Skip to main content
SpringerLink
Log in

Immunology of pregnancy

Implications for the mother

  • Published:
Clinical Reviews in Allergy & Immunology Aims and scope Submit manuscript

Abstract

Pregnancy is a unique event in which a genetically and immunologically foreign fetus usually survives to full term without apparent rejection by the mother's immune system. Over the past decade, more information has been gathered to provide insight into the complex immunological mechanisms that allow the fetus to grow and survive in most cases. Whereas the maternal-fetal interface was once felt to be an immunologically privileged site with complete separation between the fetus and the mother, it is now known that recognition of the foreign fetus does occur. However, despite this immunological recognition, several mechanisms have been discovered which may explain why the mother does not reject the foreign fetus. These mechanisms include fetal factors such as trophoblast cell properties and altered MHC Class I expression as well as local maternal factors such as specialized uterine natural killer cells and a shifting of the T-helper cell cytokine profile from a type 1 to a type II array. Other novel immunomodulators are found to be expressed in the local uterine environment to aid in fetal survival. Furthermore, the persistence of fetal cells in the maternal circulation long after pregnancy is over (termed chronic microchimerism) and may have implications for autoimmune diseases. This review presents investigations and developments relevant to an understanding as to why the fetus is not rejected by the maternal immune system.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Medawar, P.B. (1953) Symp Soc Exp Biol 11, 320–338.

    Google Scholar 

  2. Beer, A.E., and Billingham, R.E. (1971), in Advances in Immunology. Dixon, F. J. and Kunkel, H.G., eds. Academic Press, New York, pp. 1–84.

