Learning immunology from mothers and babies

Abstract

Pregnancy is an immunological marvel allowing intimate approximation between genetically discordant tissues of maternal and fetal origin. Shared immunity across the maternal-fetal dyad including intact cells of maternal and fetal origin establishing microchimerism in both individuals after parturition and protection by vertically transferred maternal IgG antibodies are increasingly recognized. Nonetheless, basic questions regarding why mothers do not reject allogeneic fetal tissues and why developing fetal immune cells do not reject allogenic maternal tissue remain unresolved. Establishing how this essential process works holds exciting promise for new therapeutic strategies for common disorders linked with fetal intolerance such as stillbirth, preeclampsia and preterm birth. Besides translational application for improving the health of children through improved pregnancy outcomes, pregnancy also represents an incredibly instructive platform for investigating how immunology works, which can be applied to other physiological contexts where expanded immune tolerance is desired. This perspective highlights several emerging immunological considerations from a pregnancy-focused viewpoint, including maternal immune cell memory, microchimerism and vertically transferred protective antibodies, with particular attention to unresolved questions and application to immunity in non-reproductive contexts.

Keywords: Antagonistic pleiotropy; Microchimeric cell; Parity; Regulatory T cell; Trait selection.