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Effect of Pregnancy on Autoimmune Rheumatic Diseases

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Women's Health in Autoimmune Diseases
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Abstract

Pregnancy is associated with significant physiological changes in multiple organ systems including immune system. Due to the need to maintain the fetus, the immune responses are blunted or skewed to prevent rejection of the fetus. These changes include inhibition of uterine NK cells, increase in immunoregulatory macrophages, dendritic cells, and T cells. These changes are probably mediated by the hormonal changes present in pregnancy. Pregnancy has variable effect on disease activity of different autoimmune disease with decrease in RA and some increase in risk of flares in SLE, while data on other diseases is scant.

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References

  1. Yockey LJ, Interferons IA (2018) Proinflammatory cytokines in pregnancy and fetal development. Immunity 49(3):397–412

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  2. Leach RE, Khalifa R, Ramirez ND et al (1999) Multiple roles for heparin-binding epidermal growth factor-like growth factor are suggested by its cell-specific expression during the human endometrial cycle and early placentation. J Clin Endocrinol Metab 84(9):3355–3363

    CAS  PubMed  Google Scholar 

  3. Moffett-King A (2002) Natural killer cells and pregnancy. Nat Rev Immunol 2(9):656–663

    Article  CAS  PubMed  Google Scholar 

  4. Rätsep MT, Felker AM, Kay VR, Tolusso L, Hofmann AP, Croy BA (2015) Uterine natural killer cells: supervisors of vasculature construction in early decidua basalis. Reproduction 149(2):R91–R102

    Article  PubMed  Google Scholar 

  5. Ning F, Liu H, Lash GE (2016) The role of decidual macrophages during normal and pathological pregnancy. Am J Reprod Immunol 75(3):298–309

    Article  PubMed  Google Scholar 

  6. Gardner L, Moffett A (2003) Dendritic cells in the human decidua. Biol Reprod 69(4):1438–1446

    Article  CAS  PubMed  Google Scholar 

  7. Saito S, Nishikawa K, Morii T, Narita N, Enomoto M, Ichijo M (1992) Expression of activation antigens CD69, HLA-DR, interleukin-2 receptor-alpha (IL-2R alpha) and IL-2R beta on T cells of human decidua at an early stage of pregnancy. Immunology 75(4):710–712

    CAS  PubMed  PubMed Central  Google Scholar 

  8. Feyaerts D, Benner M, van Cranenbroek B, van der Heijden OWH, Joosten I, van der Molen RG (2017) Human uterine lymphocytes acquire a more experienced and tolerogenic phenotype during pregnancy. Sci Rep 7(1):2884

    Article  PubMed  PubMed Central  Google Scholar 

  9. Guzman-Genuino RM, Diener KR (2017) Regulatory B cells in pregnancy: lessons from autoimmunity, graft tolerance, and cancer. Front Immunol 8:172

    Article  PubMed  PubMed Central  Google Scholar 

  10. Hunt JS, Langat DK, McIntire RH, Morales PJ (2006) The role of HLA-G in human pregnancy. Reprod Biol Endocrinol 4(Suppl 1):S10

    Article  PubMed  PubMed Central  Google Scholar 

  11. Petroff MG, Kharatyan E, Torry DS, Holets L (2005) The immunomodulatory proteins B7-DC, B7-H2, and B7-H3 are differentially expressed across gestation in the human placenta. Am J Pathol 167(2):465–473

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. Kinder JM, Stelzer IA, Arck PC, Way SS (2017) Immunological implications of pregnancy-induced microchimerism. Nat Rev Immunol 17(8):483–494

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  13. Ince-Askan H, Hazes JMW, Dolhain RJEM (2017) Identifying clinical factors associated with low disease activity and remission of rheumatoid arthritis during pregnancy. Arthritis Care Res (Hoboken) 69(9):1297–1303

