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Macrophages (M\u03c6s) play essential roles in maintaining maternal\u2013fetal tolerance, remodeling spiral arteries, and regulating trophoblast biological behaviors. In the present study, the formation of the labyrinth zone showed striking defects in pregnant mice treated with Tim-3 neutralizing antibodies. The adoptive transfer of Tim-3+M\u03c6s, rather than Tim-3\u2212M\u03c6s, reversed the murine placental dysplasia resulting from M\u03c6 depletion. With the higher production of angiogenic growth factors (AGFs, including PDGF-AA, TGF-\u03b1, and VEGF), Tim-3+dM\u03c6s were more beneficial in promoting the invasion and tube formation ability of trophoblasts. The blockade of AGFs in Tim-3+M\u03c6s led to the narrowing of the labyrinthine layer of the placenta, compromising maternal\u2013fetal tolerance, and increasing the risk of fetal loss. Meanwhile, the AGFs-treated Tim-3\u2212M\u03c6s could resolve the placental dysplasia and fetal loss resulting from M\u03c6 depletion. These findings emphasized the vital roles of Tim-3 in coordinating M\u03c6s-extravillous trophoblasts interaction via AGFs to promote pregnancy maintenance and in extending the role of checkpoint signaling in placental development. The results obtained in our study also firmly demonstrated that careful consideration of reproductive safety should be taken when selecting immune checkpoint and AGF blockade therapies in real-world clinical care.<\/jats:p>","DOI":"10.3390\/ijms24021538","type":"journal-article","created":{"date-parts":[[2023,1,13]],"date-time":"2023-01-13T01:30:26Z","timestamp":1673573426000},"page":"1538","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Tim-3 Coordinates Macrophage-Trophoblast Crosstalk via Angiogenic Growth Factors to Promote Pregnancy Maintenance"],"prefix":"10.3390","volume":"24","author":[{"given":"Liyuan","family":"Cui","sequence":"first","affiliation":[{"name":"Laboratory for Reproductive Immunology, Key Laboratory of Reproduction Regulation (Shanghai Institute of Planned Parenthood Research), Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Hospital of Obstetrics and 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