medigraphic.com
ISSN 0185-6014 (Print)
Órgano oficial de difusión de la Federación Mexicana de Patología Clínica, AC y de la Asociación Latinoamericana de Patología Clínica/Medicina de Laboratorio

2002, Number 1

<< Back Next >>

Rev Mex Patol Clin Med Lab 2002; 49 (1)

Rheumatic diseases and pregnancy: clinical manifestations and immunologic and molecular changes

Cuéllar-Dávila JA, Reyes-Jaime AM, Muñoz-Valle JF, Vázquez-Del Mercado M

Language: Spanish
References: 38
Page: 15-22
PDF size: 76.38 Kb.


ABSTRACT

The rheumatic diseases belong to a group of pathologies who have multiple factors involved in their development: endocrines, molecular and immunology. This environment leads to a progressive clinical deteriorment of the patients. By the other hand the pregnancy is a phenomenon that has transitory modifications on the immunity and endocrinology system, with a secondary influence on the humoral immunity and the antibodies production, that superimpose to the cellular immunity dependent by T-cells. This give us a support for explaining the clinical changes in the rheumatoid arthritis and systemic lupus erythematosus, which are the most common rheumatic diseases, clarifying the molecular modifications that are present in this reproductive status. One important factor is the clinical improvement in the patients with rheumatoid arthritis, and the variables exacerbations in the systemic lupus Erythematosus patients. In the present article we discuss the immunologic, hormonal and molecular aspects that are present in the pregnancy, trying to explain the physiology and physiopathology for a better understanding of the phenomenon: Pregnancy and rheumatic diseases.


REFERENCES

  1. Michelle P. Rheumatic Disease Clinics of North America. Pregnancy and Rheumatic Disease. 1997.

  2. Alfonse TM. Seminars in arthritis and rheumatics. Hormonal and pregnancy relationships to rheumatoid arthritis: convergent effects with immunologic and microvascular systems. 1995; 25(1): 1-27.

  3. Ostensen. Sex hormones and pregnancy in rheumatoid arthritis and systemic lupus erythematosus. Annals of the New York Academy of Sciences. 1999; 876: 131-134.

  4. McCune WJ. Rheumatic Disease Clinics of North America. 1994.

  5. Vigano A. Characterization of type 1 and type 2 cytokine production profile in physiologic and pathologic human pregnancy. Clinical and Experimental Immunology 1996; 106(1): 127-133.

  6. Wilder R. Hormonal regulation of tumor necrosis factor-[alpha], interleukin-12 and interleukin-10. Production by activated macrophages: A disease-modifying mechanism in rheumatoid arthritis and systemic lupus erithematosus? Annals of the New York Academy of Sciences. 1999; 876: 14-31.

  7. Puppo F. Determination of soluble HLA-G and HLA-A, -B, and -C molecules in pregnancy. Transplantation Proceedings 1999; 31: 1841-1843.

  8. Athanassakis. Detection of soluble HLA-G levels in maternal serum can be predictive for a successful pregnancy. Transplantation Proceedings 1999; 31: 1834-1837.

  9. Emmer PM. Natural killer cell reactivity and HLA-G in recurrent spontaneous abortion.

  10. Clemens LE. Mechanism of immunosuppression of progesterone on maternal lymphocyte activation during pregnancy. Journal of Immunology 1979: 1978-1985.

  11. Hui L. Synthesis of T helper 2-Type cytokines at the maternal-fetal interface. Journal of Immunology 1993: 574-580.

  12. Athanassakis I. The immunostimulatory effect of T cells and T cells lymphokines on murine fetally derived. Placental Cells 1987; 13 8(1): 37-44.

  13. Mendonca LLF. Natural immune response involving anti-endothelial cell antibodies in normal and lupus pregnancy. Arthritis and Rheumatism 2000; 43(7): 1511-1515.

  14. Kruse N. Variations in cytokine mRNA expression during normal human pregnancy. Clinical and Experimental Immunology 2000; 119(2): 317-322.

  15. Athanassakis I. The immunostimulating effects of T cells and T cell lymphokines on murine fetally derived placental cells. Journal of Immunology 1999; 138(37): 125-130.

