title: Reduced pro-inflammatory profile of γδT cells in pregnant patients with rheumatoid arthritis.
abstract: BACKGROUND
  During pregnancy, many patients with rheumatoid arthritis (RA) experience disease improvement, whereas patients with ankylosing spondylitis often suffer from persistent active disease. Here we investigated whether pregnancy-related changes in disease activity were associated with changes in the proportion and function of γδT cells.
  
  
  METHODS
  The study population comprised 55 patients with RA, 31 patients with ankylosing spondylitis, and 35 healthy controls. Among these participants, 28 RA patients, 21 ankylosing spondylitis patients, and 23 healthy controls were investigated once before conception when possible, at each trimester of pregnancy, and at 8 weeks postpartum. Data were compared with age-matched non-pregnant patients to obtain disease-related background. In all subjects, peripheral Vδ1 and Vδ2 T cells were analyzed for cell frequencies, the activation marker CD69, the cytotoxicity markers NKG2D and NKG2A, and the intracellular cytokines tumor necrosis factor (TNF)α, interferon (IFN)γ, interleukin (IL)-17 and IL-10.
  
  
  RESULTS
  Pregnant patients showed a decreased Vδ2/Vδ1 ratio in the third trimester, which resulted from a slightly reduced proportion of Vδ2 cells. Changes in RA disease activity during pregnancy and postpartum were not associated with numerical proportions of γδT cells but with changes of the cell activation marker CD69 on Vδ1 and Vδ2 cells. Only RA patients showed reduced proportions of TNFα-positive Vδ1and Vδ2 cells and IFNγ-positive Vδ2 cells at the third trimester of pregnancy, a finding that was not apparent in the entire population of CD3 T cells. The proportions of IL-17-positive γδT cells and IL-10-positive γδT cells did not differ between pregnant and non-pregnant women of the different groups.
  
  
  CONCLUSIONS
  Changes of disease activity in pregnant RA patients were associated with functional changes in both γδT cell subsets. This reduced pro-inflammatory profile of γδT cells might contribute to the immunomodulation resulting in pregnancy-induced improvement of RA.
authors.affiliation: Department of Rheumatology, Immunology and Allergology, University Hospital and University of Bern, Bern, Switzerland. manuela_tham@web.de.|Graduate School, University of Bern, Bern, Switzerland. manuela_tham@web.de.
authors.forename: Manuela
authors.initials: M
authors.lastname: Tham
authors.affiliation: Department of Rheumatology, Immunology and Allergology, University Hospital and University of Bern, Bern, Switzerland. gabi.schloer@students.unibe.ch.
authors.forename: Gabriele R
authors.initials: GR
authors.lastname: Schlör
authors.affiliation: Department of Rheumatology, Immunology and Allergology, University Hospital and University of Bern, Bern, Switzerland. daniel.yerly@allergy.unibe.ch.
authors.forename: Daniel
authors.initials: D
authors.lastname: Yerly
authors.affiliation: Department of Rheumatology, Immunology and Allergology, University Hospital and University of Bern, Bern, Switzerland. muellerchv@gmail.com.
authors.forename: Christina
authors.initials: C
authors.lastname: Mueller
authors.affiliation: Department of Obstetrics and Gynecology, University Hospital and University of Bern, Bern, Switzerland. Daniel.Surbek@insel.ch.
authors.forename: Daniel
authors.initials: D
authors.lastname: Surbek
authors.affiliation: Department of Rheumatology, Immunology and Allergology, University Hospital and University of Bern, Bern, Switzerland. Peter.Villiger@insel.ch.
authors.forename: Peter M
authors.initials: PM
authors.lastname: Villiger
authors.affiliation: Department of Rheumatology, Immunology and Allergology, University Hospital and University of Bern, Bern, Switzerland. Frauke.Foerger@insel.ch.
authors.forename: Frauke
authors.initials: F
authors.lastname: Förger
mesh_terms: D000293:Adolescent; D000328:Adult; D001172:Arthritis, Rheumatoid / Q000097:blood* / Q000175:diagnosis*; D015331:Cohort Studies; D005260:Female; D005434:Flow Cytometry / Q000639:trends; D006801:Humans; D018836:Inflammation Mediators / Q000097:blood*; D008137:Longitudinal Studies; D008875:Middle Aged; D011181:Postnatal Care / Q000639:trends; D011247:Pregnancy; D011248:Pregnancy Complications / Q000097:blood* / Q000175:diagnosis*; D011446:Prospective Studies; D016176:T-Lymphocyte Subsets / Q000378:metabolism*; D055815:Young Adult
chemical_list: D018836:Inflammation Mediators