Immunologic Methods Of Fertility Regulation

The no-man's-land between reproductive physiology and immunology is becoming crowded. The last 10 years have seen a revolution in our under standing of many reproductive processes, brought about by the application of ever more sophisticated immunological methods. The increasing precision of these techniques has given us specific ways of assaying, enhancing or blocking hormonal mechanisms to yield more critical and interpretable information. In this volume eleven authors have presented the current status and future prospects of some immunological aspects of reproduction and fertility con trol. These include the relationships between mother and fetus, the diagnosis of pregnancy, the immunological complications seen in clinical management of human reproduction and some novel approaches for immunological control of fertility. We hope that in these chapters we have achieved an up-to-date account of a fast-moving field that calls on several disciplines. We intend the book to provide an adequate background and a current review for research workers and clinicians who wish both to understand the complex mechanisms involved and to develop improved scientific and clinical methods. We hope too that the student and newcomer will find this a useful reference book.

The "contraceptive revolution" of the 1960s and 1970s introduced totally new contraceptive options and launched an era of research and product development. Yet by the late 1980s, conditions had changed and improvements in contraceptive products, while very important in relation to improved oral contraceptives, IUDs, implants, and injectables, had become primarily incremental. Is it time for a second contraceptive revolution and how might it happen? Contraceptive Research and Development explores the frontiers of science where the contraceptives of the future are likely to be found and lays out criteria for deciding where to make the next R&D investments. The book comprehensively examines today's contraceptive needs, identifies "niches" in those needs that seem most readily translatable into market terms, and scrutinizes issues that shape the market: method side effects and contraceptive failure, the challenge of HIV/AIDS and other sexually transmitted diseases, and the implications of the "women's agenda." Contraceptive Research and Development analyzes the response of the pharmaceutical industry to current dynamics in regulation, liability, public opinion, and the economics of the health sector and offers an integrated set of recommendations for public- and private-sector action to meet a whole new generation of demand.

Reproductive Immunology is a compilation of research articles presented during the VII International Congress of Reproductive Immunology which was held in New Delhi, India on 27-30 October 1998. The articles pertain to the following six major themes: Molecular and Immunological Aspects of Sperm-Egg Interaction Embryonic-Endometrial Cross-Talk Immunobiology of Pregnancy Autoantibodies and Infertility Immunocontraception Mucosal Immunology and Reproductive Tract Infections . The first section deals with our current understanding of various steps involved in fertilization. The functional significance of sperm surface mannosidase and glutathione S-transferases to bind zona pellucida is described. The role of zona pellucida glycoproteins in the binding of sperm, induction of acrosome reactions and avoidance of polyspermy is discussed. In the second section, the role of various cytokines, growth factors and immunomodulatory agents in implantation of embryos is described. In the field of reproductive immunology, one of the major issues is to explore the successful gestation of the histoincompatible fetus in the uterus of an immunologically competent mother. The Proceedings presents the issues of paternal antigens at the feto-maternal interface and shows that Th2-type of immunity is involved in normal successful conception. The role of membrane-bound and soluble HLA-G in protecting the fetus from the lytic activities of maternal uterine and peripheral blood natural killer (NK) cells is also presented. Nature's experiments suggest that antibodies against sperm-specific antigens are responsible for infertility in some women. The possibility that an immunogenetic background contributes to production of sperm-immobilizing antibodies in infertile women is discussed in the section on autoantibodies and infertility. The Proceedings presents the issue of Th1-type cytokines in inducing recurrent spontaneous abortions of unexplained etiology. The roles of β2-glycoprotein 1 (β2-GP1)-dependent anticardiolipin antibody, lupus anticoagulant, antiphospholipids, anti-thyroid antibody and anti-nuclear antibody in miscarriages are also described. The rising global human population, particularly in the developing countries, has driven the need for new and safer methods of contraception. Fertility regulation by vaccines is thus an interesting proposition. The section on contraceptive vaccines discusses the latest advances in this area and describes the current status of vaccines based on βhCG, sperm antigens, zona pellucida glycoproteins, and riboflavin carrier proteins. The issues of mucosal immunity and strategies for enhancing local genital immune responses to combat HIV infection is discussed. The role of inflammatory and related cytokines in chorioamnionitis is described. The contents of this Proceedings describes various facets of reproductive immunology which will help us to design strategies to combat genital infections and miscarriages caused by immunological etiology. Descriptions of the molecular basis of gamete recognition, implantation and survival of the allogenic fetus will help in designing strategies for overcoming infertility and also new contraceptive approaches. The Proceedings will be useful to researchers and clinicians involved in basic or applied research in the disciplines of reproductive biology, reproductive immunology, and obstetrics and gynecology.

Contraceptive research has entered the new age of vaccines. Realistic prospects exist for the development of an entirely new battery of vaccines for use in human and veterinary medicine. Among them may be anti-fertility vaccines, based on physiological mechanisms applicable to either the female or male. This volume is a comprehensive review - a status report - of the subjects including fundamental work on the search for useful epitopes and ranging to applied vaccinology. One vaccine to prevent pregnancy, for use by women, has already been studied extensively. G.P. Talwar, the volume's editor and his colleagues in New Oelhi, India, published in 1976 a landmark series of papers describing the immunological properties of a preparation consisting of the alum-precipitated beta-subunit of human chorionic gonadotropin (hCG) chemically linked to tetanus toxoid. The principle of enhancing antigenicity of a self-protein by linkage of the epitope to a carrier protein was employed and tested clinically. These trials, carried out under the auspices of the Indian Council for Medical Research, were the first application of the carrier protein concept for a vaccine for human use. The encouraging results stimulated a wave of research not only on the use of hCG-based vaccines, but on other antigens as well.

Now in its second edition, the Oxford Textbook of Endocrinology and Diabetes is a fully comprehensive, evidence-based, and highly-valued reference work combining basic science with clinical guidance, and providing first rate advice on diagnosis and treatment.