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. 2022 Feb 18;20:86. doi: 10.1186/s12951-022-01283-2

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© The Author(s) 2022

Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

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Fig. 6 — Schematic illustration showing the roles of pEXO on regulating maternal immune tolerance via reprogramming circulating monocytes. The maternal immune system needs to adapt to tolerate the semi-allogeneic conceptus. During early pregnancy, pEXO facilitates the establishment of systemic immune tolerance by transforming monocytes to an immunosuppression phenotype, including the MDSC subset. These pEXO-educated monocytes exhibited pleiotropic roles in promoting M2 macrophage polarization, suppressing T cell proliferation and inducing Treg cell differentiation