The role of the immune system in preeclampsia: current understanding of the maternal immune response in pregnancy induced hypertension

Abstract:

Preeclampsia and eclampsia are unique disorders closely associated with pregnancy and puerperium and it is serious complication affecting both mother and the fetus. The origin of preeclampsia, a disease unique to pregnancy is still matter of debate and numerous theories have been proposed. The pathophysiology of the disease involves impaired trophoblast invasion, abnormal genetic polymorphism, vascular endothelial cell activation, immune intolerance by the maternal immune system, but also an exaggeration of a systemic inflammatory process. Recent data demonstrate that an altered immune response may play a key role in the development of preeclampsia. Some epidemiological findings and animal models support this idea; the cytokine profile in preeclampsia shows that the production of type 1 cytokines is dominant while the production of type 2 cytokines, which regulates inflammation, is suppressed, and therefore, systematical immunoactivation may be one cause of preeclampsia. This review summarizes our current understanding of the role of the innate and adaptive immune system in preeclampsia and discuss the pathophysiology of preeclampsia f.rom an immunological viewpoint. 

Key words:
pregnancy, preeclampsia, immune system