title: Characterizing the pregnancy immune phenotype: results of the viral immunity and pregnancy (VIP) study.
abstract: OBJECTIVE
  The increased risk of morbidity and mortality from certain microbial infections and the demonstrated improvements in the clinical course of some autoimmune diseases support the existence of pregnancy-related alterations in immune status. Elucidating the changes in innate and adaptive immunity during gestation may improve pregnancy outcomes and facilitate the development of targeted therapies for autoimmune diseases.
  
  
  METHODS
  The Viral Immunity and Pregnancy (VIP) study evaluated over 50 subjects longitudinally at three time points during pregnancy and at two time points post-delivery. Leukocyte enumeration was performed; functional responses of NK cells and CD4 T cells were analyzed, and soluble factors such as cytokines, defensins, and steroid hormones were measured in maternal blood.
  
  
  RESULTS
  In comparison to the post-partum period, the latter part of pregnancy was characterized by significant increases in blood phagocytes and pDCs and decreases in the number and activity of NK and T cells. Alterations were found in antimicrobial proteins and serum cytokines.
  
  
  CONCLUSIONS
  These data show that pregnancy is not a period of immunosuppression but an alteration in immune priorities characterized by a strengthening of innate immune barriers and a concomitant reduction in adaptive/inflammatory immunity in the later stages of pregnancy.
authors.affiliation: Department of Obstetrics, Gynecology and Reproductive Sciences, Mount Sinai School of Medicine, New York, NY 10029, USA. Thomas.Kraus@mssm.edu
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Kraus
authors.forename: Stephanie M
authors.initials: SM
authors.lastname: Engel
authors.forename: Rhoda S
authors.initials: RS
authors.lastname: Sperling
authors.forename: Lisa
authors.initials: L
authors.lastname: Kellerman
authors.forename: Yungtai
authors.initials: Y
authors.lastname: Lo
authors.forename: Sylvan
authors.initials: S
authors.lastname: Wallenstein
authors.forename: Maria M
authors.initials: MM
authors.lastname: Escribese
authors.forename: Jose L
authors.initials: JL
authors.lastname: Garrido
authors.forename: Tricia
authors.initials: T
authors.lastname: Singh
authors.forename: Martine
authors.initials: M
authors.lastname: Loubeau
authors.forename: Thomas M
authors.initials: TM
authors.lastname: Moran
mesh_terms: D056704:Adaptive Immunity; D000328:Adult; D005260:Female; D006801:Humans; D007113:Immunity, Innate; D016130:Immunophenotyping; D007962:Leukocytes / Q000276:immunology / Q000378:metabolism; D010641:Phenotype; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000276:immunology*; D044967:Serum / Q000737:chemistry; D055815:Young Adult