    Google Scholar 

  3. Pijnenborg, R., Robertson, W.B., Brosens, I., and Dixon, G. (1981), Placenta 2, 71–91.

    PubMed  CAS  Google Scholar 

  4. Pijnenborg, R., Bland, J.M., Robertson, W.B., et al. (1981), Placenta 2, 206–216.

    Google Scholar 

  5. Damsky, C.H. and Fisher, S.J. (1988), Curr Opin Cell Biol 10, 660–666.

    Article  Google Scholar 

  6. Campbell, S., Swann, H.R., Seif, M.W., et al. (1995), Hum Reprod 10, 1571–1578.

    PubMed  CAS  Google Scholar 

  7. Zhou, Y., Damsky, C.H., and Fisher, S.J. (1997), J Clin Invest 99, 2152–2164.

    Article  PubMed  CAS  Google Scholar 

  8. Librach, C.L., Werb, Z., Fitzgerald, M.L., et al. (1991), J Cell Biol 113, 437–449.

    Article  PubMed  CAS  Google Scholar 

  9. Schatz F., Krikun, G., Runic, R., et al. (1999), Semin Reprod Endocrinol 17, 3–12.

    Article  PubMed  CAS  Google Scholar 

  10. Norwitz, E.R., Schust, D.J., and Fisher, S.J. (2001), N Engl J Med 345, 1400–1408.

    Article  PubMed  CAS  Google Scholar 

  11. Goodfellow, P.N., Barnstable, C.J., Bodmer, W.F., et al. (1976), Transplantation 22, 595–603.

    Article  PubMed  CAS  Google Scholar 

  12. Le Bouteiller, P., Rodriguez, A.M., Mallet, V., et al. (1996), Am J Reprod Immunol 35, 216–225.

    PubMed  Google Scholar 

  13. Hunt, J.S., Fishback, J.L., Andrews, G.K., et al. (1988), J Immunol 140, 1293–1299.

    PubMed  CAS  Google Scholar 

  14. Kovats, S., Main, E.K., Librach, C., et al. (1990), Science 248, 220–223.

    Article  PubMed  CAS  Google Scholar 

  15. King, A., Burrows, T.D., Hiby, S.E., et al. (2000), Placenta 21, 376–387

    Article  PubMed  CAS  Google Scholar 

  16. Hunt, J.S., Jadhav, L., Chu, W., et al. (2000), Am J Obstet Gynecol 188, 682–688.

    Article  Google Scholar 

  17. Carosella, E.D., Paul, P., Moreau, P., et al. (2000), Immunol Today 21, 532–534.

    Article  CAS  Google Scholar 

  18. Ober, C. and Aldrich, C. (1997), J Reprod Immunol 36, 1–21.

    Article  PubMed  CAS  Google Scholar 

  19. Bainbridge, D.R., Ellis, S.A., and Sargent, I.L. (1999), J Immunol 163, 2023–2027.

    PubMed  CAS  Google Scholar 

  20. Langat, D.K. and Hunt, J.S. (2002), Biol Reprod 67, 1367–1374.

    Article  PubMed  CAS  Google Scholar 

  21. Crisa, L., McMaster, M.T., Ishii, J.K., et al. (1997), J Exp Med 186, 289–298.

    Article  PubMed  CAS  Google Scholar 

  22. Onno, M., Guillaudeux, T., Amiot, L., et al. (1994), Hum Immunol 41, 79–86.

    Article  PubMed  CAS  Google Scholar 

  23. Carosella, E.D., Moreau, P., Aractingi, S., et al. (2001), Trends Immunol 22, 553–555.

    Article  PubMed  CAS  Google Scholar 

  24. Athanassakis, I. and Vassiliadis, S. (2002), Immunology 107, 281–287.

    Article  PubMed  CAS  Google Scholar 

  25. Bulmer, J.N., Morrison, L., Longfellow, M., et al. (1991), Hum Reprod 6, 791–798.

    PubMed  CAS  Google Scholar 

  26. Starkey, P.M., Sargent, I.L., and Redman, C.W. (1988), Immunology 65, 129–134.

    PubMed  CAS  Google Scholar 

  27. King, A., Burrows, T., Verma, S., et al. (1998), Hum Reprod Update 4, 480–485.

    Article  PubMed  CAS  Google Scholar 

  28. Drake, P.M., Gunn, M.D., Charo I.F., et al. (2001), J Exp Med 193, 1199–1212.

    Article  PubMed  CAS  Google Scholar 

  29. Le Bouteiller, P. (1994), Crit Rev Immunol 14, 89–129.

    PubMed  Google Scholar 

  30. Pazmany, L., Mandelboim, O., Vales-Gomez, M., et al. (1996), Science 274, 792–795.

    Article  PubMed  CAS  Google Scholar 

  31. Long, E.O. (1999), Annu Rev Immunol 17, 875–904.

    Article  PubMed  CAS  Google Scholar 

  32. Le Bouteiller, P. and Blaschitz, A. (1999), Immunol Rev 167, 233–244.

    Article  PubMed  Google Scholar 

  33. Petroff, M.G., Sedlmayr, P., Azzola, D., et al. (2002), J Reprod Immunol 56, 3–17.

    Article  PubMed  CAS  Google Scholar 

  34. Robert, C.W., Walker, W., and Alexander, J. (2001), Clin Microbiol Rev 14, 476–488.

    Article  Google Scholar 

  35. Piccinni, M.P., Giudizi, M.G., Biagiotti, R., et al. (1995), J Immunol 155, 128–133.

    PubMed  CAS  Google Scholar 

  36. Vercelli, D., De Monte, L., Monticelli, S., et al. (1998), Int Arch Allergy Immunol 116, 1–4.

    Article  PubMed  CAS  Google Scholar 

  37. Roth, I., Corry, D.B., Locksley, R.M., et al. (1996), J Exp Med 184, 539–548.

    Article  PubMed  CAS  Google Scholar 

  38. Szekeres-Bartho, J., Faust, Z., and Varga, P. (1995), Am J Reprod Immunol 34, 342–348.

    PubMed  CAS  Google Scholar 

