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Front Immunol. 2018 Nov 13;9:2630. doi: 10.3389/fimmu.2018.02630. eCollection 2018.

The Immunogenetic Conundrum of Preeclampsia.

Author information

1
Research Programs Unit, Immunobiology Research Program, University of Helsinki, Helsinki, Finland.
2
Bacteriology and Immunology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
3
Obstetrics and Gynecology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
4
Medical and Clinical genetics, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
5
Institute for Molecular Medicine Finland, Helsinki Institute of Life Science, University of Helsinki, Helsinki, Finland.
6
Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland.
7
Department of Obstetrics and Gynecology, Tampere University Hospital, Tampere, Finland.

Abstract

Pregnancy is an immunological challenge to the mother. The fetal tissues including the placenta must be protected from activation of the maternal immune system. On the other hand, the placental tissue sheds into the maternal circulation and must be adequately identified and phagocytized by the maternal immune system. During a healthy pregnancy, numerous immunosuppressive processes take place that allow the allograft fetus to thrive under exposure to humoral and cellular components of the maternal immune system. Breakdown of immune tolerance may result in sterile inflammation and cause adverse pregnancy outcomes such as preeclampsia, a vascular disease of the pregnancy with unpredictable course and symptoms from several organs. Immunological incompatibility between mother and fetus is strongly indicated in preeclampsia. Recently, genetic factors linking immunological pathways to predisposition to preeclampsia have been identified. In this mini-review genetic variation in immunological factors are discussed in the context of preeclampsia. Specifically, we explore immunogenetic and immunomodulary mechanisms contributing to loss of tolerance, inflammation, and autoimmunity in preeclampsia.

KEYWORDS:

FLT1; autoimmunity; complement; genetics; major histocompatibility complex; preeclampsia; pregnancy

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