Understanding and Managing Pregnancy in Patients with Lupus

Table 1

Hormonal and immune response differences between normal pregnancies.

Immune and hormonal response	Normal pregnancy	Lupus and pregnancy	Clinical manifestation associated
Th17: IL-17	High	Higher increase	Preeclampsia and pregnancy loss
Estradiol and progesterone	Higher in second and third trimester	Lower in second and third trimester	Impaired placental function and fetal loss
IL-6	Low at first trimester but high in the third trimester	Low in the three trimesters	Altered immune regulation from T cell to B cell
IL-10	Low in the trimester but high in the last trimester	High since preconception throughout pregnancy and still postpartum	Continuous B cell stimulation
Treg cells	High	Low number and impaired function	Lupus activity
Chemokines; CXCL8/IL-8; CXCL9/MIG; CXCL10/IP-10	Low	Higher serum concentrations	Increase pregnancy complications and lupus flares
Ficolin-3	Low	Increase	Haemolysis
IFN-	Low	Higher concentration	Contribution to preeclampsia
C4d	Low	Higher concentration	Low placenta weight and low birth weight
Prolactin	Low	Higher concentration	Lupus activity

IL: interleukin; Treg cells: T regulatory cells; CXCL: chemokine ligand; MIG: monokine induced by gamma interferon; IP-10: interferon gamma-induced protein 10; INF-: interferon alpha; C4d: complement component.