Preeclampsia as acute fetal rejection
Preeclampsia is a disease unique to human pregnancy. The only cure is delivery, even when inflicting prematurity on the neonate. The risk factors (first gestations, changes in paternity, extremes of reproductive age, concomitant autoimmune conditions) suggest an immunologic disorder as part of the fundamental pathology. We are working on understanding the local factors the influence Treg : NK interactions at the uteroplacental interface during normal and preeclamptic pregnancies. In addition, we are working on understanding if fundamental Treg functions are altered in preeclamptic pregnancies and why these women aren't all universally at risk for autoimmune disease.
Fetal response to maternal antigens
The fetus has a robust immune system. What is unique about the fetus is that they make overwhelmingly tolerance type of responses, mainly through Treg activation. This kind of immune tolerance is long lasting (years). Thus, if fetuses were to "experience" antigens to which an inflammatory response would be desirable later in life (e.g., infectious antigens), than in utero encounters could have long-lasting counter productive effects. We are working on understanding the factors, both maternal and fetal, that alter antigen trafficking from the mother to her fetus.