About this Research Topic
Successful pregnancy provides an intriguing immunologic paradox. The fetus carries both paternal and maternal genes and therefore is for 50% foreign to the mother but is tolerated by the maternal immune system. Immune tolerance is thought to be driven by immune modulatory mechanisms that operate locally at the fetal-maternal interface. This Research Topic will focus on the potential immunological basis of pregnancy complications that arise from failures of maternal tolerance to the fetus, which may be encountered throughout gestation, at first term or later.
As the fetal cells are tolerated by the maternal immune system in healthy pregnancy, immunological mechanisms and disturbances therein may underlie recurrent pregnancy loss. Hereby, women have had two or more spontaneous miscarriages. It affects 3% of all fertile couples. In more than 50% of couples, the underlying cause is not clear, and it is thought that this is of an immunologic nature.
In pregnancy, chronic intervillositis of unknown etiology (CIUE) is a poorly understood histopathological lesion. CIUE is significantly associated with fetal growth restriction and intrauterine fetal death. In this disease, an intervillous infiltrate mostly of maternal origin is encountered in the placenta. The interplay between maternal immune cells and fetal trophoblasts in this disease might point toward a breach in immune tolerance and is a topic for ongoing research.
In pregnancy from a donated oocyte, the fetus carries genes of the oocyte donor and of the father. Thus, the antigens of the fetus are completely foreign compared to those of the mother. Consequently, oocyte donation pregnancies are associated with a higher risk of complications compared to natural-conceived pregnancies. Pregnancy conceived after oocyte donation reflects an interesting model to study immunological reactions.
Several complications of pregnancy are more frequent in women with autoimmune diseases such as antiphospholipid syndrome or systemic lupus erythematosus. These include spontaneous abortion, intrauterine fetal death, intrauterine fetal growth restriction, preterm birth and premature rupture of membranes, and preeclampsia. The immunological challenges faced by these mothers may change maternal peripheral tolerance complicating pregnancy and/or ameliorating their symptomatology. Understanding the unique immunological situation in pregnancy and autoimmune disease could contribute to predict and intervene the mother’s disease course and the development of her fetus.
For this Research Topic, authors are encouraged to submit contribution that concerns study of the immune system in complicated pregnancies, possibly in relation to healthy pregnancy. We particularly welcome Original Research, Reviews, Clinical Trials, Methods, and Perspective articles covering, but not limited to the following subtopics:
- immunological aspects of unexplained (recurrent) pregnancy loss
- chronic inflammation and intervillositis of unknown etiology (CIUE)
- immunology in oocyte donation pregnancies
- immunology in pregnancy complications
- autoimmune diseases and pregnancy
Keywords: Pregnancy; Complications; Tolerance; Fetus
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