  39. Szekeres-Bartho, J. and Wegmann, T.G. (1996), J Reprod Immunol 31, 81–95.

    Article  PubMed  CAS  Google Scholar 

  40. Miller, L. and Hunt, J.S. (1998), J Immunol 160, 5098–5104.

    PubMed  CAS  Google Scholar 

  41. Simister, N.E. and Story, C.M. (1997), J Reprod Immunol 37, 1–23.

    Article  PubMed  CAS  Google Scholar 

  42. Holmes, C.H., Simpson, K.L., Okada, H., et al. (1992), Eur J Immunol 22, 1579–1585.

    Article  PubMed  CAS  Google Scholar 

  43. Xu, C., Mao, D., Holers, V.M., et al. (2000), Science 287, 498–501.

    Article  PubMed  CAS  Google Scholar 

  44. Borish, L.C. and Steinke, J.W. (2003), J Allergy Clin Immunol 111, S460-S475.

    Article  PubMed  CAS  Google Scholar 

  45. Wegmann, T.G., Hui, L., Guilbert, L., et al. (1993), Immunol Today 14, 353–355.

    Article  PubMed  CAS  Google Scholar 

  46. Athanassakis, I., Bleackley, R.C., Paetkau, V., et al. (1987), J Immunol 138, 37–44.

    PubMed  CAS  Google Scholar 

  47. Chaouat, G., Menu, E., Clark, D.A., et al. (1990), J Reprod Fertil 89, 447–458.

    Article  PubMed  CAS  Google Scholar 

  48. Ashkar, A.A., Di Santo, J.P., and Croy, B.A. (2000), J Exp Med 192, 259–270.

    Article  PubMed  CAS  Google Scholar 

  49. Vassiliadis, S., Ranella, A., Papadimitriou, L., et al. (1998), Med Inflamm 7, 69–72.

    Article  CAS  Google Scholar 

  50. Mellor, A.L. and Munn, D.H. (2000), Annu Rev Immunol 18, 367–391.

    Article  PubMed  CAS  Google Scholar 

  51. Nagaeva, O., Jonsson, L., and Mincheva-Nilsson, L. (2002), Am J Reprod Immunol 48, 9–17.

    Article  PubMed  Google Scholar 

  52. Moreau, P., Adrian-Cabestre, F., Menier, C., et. al. (1999), Int Immunol 11, 803–811.

    Article  PubMed  CAS  Google Scholar 

  53. Da Silva, J.A. and Spector, T.D. (1992), Clin Rheumatol 11, 189–194.

    Article  PubMed  Google Scholar 

  54. Falkoff, R. (1987), Clin Rev Allergy 5, 287–300.

    PubMed  CAS  Google Scholar 

  55. Palmer, G.W. and Claman, H.N. (2002), Ann Allergy Asthma Immunol 29, 350–359.

    Article  Google Scholar 

  56. Silver, H.M. (1998), Obstet Gynecol Surv 53, 737–740.

    Article  PubMed  CAS  Google Scholar 

  57. Mellor, A.L. and Munn, D.H. (1999), Immunol Today 20, 469–473.

    Article  PubMed  CAS  Google Scholar 

  58. Kamimura, S., Eguchi, K., Yonezawa, M., et al. (1991), Acta Med Okayama 45, 135–139.

    PubMed  CAS  Google Scholar 

  59. Schrocksnadel, H., Baier-Bitterlich, G., Dapunt, O., et al. (1996), Obstet Gynecol 88, 47–50.

    Article  PubMed  CAS  Google Scholar 

  60. Munn, D.H., Zhou, M., Attwood, J.T., et al. (1998), Science 281, 1191–1193.

    Article  PubMed  CAS  Google Scholar 

  61. Dong, H., Zhu, G., Tamada, K., et al. (1999), Nat Med 5, 1365–1369.

    Article  PubMed  CAS  Google Scholar 

  62. Latchman, Y., Wood, C.R., Chernova, T., et al. (2001), Nat Immunol 2, 261–268.

    Article  PubMed  CAS  Google Scholar 

  63. Petroff, M.G., Chen, L., Phillips, T.A., et al. (2003), Biol Reprod 68, 1496–1504.

    Article  PubMed  CAS  Google Scholar 

  64. Petroff, M.G., Chen, L., Phillips, T.A., et al. (2002), Placenta 23(suppl A), S95-S101.

    Article  PubMed  Google Scholar 

  65. Freeman, G.J., Long, A.J., Iwai, Y., et al. (2000), J Exp Med 192, 1027–1034.

    Article  PubMed  CAS  Google Scholar 

  66. Runic, R., Lockwood, C.J., Ma, Y., et al. (1996), J Clin Endocrinol 81, 3119–3122.

    Article  CAS  Google Scholar 

  67. Phillips, T.A., Ni, J., Guohua, P., et al. (1999), J Immunol 162, 6053–6059.

    PubMed  CAS  Google Scholar 

  68. Nelson, J.L. (1996), Arthritis Rheum 39, 191–194.

    Article  PubMed  CAS  Google Scholar 

  69. Lambert, L. and Nelson, J.L. (2003), Autoimmunity Reviews 2, 133–139.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. National Jewish Medical and Research Center, Denver, CO

    Jill A. Poole & Henry N. Claman

  2. Division of Allergy and Clinical Immunology, Department of Medicine, University of Colorado Health Sciences Center, Denver, CO

    Jill A. Poole & Henry N. Claman

Authors
  1. Jill A. Poole
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Henry N. Claman
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Henry N. Claman.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Poole, J.A., Claman, H.N. Immunology of pregnancy. Clinic Rev Allerg Immunol 26, 161–170 (2004). https://doi.org/10.1385/CRIAI:26:3:161

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1385/CRIAI:26:3:161

Index Entries

Search

Navigation