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Bi-Directional Cell Trafficking during Pregnancy

Long-Term Consequences for Human Health

  • Chapter
Immunology of Pregnancy

Part of the book series: Medical Intelligence Unit ((MIUN))

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Abstract

During pregnancy some cells traffic between the fetus and mother and recent studies indicate low levels persist in the respective hosts decades later. Microchimerism (Me) refers to a small population of cells or DNA harbored by one individual that derive from a genetically distinct individual. Persistent Me can also arise from cell transfer between twins in utero or after a blood transfusion. Because women are preferentially affected by autoimmune disease, often with an increased incidence in post-reproductive years, fetal Me has been investigated in diseases such as systemic sclerosis (SSc), autoimmune thyroiditis, primary biliary cirrhosis, Sjögren’s syndrome and systemic lupus erythematosus. Maternal Me has been investigated in SSc, myositis and neonatal lupus. Evidence implicating fetal Me is strongest in SSc where quantitatively higher levels of fetal Me have been found and particular human leukocyte antigen (HLA) relationships of mother and child are associated with increased risk of subsequent SSc in the mother. Maternal Me is implicated in myositis and neonatal lupus. It is unknown how Me might be involved in autoimmune disease. Me could play a role in the effector arm of immune responses either directly or indirectly. Microchimeric cells could be targets of an immune response, an intriguing possibility suggested by a recent study in which maternal cells identified in hearts of infants with neonatal lupus congenital heart block were predominantly cardiac myocytes. Alternatively microchimeric cells could be recruited secondarily to diseased tissues and function in tissue repair. The long-term consequences of naturally acquired Me deriving from pregnancy are not yet known. Because persistent fetal and maternal Me are not uncommon in healthy individuals it seems likely that beneficial effects may also accrue to the host. Recent advances in this active frontier of scientific research are discussed.

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Author information

Authors and Affiliations

  1. Division of Clinical Research, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA

    Kristina M. Adams & J. Lee Nelson

  2. Department of Obstetrics and Gynecology, University of Washington, Seattle, Washington, USA

    Kristina M. Adams

  3. Division of Rheumatology, University of Washington, Seattle, Washington, USA

    J. Lee Nelson

Authors
  1. Kristina M. Adams
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  2. J. Lee Nelson
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Editors and Affiliations

  1. Department of Obstetrics and Gynecology, Reproductive Immunology Unit, Yale University School of Medicine, New Haven, Connecticut, USA

    Gil Mor M.D., Ph.D.

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Adams, K.M., Nelson, J.L. (2006). Bi-Directional Cell Trafficking during Pregnancy. In: Mor, G. (eds) Immunology of Pregnancy. Medical Intelligence Unit. Springer, New York, NY. https://doi.org/10.1007/0-387-34944-8_21

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