implantation, and delivery. Macrophages classified as typically activated (M1, with the inflammatory role), or alternatively activated (M2, characterized by the anti-inflammatory role). Plants have a rich supply of strong bioactive components that can polarize macrophages toward an M1 pro-inflammatory state or an M2 anti-inflammatory phenotype. This review focuses on the potential role of derived plant-natural components in influencing macrophage polarization resulting in the management treatment of RSA.