  16. Armstrong DT. Effects of lymphokines and immune complexes on murine placental cell growth in vitro. 1999; 40: 466.

  17. Robertson SA. Uterine epithelial cells synthesize granulocyte-macrophage colony-stimulating factor (GM-CSF) and interleukin-6 (IL-6) in pregnant and non pregnant mice. 1992; 46: 1069.

  18. Hill JA. T-helper 1-Type immunity to trophoblast in woman with recurrent spontaneous abortion. JAMA 1995; 273(24): 1933-1936.

  19. Wegmann TG. Bidirectional cytokine interactions in the maternal-fetal relationship: is successful pregnancy a Th2 phenomenon? Immunology Today 1993; 14(7): 136-139.

  20. Hench PS. The ameliorating effect of pregnancy on chronic atrophic (infectious rheumatoid) arthritis, fibrositis, and intermittent hydrarthrosis. Mayo Clinic Procedures 1938; 13: 161-167.

  21. Perselin RH. The interaction of pregnancy and the rheumatic diseases. Clinical and Rheumatology Diseases 1981; 7: 747-768.

  22. Zvaifler NJ. The immunopathology of joint inflammation rheumatoid arthritis. Advances in Immunology 1973; 16: 265-283.

  23. Yoshinoya S. Detection and partial characterization of immune complexes in patients with rheumatoid arthritis plus Sjogren’s syndrome and with Sjogren’s syndrome alone. Clin Exp Immunol 1982; 2: 208-211.

  24. Unger. Disease activity and pregnancy associated (alpha) 2-glycoprotein in rheumatoid arthritis during pregnancy. Br Med J 1983; 286: 750-752.

  25. Persellin RH, Wiginton D, Rutstein J. Pregnancy alpha-glycoprotein (PAG) and rheumatoid arthritis (RA) activity: a prospective analysis during gestation. Arthritis Rheum 1982; 25: 6-21.

  26. Ostensen MB, Von Shoultz GH. Comparison between serum (alpha) 2-pregnancy-associated globulin and activity of rheumatoid arthritis and ankylosing spondylitis during pregnancy. Scand J Rheumatol 1983; 12: 315-318.

  27. Wilder R. Hormones, pregnancy and autoimmune diseases [Neuroimmunomodulation: molecular aspects, integrative systems, and clinical advances: new perspectives in neuroimmunomodulation] Ann N Y Acad Sci 1998; 840(1): 45-50.

  28. Khamashta MA. Systemic lupus erythematosus flares during pregnancy. Pregnancy and rheumatic disease. Rheumatic Disease Clinics of North America 1997.

  29. Siegel MS, Lee L. The epidemiology of systemic lupus erythematosus. Semin Arthritis Rheum 1973; 3: 1-54.

  30. Lima F. Obstetric outcome in systemic lupus erythematosus. Semin Arthritis Rheum 1999; 25: 184-192.

  31. Buyon JP. Neonatal lupus: bedside to bench and back. Scand J Rheumatol 1996; 25: 271-276.

  32. Petri M. Oral contraceptives and systemic lupus erythematosus. Arthritis Rheum 1997; 40: 797-803.

  33. Lahita RG. The effect of sex hormones on the immune system in pregnancy. Am J Reprod Immunol 1992; 28: 136-137.

  34. Cutolo M, Sulli A, Barole A. Sex hormones, proto-oncogene expression ad apoptosis: their effects on rheumatoid synovial tissue. Clin Exp Rheumatol 1996; 14: 87-94.

  35. Evans MJ, MacLauglilin S, Marvin RD. Estrogen decreases in vitro apoptosis of peripheral blood mononuclear cells from women with normal menstrual cycles and decreases TNF-alpha production in SLE but not in normal cultures. Clin Immunol Immunopathol 1997; 82: 258-262.

  36. Jara-Quezada L, Graef A, Lavalle C. Prolactin and gonadal hormones during pregnancy in systemic lupus erythematosus. J Rheumatol 1991; 18: 349-353.

  37. Petri M, Chan D. Longitudinal analysis of prolactin and disease activity in SLE pregnancy. Arthritis Rheum 1995; 38(Suppl.): S220.

  38. McMurray RW, Keisler D, Izui SS, Walker SE. Effects of parturation, suckling and pseudopregnancy on variables of disease activity in the BW mouse model of systemic lupus erythematosus. J Rheumatol 1993; 20: 1143-1151.




2020     |     www.medigraphic.com