Preeclampsia: a view through the danger model

J Reprod Immunol. 2007 Dec;76(1-2):68-74. doi: 10.1016/j.jri.2007.03.006. Epub 2007 May 4.

Abstract

Classical thinking suggests that the immune system undergoes activation on the basis of discrimination between 'self' and 'non-self'. Accordingly, the fetus activates the mother's immune system because the fetus is in part 'non-self'. Thus, successful pregnancy depends on constraint of maternal immunity. Preeclampsia is an outcome of lost constraint. Instead, the danger model suggests that normal pregnancy, regardless of the expression of 'non-self' antigens, does not activate the maternal immune system unless that pregnancy expresses danger signals. Thus, preeclampsia stems from stress or abnormal cell death in pregnancy-related tissues. This compels expression of specific danger signals and potential activation of anti-fetal immunity, which secondarily feeds the syndrome. Study of preeclampsia from this perspective may bring forth novel mechanisms and indicators of vascular and metabolic dysfunction during pregnancy.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Female
  • Fetal Death
  • Fetus / immunology
  • Fetus / physiology
  • HELLP Syndrome / immunology*
  • HELLP Syndrome / physiopathology
  • Humans
  • Immune Tolerance
  • Maternal-Fetal Exchange
  • Models, Biological
  • Placenta / immunology*
  • Pre-Eclampsia / immunology*
  • Pre-Eclampsia / physiopathology
  • Pregnancy