Leiden University Scholarly Publications

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Hoorn, M.L. van der (2012)

Immunological challenges during pregnancy : preeclampsia and egg donation

Doctoral Thesis
Human pregnancy is an interesting immunological paradox. The fetus is a semi-allograft, carrying paternal and maternal genes but is not rejected by the maternal immune system. The placenta is a key player in maintaining the pregnancy, since this fetus-derived organ is in direct contact with the mother. This thesis describes the results of investigations on the immune regulation at the fetal-maternal interface with emphasis on two immunological challenges during pregnancy. First, preeclampsia, which might be immunologically related to host versus graft disease as seen in solid organ transplantation and second, egg donation (ED) pregnancies, which show that even complete allogeneic fetal allografts can be tolerated by the mother. The immunological mechanisms involved in acceptance of the totally allogeneic fetus in ED pregnancies are not well understood yet. It is possible that it leads to differential immunological regulation. This hypothesis is tested in this thesis. We found...Show moreHuman pregnancy is an interesting immunological paradox. The fetus is a semi-allograft, carrying paternal and maternal genes but is not rejected by the maternal immune system. The placenta is a key player in maintaining the pregnancy, since this fetus-derived organ is in direct contact with the mother. This thesis describes the results of investigations on the immune regulation at the fetal-maternal interface with emphasis on two immunological challenges during pregnancy. First, preeclampsia, which might be immunologically related to host versus graft disease as seen in solid organ transplantation and second, egg donation (ED) pregnancies, which show that even complete allogeneic fetal allografts can be tolerated by the mother. The immunological mechanisms involved in acceptance of the totally allogeneic fetus in ED pregnancies are not well understood yet. It is possible that it leads to differential immunological regulation. This hypothesis is tested in this thesis. We found differential immunological interactions in successful ED and in preeclamptic pregnancies compared with naturally conceived pregnancies. These results indicate that preeclampsia and ED pregnancies are indeed immunological challenges during pregnancy. It is a scientific challenge to further reveal the immunological mechanisms, contributing to precious information for the fields of immunology, transplantation and obstetrics.Show less
Pregnancy
Preeclampsia
Placenta
Immunology
Human leukocyte antigen
Egg donation
Decidua
All authors
Hoorn, M.L. van der
Supervisor
Claas, F.H.J.; Lith, J.M.M. van
Co-supervisor
Scherjon, S.A.
Qualification
Doctor (dr.)
Awarding Institution
Leiden University Medical Center (LUMC), Leiden University
Date
2012-01-11
ISBN (print)
9786461820532

Funding

Sponsorship
Beckman Coulter BV, BMA BV (Mosos), Clean Air Techniek BV, Corning BV, Freya; vereniging voor mensen met vruchtbaarheidsproblemen, Greiner Bio-One, J.E. Juriaanse Stichting, Medical Dynamics, Memidis Pharma BV, Nationaal Referentie Centrum voor Histocompatibiliteit, Rabobank Medicidesk, Stichting HELLP-syndroom, Stichting Oranjekliniek and VPS Diagnostics.