Maternal Immune Modulation During Pregnancy
Summary
Pregnancy represents a unique immunological state in which the maternal immune system adapts to tolerate the semi-allogeneic fetus while maintaining defence against pathogens. This adaptation involves a dynamic balance between pro-inflammatory and anti-inflammatory mechanisms that shift across gestation. Early implantation is characterised by controlled inflammation to facilitate trophoblast invasion and placental development. As pregnancy progresses, a predominantly anti-inflammatory environment prevails, driven by increased regulatory T cell activity, a switch from Th1-type to Th2-type cytokine profiles, and the action of pregnancy hormones such as progesterone and glucocorticoids. In late gestation, a resurgence of inflammatory signals promotes labour by enhancing uterine contractility and cervical ripening. Central to these processes are epigenetic modifications and transcriptomic changes in maternal immune cells, local immune cell populations at the decidua, and hormone-induced mediators such as progesterone-induced blocking factor. Dysregulation of these finely tuned mechanisms is implicated in obstetric complications including pre-eclampsia, preterm labour and recurrent miscarriage. Understanding the interplay between systemic and tissue-resident immune responses, endocrine cues and placental signalling pathways offers opportunities to develop targeted therapies that support both maternal and fetal health.
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Maternal Immune Modulation During Pregnancy publication trend
The graph below shows the total number of articles in maternal immune modulation during pregnancy across all publications each year (not limited to Nature Index journals).
Technical terms
Cytokines: Small protein mediators released by immune cells that coordinate inflammation and tolerance.
Regulatory T cells (Treg cells): A subset of CD4+ lymphocytes that suppress excessive immune responses and promote tolerance.
Epigenetic modifications: Heritable chemical changes to DNA or histones that influence gene expression without altering the DNA sequence.
Transcriptomic profiling: The comprehensive analysis of RNA transcripts to determine gene expression patterns.
Semi-allograft: A graft containing genetically distinct tissue from the biological father carried within the mother.
Progesterone-induced blocking factor (PIBF): A progesterone-dependent protein that favours Th2-type immunity and supports pregnancy maintenance.
References
- Prominent epigenetic and transcriptomic changes in CD4+ and CD8+ T cells during and after pregnancy in women with multiple sclerosis and controls. Journal of Neuroinflammation (2023).
- Progesterone-Related Immune Modulation of Pregnancy and Labor. Frontiers in Endocrinology (2019).
- Progesterone Modulation of Pregnancy-Related Immune Responses. Frontiers in Immunology (2018).
- Changes in T Cell and Dendritic Cell Phenotype from Mid to Late Pregnancy Are Indicative of a Shift from Immune Tolerance to Immune Activation. Frontiers in Immunology (2017).
- Progesterone as an Anti-Inflammatory Drug and Immunomodulator: New Aspects in Hormonal Regulation of the Inflammation. Biomolecules (2022).
- Progesterone: A Unique Hormone with Immunomodulatory Roles in Pregnancy. International Journal of Molecular Sciences (2022).
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