    Article  CAS  Google Scholar 

  14. Barrett JH, Brennan P, Fiddler M, Silman AJ (1999) Does rheumatoid arthritis remit during pregnancy and relapse postpartum? Results from a nationwide study in the United Kingdom performed prospectively from late pregnancy. Arthritis Rheum 42(6):1219–1227

    Article  CAS  PubMed  Google Scholar 

  15. de Man YA, Bakker-Jonges LE, Goorbergh CM et al (2010) Women with rheumatoid arthritis negative for anti-cyclic citrullinated peptide and rheumatoid factor are more likely to improve during pregnancy, whereas in autoantibody-positive women autoantibody levels are not influenced by pregnancy. Ann Rheum Dis 69(2):420–423

    Article  PubMed  Google Scholar 

  16. Zrour SH, Boumiza R, Sakly N et al (2010) The impact of pregnancy on rheumatoid arthritis outcome: the role of maternofetal HLA class II disparity. Joint Bone Spine 77(1):36–40

    Article  PubMed  Google Scholar 

  17. Østensen M, Villiger PM, Förger F (2012) Interaction of pregnancy and autoimmune rheumatic disease. Autoimmun Rev 11(6–7):A437–A446

    Article  PubMed  Google Scholar 

  18. Murase JE, Chan KK, Garite TJ, Cooper DM, Weinstein GD (2005) Hormonal effect on psoriasis in pregnancy and postpartum. Arch Dermatol 141(5):601–606

    Article  CAS  PubMed  Google Scholar 

  19. Clowse MEB, Magder LS, Witter F, Petri M (2005) The impact of increased lupus activity on obstetric outcomes. Arthritis Rheum 52(2):514–521

    Article  PubMed  Google Scholar 

  20. Doria A, Ghiradello A, Iaccarino L et al (2004) Pregnancy, cytokines, and disease activity in systemic lupus erythematosus. Arthritis Rheum 51:989–995

    Article  CAS  PubMed  Google Scholar 

  21. Petri M (2007) The Hopkins Lupus Pregnancy Center: ten key issues in management. Rheum Dis Clin North Am 33(2):227–235, v

    Article  PubMed  PubMed Central  Google Scholar 

  22. Kitridou RC (2005) Pregnancy in mixed connective tissue disease. Rheum Dis Clin N Am 31(3):497–508

    Article  Google Scholar 

  23. Taraborelli M, Ramoni V, Brucato A et al (2012 Jun) Brief report: successful pregnancies but a higher risk of preterm births in patients with systemic sclerosis: an Italian multicenter study. Arthritis Rheum 64(6):1970–1977

    Article  PubMed  Google Scholar 

  24. Steen VD, Conte C, Day N et al (1989) Pregnancy in women with systemic sclerosis. Arthritis Rheum 32(2):151–157

    Article  CAS  PubMed  Google Scholar 

  25. Kofteridis DP, Malliotakis PI, Sotsiou F, Vardakis NK, Vamvakas LN, Emmanouel DS (1999) Acute onset of dermatomyositis presenting in pregnancy with rhabdomyolysis and fetal loss. Scand J Rheumatol 28(3):192–194

    Article  CAS  PubMed  Google Scholar 

  26. Gatto M, Iaccarino L, Canova M, Zen M et al (2012) Pregnancy and vasculitis: a systematic review of the literature. Autoimmun Rev 11(6–7):A447–A459

    Article  PubMed  Google Scholar 

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Correspondence to Amita Aggarwal .

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Muhammed, H., Aggarwal, A. (2020). Effect of Pregnancy on Autoimmune Rheumatic Diseases. In: Sharma, S. (eds) Women's Health in Autoimmune Diseases. Springer, Singapore. https://doi.org/10.1007/978-981-15-0114-2_11

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  • DOI: https://doi.org/10.1007/978-981-15-0114-2_11

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  • Publisher Name: Springer, Singapore

  • Print ISBN: 978-981-15-0113-5

  • Online ISBN: 978-981-15-0114-2

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