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Autoimmune diseases comprise approximately 80 different disorders, with a total prevalence of 7.6 and 9.4 % of the population. Classification as an autoimmune disorder involves showing that an immune response to a self-antigen causes the disease pathogenesis.

During pregnancy, the maternal immune ...

Autoimmune diseases comprise approximately 80 different disorders, with a total prevalence of 7.6 and 9.4 % of the population. Classification as an autoimmune disorder involves showing that an immune response to a self-antigen causes the disease pathogenesis.

During pregnancy, the maternal immune system performs a balancing act between maintaining immune tolerance to the fetus and protecting against pathogens. This act of tolerance is thought to emerge due to temporary immune and endocrine system changes induced during pregnancy, with an increase in the levels of the steroid hormones, including progesterone (P4). P4 is a crucial hormone in the initiation and maintenance of pregnancy.

Though P4 is well known for its roles in myometrial homeostasis and remodeling, it also has important immunomodulatory functions in the control of autoimmune diseases during pregnancy. This immunomodulatory function of has been shown in various autoimmune diseases including multiple sclerosis (MS), rheumatoid arthritis (RA), and Autoimmune Hepatitis (AIH). The highest and lowest levels of P4 during pregnancy pertain to the respective improvement and subsequent worsening of autoimmune disease presentation.

This Research Topic aims to review the relationship between immune tolerance, via immune and endocrine system changes, and autoimmune diseases during pregnancy. We will welcome submissions focusing on the immunomodulatory role of P4, as well as other hormones and immune mediators, in the presentation of autoimmune diseases during pregnancy. Given the evidence supporting P4 and other steroid hormones in the immunomodulation of autoimmune diseases, we will also welcome studies which evaluating their use as a future treatment option.

In this Research Topic, we welcome the submission of Original Research, Review, Mini Review, Case Report, Clinical Trial, and Opinion articles focusing on the relationship between autoimmune diseases and immunological tolerance during pregnancy. We welcome submissions covering, but not limited to, the following sub-topics:

• Temporary immune and endocrine system changes induced during pregnancy and relationship with the presentation of autoimmune diseases

• The mechanisms underlying the immunomodulatory role of P4, and other steroid hormones in controlling autoimmune disease during pregnancy

• Evaluation of P4, and other steroid hormones, as a potential treatment option for patients with autoimmune diseases during pregnancy



Topic Editor Piotr Trzonkowski is the founder and CEO and stakeholder of POLTREG S.A. venture. The other Topic Editors declare no competing interests with regard to the Research Topic subject.

Keywords: Autoimmunity, autoimmune diseases, tolerance, immune tolerance, immunological tolerance, pregnancy, p4, progesterone, endocrine, steroid hormone


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