title: Hormones, immune response, and pregnancy in healthy women and SLE patients.
abstract: During pregnancy the maternal immune system is modified in order to achieve immune tolerance toward paternal antigen expressed on foetal cells. These modifications, which occur both at the foeto-maternal interface and in the systemic circulation, are driven by oestrogens and progesterone whose blood concentrations increase during pregnancy. The cytokine profile is also modified. Th2 cytokines are enhanced while the Th1 response is inhibited. This could explain why Th1-mediated autoimmune diseases tend to improve and Th2-mediated diseases, such as systemic lupus erythematosus (SLE), tend to worsen during pregnancy. However, whether or not SLE relapses more frequently during pregnancy is still a matter of debate. Steroid hormone and cytokine profiles differ in SLE patients compared with healthy subjects during pregnancy leading to a dysregulation of the balance between cell-mediated and humoral immune response, which, in turn, could explain the variability of the SLE course during gestation. This review focuses on hormonal-related cytokine changes observed during pregnancy in healthy subjects and SLE patients.
authors.affiliation: Division of Rheumatology, Clinical and Experimental Medicine, University of Padova, Padova, Italy. adoria@unipd.it
authors.forename: Margherita
authors.initials: M
authors.lastname: Zen
authors.forename: Anna
authors.initials: A
authors.lastname: Ghirardello
authors.forename: Luca
authors.initials: L
authors.lastname: Iaccarino
authors.forename: Michele
authors.initials: M
authors.lastname: Tonon
authors.forename: Carla
authors.initials: C
authors.lastname: Campana
authors.forename: Silvia
authors.initials: S
authors.lastname: Arienti
authors.forename: Mariaelisa
authors.initials: M
authors.lastname: Rampudda
authors.forename: Mariagrazia
authors.initials: M
authors.lastname: Canova
authors.forename: Andrea
authors.initials: A
authors.lastname: Doria
mesh_terms: D016207:Cytokines / Q000276:immunology; D004967:Estrogens / Q000276:immunology; D005260:Female; D012739:Gonadal Steroid Hormones / Q000276:immunology*; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000276:immunology*; D011247:Pregnancy / Q000276:immunology*; D011248:Pregnancy Complications / Q000276:immunology*; D011374:Progesterone / Q000276:immunology; D011388:Prolactin / Q000276:immunology
chemical_list: D016207:Cytokines; D004967:Estrogens; D012739:Gonadal Steroid Hormones; D011374:Progesterone; D011388:Prolactin