Institute of Liver Studies, King's College Hospital, London, SE5 9RS, United Kingdom.
Department of Anesthesia, Critical Care & Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue, Boston, MA, 02215, USA.
J Autoimmun. 2021 Jul;121:102651. doi: 10.1016/j.jaut.2021.102651. Epub 2021 May 18.
Pregnancy presents the maternal immune system with a unique immunological challenge since it has to defend against pathogens while tolerating paternal allo-antigens expressed by fetal tissues. T helper (Th) cells play a central role in modulating immune responses and recent advances have defined distinct contributions of various Th cell subsets throughout each phase of human pregnancy, while dysregulation in Th responses show association with multiple obstetrical complications. In addition to localized decidual mechanisms, modulation of Th cell immunity during gestation is mediated largely by oscillations in sex hormone concentrations. Aberrant Th cell responses also underlie several autoimmune disorders while pregnancy-induced changes in the balance of Th cell immunity has been shown to exert favorable outcomes in the progression Th1 and Th17 driven autoimmune conditions only to be followed by post-partal exacerbations in disease.
妊娠给母体免疫系统带来了独特的免疫挑战，因为它既要抵御病原体，又要容忍胎儿组织表达的父系同种抗原。辅助性 T 细胞（Th 细胞）在调节免疫反应中起着核心作用，最近的研究进展明确了各种 Th 细胞亚群在人类妊娠各个阶段的不同贡献，而 Th 反应的失调与多种产科并发症有关。除了局部蜕膜机制外，妊娠期间 Th 细胞免疫的调节在很大程度上是通过性激素浓度的波动来介导的。异常的 Th 细胞反应也是几种自身免疫性疾病的基础，而妊娠诱导的 Th 细胞免疫平衡的改变已被证明对 Th1 和 Th17 驱动的自身免疫性疾病的进展有有利的影响，只是随后在产后疾病加剧。
