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Summary Placental insufficiency affects fetomaternal health throughout life. Although the interaction between the maternal uterine immune milieu and fetal-derived cells plays a crucial role in placental formation, several aspects remain unclear. Therefore, we conducted this study to investigate the effects of interleukin (IL)- 18, a unique cytokine with both proinflammatory and anti-inflammatory properties, on the uterine immune milieu and placental development. Our results identified pregnant uterine smooth muscle cells as an important source of IL-18, which supports homeostatic type 1 immune responses. IL-18 facilitates appropriate placental development through uterine vascular remodeling and placental angiogenesis. Smooth muscle cell–specific Il18 -knockout dam mice exhibited impaired fetoplacental growth and elevated maternal blood pressure, reflecting preeclampsia-like phenotypes. Their offspring demonstrated a tendency toward excessive weight gain and delayed neurodevelopment. Overall, this study emphasizes the essential role of IL-18 in placental formation and its wider implications for fetomaternal health. Graphical Abstract Highlights Smooth muscle cells in the pregnant uterine myometrium sufficiently produce IL-18 IL-18 induces type 1 immune responses in the uterine immune milieu IL-18 promotes maternal uterine vascular remodeling and placental angiogenesis IL-18-signaling deficiency in the mouse model shows the preeclampsia-like clinical course
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Ino et al. (2025) studied this question.
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