Relationship between Maternal Immunological Response during Pregnancy and Onset of Preeclampsia

Abstract

Maternofetal immune tolerance is essential to maintain pregnancy. The maternal immunological tolerance to the semiallogeneic fetus becomes greater in egg donation pregnancies with unrelated donors as the complete fetal genome is allogeneic to the mother. Instead of being rejected, the allogeneic fetus is tolerated by the pregnant woman in egg donation pregnancies. It has been reported that maternal morbidity during egg donation pregnancies is higher as compared with spontaneous or in vitro fertilization pregnancies. Particularly, egg donation pregnancies are associated with a higher incidence of pregnancy-induced hypertension and placental pathology. Preeclampsia, a pregnancy-specific disease characterized by the development of both hypertension and proteinuria, remains the leading cause of maternal and perinatal mortality and morbidity. The aim of this review is to characterize and relate the maternofetal immunological tolerance phenomenon during pregnancies with a semiallogenic fetus, which are the spontaneously conceived pregnancies and in vitro fertilization pregnancies, and those with an allogeneic fetus or egg donation pregnancies. Maternofetal immune tolerance in uncomplicated pregnancies and pathological pregnancies, such as those with preeclampsia, has also been assessed. Moreover, whether an inadequate maternal immunological response to the allogenic fetus could lead to a higher prevalence of preeclampsia in egg donation pregnancies has been addressed.

Adjunctive Use of Esomeprazole in the Treatment of Pre-Eclampsia: A Case Report and Literature Review

“…[25] Thus, egg-donation pregnancies have a much higher rate of pre-eclampsia and miscarriage. balance is mandatory for normal pregnancy and normal pregnancy is pro-Th 2 .…”

“…[25][31] [32] VEGF-A binds and activates sVEGFR-I or sFlt-I (anti-angiogenic) and sVEGFR-2 (angiogenic). [33] [48] and excess placenta-derived factors such as cell-free fetal DNA in mother's blood secondary to placental damage.…”

The role of visfatin (PBEF/Nampt) in pregnancy complications

“…However, these pathogenic pathways may have a common mechanism -the disrupted maternofetal immune tolerance to the semiallogeneic fetus that possesses half maternal genes and half paternal genes (Martínez-Varea et al, 2014). The current understanding of the role of immunity in PE development is far from being complete; however, recent data suggest that PE might actually be caused by a Th17/Treg imbalance with a predominance of Th17 immunity (Darmochwał-Kolarz and Oleszczuk, 2014).…”

Hemophagocytic Lymphohistiocytosis during the Postpartum Stage of Pregnancy: A Report of Eight Cases

“…Pre-eclampsia is characterized by inadequate placentation, leading to the secretion of pro-inflammatory cytokines and the release of angiogenic and anti-angiogenic factors and miRNAs [9]. The changes in T cell subsets that occur in pre-eclampsia include low regulatory T cell activity, a shift towards a Th1 response, and the presence of Th17 lymphocytes [10]. The cytokines related to pre-eclampsia include TNF-α, IL-1β, IL-6, IL-10, and IFN-γ, which are generally considered to be related to HLH [11].…”