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Recent Insight into the Role of the PD‐1/PD‐L1 Pathway in Feto‐Maternal Tolerance and Pregnancy

Pregnancy presents a great challenge to the maternal immune system. Given that maternal alloreactive lymphocytes are not depleted during pregnancy, local and/or systemic mechanisms have to serve a central function in altering the maternal immune responses. Regulatory T cells (Tregs) and the PD‐1/PD‐L1 pathway are both critical in controlling the immune responses. Recent studies have proved the critical function of the PD‐1/PD‐L1 pathway in regulating the T‐cell homeostasis and the peripheral tolerance through promoting the development and function of Tregs, and inhibiting the activation of effector T cells. The function of the PD‐1/PD‐L1 pathway in feto‐maternal interface and pregnancy has been investigated in human and animal models of pregnancy. In this review, we provide recent insight into the role of the PD‐1/PD‐L1 pathway in regulating T‐cell homeostasis, maternal tolerance, and pregnancy‐related complications as well as its possible applicability in clinical immunotherapy.