Document Detail


The changing maternal "self" hypothesis: a mechanism for maternal tolerance of the fetus.
MedLine Citation:
PMID:  16934327     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Recent advances in placental biology and immunology lead us to propose a novel hypothesis for maternal tolerance of the semi-allogeneic fetus and amelioration of rheumatoid arthritis (RA) during pregnancy. The initial event in this hypothesis is extrusion of placental apoptotic syncytiotrophoblast debris recently identified to contain intracellular fetal HLA Class II molecules, into maternal blood. The second event is uptake of apoptotic syncytiotrophoblast by immature maternal dendritic cells and presentation of fetal HLA class II peptides. In addition to presenting foreign antigens, HLA molecules also present HLA self-peptides. In the setting of the non-inflammatory environment of pregnancy, this process is expected to induce peripheral tolerance of fetal antigens through T cell death, anergy or induction of regulatory T cells in the lymph nodes. This hypothesis suggests a mechanism by which the simultaneous presentation of fetal and self (RA-associated) HLA peptides by tolerogenic dendritic cells during pregnancy may explain the observed amelioration of RA as a secondary benefit of fetal tolerance. After delivery, apoptotic syncytiotrophoblast debris disappears from maternal blood, autoimmunity returns and RA recurs. Thus, during pregnancy maternal immunologic "self" includes fetal HLA Class II as a result of apoptotic syncytiotrophoblast uptake by maternal tolerogenic dendritic cells.
Authors:
K M Adams; Z Yan; A M Stevens; J L Nelson
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2006-08-24
Journal Detail:
Title:  Placenta     Volume:  28     ISSN:  0143-4004     ISO Abbreviation:  Placenta     Publication Date:    2007 May-Jun
Date Detail:
Created Date:  2007-04-24     Completed Date:  2007-08-01     Revised Date:  2007-12-03    
Medline Journal Info:
Nlm Unique ID:  8006349     Medline TA:  Placenta     Country:  England    
Other Details:
Languages:  eng     Pagination:  378-82     Citation Subset:  IM    
Affiliation:
Division of Clinical Research, Fred Hutchinson Cancer Research Center, Human Immunogenetics Program, 1100 Fairview Ave. N., D2-100, P.O. Box 19024, Seattle, WA 98109-1024, USA. adamsk@u.washington.edu <adamsk@u.washington.edu>
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MeSH Terms
Descriptor/Qualifier:
Arthritis, Rheumatoid / prevention & control
Female
Fetus / immunology*
HLA-D Antigens / immunology
Humans
Immune Tolerance*
Maternal-Fetal Exchange / immunology*
Pregnancy / immunology,  physiology*
Pregnancy Complications / prevention & control
Grant Support
ID/Acronym/Agency:
AI41721/AI/NIAID NIH HHS; AI45659/AI/NIAID NIH HHS; AR39282/AR/NIAMS NIH HHS; AR48084/AR/NIAMS NIH HHS; HD01264/HD/NICHD NIH HHS
Chemical
Reg. No./Substance:
0/HLA-D Antigens

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


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