Regulatory T cells in Systemic Lupus Erythematosus and Pregnancy

Authors

  • Clare Tower,

    Corresponding author
    1. Faculty of Medical and Human Sciences, Maternal and Fetal Health Research Centre, Institute of Human Development, University of Manchester, Manchester, UK
    • Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, St Mary's Hospital, Manchester, UK
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  • Stephy Mathen,

    1. Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, St Mary's Hospital, Manchester, UK
    2. Faculty of Medical and Human Sciences, Maternal and Fetal Health Research Centre, Institute of Human Development, University of Manchester, Manchester, UK
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  • Ian Crocker,

    1. Faculty of Medical and Human Sciences, Maternal and Fetal Health Research Centre, Institute of Human Development, University of Manchester, Manchester, UK
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  • Ian N. Bruce

    1. Arthritis Research UK Epidemiology Unit, School of Translational Medicine, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK
    2. NIHR Manchester Biomedical Research Unit, The Kellgren Centre for Rheumatology, Central Manchester University Hospitals NHS Foundation Trust, Manchester, UK
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Correspondence

Clare Tower, Maternal and Fetal Health Research Centre, St Mary's Hospital, Manchester M13 9WL, UK.

E-mail: clare.tower@manchester.ac.uk

Abstract

Systemic lupus erythematosus (SLE) is a chronic multisystem autoimmune disorder that predominantly affects women of reproductive age. As clinical outcomes improve, pregnancy in these women is becoming more common. Although epidemiological data have documented an improvement in the prognosis of pregnancy in these women over recent years, they are still at significantly increased risk of pregnancy complications, such as miscarriage, stillbirth, pre-eclampsia and impaired foetal growth. The pathogenesis of SLE involves marked immune dysfunction, and in particular, the function of immunosuppressive elements of the immune system is impaired, including regulatory T-cell function. Because regulatory T cells are likely to be the key cell-modulating feto-maternal tolerance, this review overviews the possibility that regulatory T-cell impairments contribute to pregnancy pathology in women with SLE and contribute to the clinical challenge of managing these women during pregnancy.

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