Reproductive immunology has been steadily evolving over the last 60 years, and the fundamental question raised by Sir Peter Medawar during a seminar lecture at a meeting of the Society of Experimental Biology in 1953, ‘How does the pregnant mother contrive to nourish within itself for many weeks or months a foetus that is an antigenically foreign body?’ is still a challenging topic to scientists. Science and medicine are codependent and they impact each other significantly. Knowledge generated by basic science is translated to clinical medicine and is dramatically changing the way medicine is practiced. Equally important is how medicine redefined questions asked by basic scientists.
Reproductive immunology is the field that explores the interaction between the immune system and components related to the reproductive system, and its principle has been quickly applied to clinical sciences. The concept of reproductive immunology had explained the underlying immunopathology of Rh sensitization in mother and neonatal alloimmune thrombocytopenia, and immunotherapeutic approaches had been established. Additionally, principles of reproductive immunology have been applied to explain the infertility of unknown etiology, premature ovarian failure, endometriosis, recurrent pregnancy loss, and obstetrical complications such as preterm pregnancy, pre-eclampsia, and intrauterine growth restriction. Mucosal immunity has been another branch of reproductive immunology, which explains the role of genital tract immunity in sexually transmitted disease including HIV, and immune consequences in reproduction in association with genital tract infection.
Reproductive immunology and its clinical applications are rapidly developing, hence physicians need to broaden their overall knowledge of human diseases, diagnostics, and treatment options as well as ask questions from a disease-oriented point-of-view. In a recent web-based survey, physicians practicing reproductive medicine report that reproductive immunology is an important principle for human reproduction; however, resources for clinical reproductive immunology are lacking (http://www.ivf-worldwide.com). Practicing clinicians rarely have a chance to learn reproductive immunology in a systematic and organized manner because there is no organized medical educational program for reproductive immunology in United States. Therefore, continuous training and education of clinicians by clinical symposia or up-to-date review articles, etc. in reproductive immunology are in critical demand.
Rapid translation and application of basic science to clinical medicine is one of the most urgent and important goals of research scientists. One of the efforts to accommodate this goal was to organize a clinical symposium for clinicians and clinical researchers. The first Clinical Reproductive Immunology symposium was held at Providence, RI, on November 19–20, 2011 under the auspice of American Society for Reproductive Immunology. The symposium was aimed to directly deliver current up-to-date information from translational research in reproductive immunology to the practicing physicians, and facilitate the application of research outcomes to the current medical practice. During the symposium, current clinical research topics and diagnosis and treatment of inflammatory immune disorders in infertility, recurrent pregnancy losses, infertility, and obstetrical complications were discussed.
In this special edition ‘Topics in clinical reproductive immunology’, review articles from the clinical symposium and others to balance the topics of this special edition are published. The reviews are evidence based and well balanced, and we hope that this edition can advance physicians' knowledge in reproductive immunology and improve their practice pattern.