Document Detail


Immunology of pregnancy-pregnancy as a remission inducing agent in rheumatoid arthritis.
MedLine Citation:
PMID:  12180824     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
A variety of hormonal and immunological alterations are induced by pregnancy in order to protect the semi-allogeneic fetus from rejection. Systemic effects of altered immunoregulation induced by pregnancy influence the activity of rheumatoid arthritis (RA) and other autoimmune diseases. Pregnancy induces improvement or even remission of disease activity in 75% of RA patients. This phenomenon has still not been explained, however, several attractive hypotheses related to the immunology of pregnancy emerge. Pregnancy polarizes the immune response towards a TH2 response, which may counterbalance the augmented TH1 response observed in RA. The increase of circulating inhibitors of proinflammatory cytokines occurring in pregnancy could act as a potent anti-inflammatory agent in joint inflammation. In what way the induction of T cell tolerance to fetal antigens or maternal-fetal HLA disparity modulates disease activity of RA has not been studied. The concept of regulatory T cells has been discussed in the context of pregnancy, but until now has not been substantiated by experimental data. In conclusion, pregnancy influences the signs and symptoms of RA, but not the underlying autoimmune process. It remains to be investigated if a single event like neutralisation of proinflammatory cytokines or an interplay between circulating and cellular mechanisms is the key to remission.
Authors:
Monika Ostensen; Peter M Villiger
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Transplant immunology     Volume:  9     ISSN:  0966-3274     ISO Abbreviation:  Transpl. Immunol.     Publication Date:  2002 May 
Date Detail:
Created Date:  2002-08-15     Completed Date:  2003-03-18     Revised Date:  2005-11-16    
Medline Journal Info:
Nlm Unique ID:  9309923     Medline TA:  Transpl Immunol     Country:  England    
Other Details:
Languages:  eng     Pagination:  155-60     Citation Subset:  IM    
Affiliation:
Department of Rheumatology, Clinical Immunology and Allergy University Hospital of Berne, Switzerland. monika.oestensen@insel.ch
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MeSH Terms
Descriptor/Qualifier:
Animals
Arthritis, Rheumatoid / etiology,  immunology*,  prevention & control
Cytokines / physiology
Female
HLA Antigens / immunology
Histocompatibility Testing
Humans
Pregnancy / immunology*
Remission Induction
T-Lymphocyte Subsets / immunology
Th1 Cells / immunology
Th2 Cells / immunology
Chemical
Reg. No./Substance:
0/Cytokines; 0/HLA Antigens

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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