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Pregnancy and Rheumatoid Arthritis: Insights into the Immunology of Fetal Tolerance and Control of Autoimmunity

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Abstract

It has long been recognized that symptoms and signs of rheumatoid arthritis (RA) frequently improve spontaneously during pregnancy, only to flare postpartum. Although the mechanisms behind this phenomenon remain poorly understood, there is growing interest in the immunologic changes that occur during healthy pregnancy as a possible explanation. Because the maternal immune system must adapt during pregnancy to accept the semi-allogeneic fetus, it has been hypothesized that these natural changes induced by pregnancy on maternal immune regulatory cells may have the additional benefit of controlling the immunopathology driving disease activity in RA. Here, we review our current understanding on the effects of pregnancy on RA and highlight some of the recent literature related to advancing our understanding on the immunology of pregnancy as well as the immunologic changes in RA during pregnancy.

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Papers of particular interest, published recently, have been highlighted as: • Of importance, •• Of major importance

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Acknowledgments

This work has been supported by a grant from the American College of Rheumatology Research and Education Foundation Within Our Reach: Finding a Cure for Rheumatoid Arthritis campaign and the Larry and Ruth Eaton Family Career Development Award in Innovative Arthritis Research.

Disclosure

Dr. Amin has served on a scientific advisory board for Merck & Co. Drs. Peterson, Reed, and Mueller reported no potential conflicts of interest relevant to this article.

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Authors and Affiliations

  1. Division of Rheumatology, College of Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA

    Shreyasee Amin & Ann M. Reed

  2. Division of Rheumatic and Autoimmune Diseases, University of Minnesota, 2101 6th Street SE, Minneapolis, MN, 55455, USA

    Erik J. Peterson & Daniel L. Mueller

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  1. Shreyasee Amin
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  2. Erik J. Peterson
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Correspondence to Shreyasee Amin.

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Amin, S., Peterson, E.J., Reed, A.M. et al. Pregnancy and Rheumatoid Arthritis: Insights into the Immunology of Fetal Tolerance and Control of Autoimmunity. Curr Rheumatol Rep 13, 449–455 (2011). https://doi.org/10.1007/s11926-011-0199-1

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  • DOI: https://doi.org/10.1007/s11926-011-0199-1

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