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Decidual macrophages (DMs) are critical regulators at the maternal\u2013fetal interface, involved in trophoblast invasion, vascular remodeling, and immune modulation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This review integrates findings from human studies, animal models, and in vitro experiments to explore how arginine metabolism regulates macrophage polarization and pregnancy outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Arginine metabolism influences DM function via two major pathways: iNOS promotes M1 polarization and pro\u2010inflammatory activity, while Arg\u20101 supports M2 polarization, tissue remodeling, and immune tolerance. Dysregulation of this balance is associated with pregnancy complications such as pre\u2010eclampsia and fetal growth restriction. Pathogens like\n                      <jats:bold>\n                        <jats:italic>Helicobacter pylori<\/jats:italic>\n                      <\/jats:bold>\n                      and\n                      <jats:bold>\n                        <jats:italic>Mycobacterium tuberculosis<\/jats:italic>\n                      <\/jats:bold>\n                      exploit Arg\u20101 activity to evade host immunity. Clinical studies also suggest that L\u2010arginine supplementation can improve placental function and fetal growth.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Arginine metabolism is a key modulator of macrophage polarization and immune balance in pregnancy. Targeting this pathway may offer novel therapeutic strategies to improve maternal and fetal outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/aji.70196","type":"journal-article","created":{"date-parts":[[2025,12,17]],"date-time":"2025-12-17T12:48:38Z","timestamp":1765975718000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Arginine Metabolism in Decidual Macrophages During Pregnancy"],"prefix":"10.1111","volume":"94","author":[{"given":"Yonghong","family":"Zhang","sequence":"first","affiliation":[{"name":"Center For Reproductive Medicine and Obstetrics and Gynecology Nanjing Drum Tower Hospital The Affiliated Hospital of Nanjing University Medical School  Nanjing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jie","family":"Mei","sequence":"additional","affiliation":[{"name":"Center For Reproductive Medicine and Obstetrics and Gynecology Nanjing Drum Tower Hospital The 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