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Dysregulated immune response and inflammation are characteristic features of ailing reproductive health. Therefore, it is pertinent to decipher the immunology of the female and male reproductive tracts. A series of studies by our group delineated the roles of the three collectins, surfactant protein A (SP-A), surfactant protein D (SP-D), and Mannose-Binding Lectin, integral components of the innate immune response, in reproductive health. The findings demonstrated that gonadal steroid hormones regulated the uterine and testicular expression of SP-D and implicated critical roles of collectins in murine embryo implantation, spermatogenesis, and placental development. The data from clinical studies inferred that SP-D was differentially expressed in the placental tissues of women undergoing spontaneous abortion and women undergoing spontaneous labor suggesting its critical role in regulating inflammation at the feto-maternal interface. In a prospective cohort of 922 pregnant women, serum SP-A, SP-D, and P4/E2 ratio were identified as potential predictive biomarkers of severe Preeclampsia and missed abortion before the 14th week of gestation. Importantly, our collaborative studies established that SP-D reverses the human immunodeficiency virus-1-induced gene expression in an ex vivo model of human vaginal tissue. A direct anti-cancer role of SP-D in both androgen-dependent and independent prostate cancer cells and the tumor biopsies from metastatic prostate cancer patients was reported for the first time. The membrane interactome studies on SP-D identified 347 potential targets on prostate cancer cells including Glucose Regulated Protein of 78 kDa (GRP78), a known prostate cancer cell target. A significantly increased expression of collectins on ectopic mesenchymal stem cells (MSCs) could contribute to endometriotic inflammation. The intensive research has offered the prospect of novel therapies, targeting inflammation-driven anomalous reproductive physiology, to restore immune homeostasis and fertility.
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Madan et al. (2025) studied this question.
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