{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T13:14:31Z","timestamp":1792588471962,"version":"4.5.0"},"reference-count":112,"publisher":"Walter de Gruyter GmbH","issue":"3","license":[{"start":{"date-parts":[[2025,10,3]],"date-time":"2025-10-03T00:00:00Z","timestamp":1759449600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,3,26]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"j_jpm-2025-0246_abs_001\">\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Pregnancy poses an immunological paradox: the maternal immune system must tolerate a semi-allogeneic fetus while maintaining defense against infections. Rather than being an immunosuppressed state, gestation is now recognized as a dynamic, highly regulated immune condition.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_jpm-2025-0246_abs_002\">\n                    <jats:title>Content<\/jats:title>\n                    <jats:p>This review applies the cancer-derived immunoediting framework \u2013 elimination, equilibrium, and escape \u2013 to maternal\u2013fetal immune tolerance. We examine how immune checkpoints, regulatory T cells, non-classical MHC molecules, and placental exosomes coordinate to create a localized tolerant environment. Integrating knowledge from oncology and reproductive immunology, this perspective provides a unifying concept for pregnancy immune regulation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_jpm-2025-0246_abs_003\">\n                    <jats:title>Summary<\/jats:title>\n                    <jats:p>The immunoediting framework reinterprets obstetric disorders such as preeclampsia, recurrent pregnancy loss, and preterm birth as failures of distinct immune phases rather than isolated pathologies. This conceptual shift allows for a broader understanding of how immune balance influences implantation, placental development, and fetal growth.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"j_jpm-2025-0246_abs_004\">\n                    <jats:title>Outlook<\/jats:title>\n                    <jats:p>Adopting an immunoediting perspective highlights potential clinical advances, including immune checkpoint modulation, regulatory T-cell therapies, and exosome-based biomarkers, paving the way for innovative diagnostic and therapeutic strategies in pregnancy care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1515\/jpm-2025-0246","type":"journal-article","created":{"date-parts":[[2025,10,3]],"date-time":"2025-10-03T06:56:22Z","timestamp":1759474582000},"page":"437-454","source":"Crossref","is-referenced-by-count":14,"title":["Immunoediting in pregnancy: a new paradigm for understanding fetal tolerance and obstetric disease"],"prefix":"10.1515","volume":"54","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1710-3909","authenticated-orcid":false,"given":"Muhammad Adrianes","family":"Bachnas","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, Fetomaternal Division , Medical Faculty of Sebelas Maret University, Dr. Moewardi Hospital , Surakarta , Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9062-8501","authenticated-orcid":false,"given":"Wiku","family":"Andonotopo","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Fetomaternal Division , Women Health Center, Ekahospital BSD City , Tangerang , Banten , Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julian","family":"Dewantiningrum","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Fetomaternal Division , Medical Faculty of Diponegoro University, Dr. Kariadi Hospital , Semarang , Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mochammad Besari Adi","family":"Pramono","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Fetomaternal Division , Medical Faculty of Diponegoro University, Dr. Kariadi Hospital , Semarang , Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad Ilham Aldika","family":"Akbar","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Maternal-Fetal Medicine Division , Faculty of Medicine Universitas Airlangga, Dr. Soetomo General Hospital , Surabaya , Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ernawati","family":"Darmawan","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Maternal-Fetal Medicine Division , Faculty of Medicine Universitas Airlangga, Dr. Soetomo General Hospital , Surabaya , Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dudy","family":"Aldiansyah","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Sumatera Utara University, H. Adam Malik General Hospital, Medan , North Sumatera , Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I Nyoman","family":"Hariyasa Sanjaya","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Maternal-Fetal Medicine Division , Faculty of Medicine, Udayana University, Prof. dr. I.G.N.G Ngoerah General Hospital , Bali , Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sri","family":"Sulistyowati","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Fetomaternal Division , Medical Faculty of Sebelas Maret University, Dr. Moewardi Hospital , Solo , Surakarta , Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Milan","family":"Stanojevic","sequence":"additional","affiliation":[{"name":"Department of Neonatology and Rare Diseases , Medical University of Warsaw , Warsaw , Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Asim","family":"Kurjak","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology , Medical School University of Zagreb , Zagreb , Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"374","published-online":{"date-parts":[[2025,10,3]]},"reference":[{"key":"2026051215133577150_j_jpm-2025-0246_ref_001","doi-asserted-by":"crossref","unstructured":"Dunn, GP, Old, LJ, Schreiber, RD. 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