Immune microenvironment dynamics in pregnant patients with concomitant autoimmune diseases: mechanisms, challenges, and clinical significance

Zi-Jun Ma; Jun Chen; Chen-Xi Yang; Shun-Ping Lin; Quan Gong; Zachary Braunstein; Ying-Ying Wei; Xiao-Quan Rao; Ji-Xin Zhong

doi:10.1016/j.mmr.2026.100015

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Immune microenvironment dynamics in pregnant patients with concomitant autoimmune diseases: mechanisms, challenges, and clinical significance

REVIEW | Updated：2026-05-11

- Immune microenvironment dynamics in pregnant patients with concomitant autoimmune diseases: mechanisms, challenges, and clinical significance
- Military Medical Research (2026)
- Affiliations：
  
  Department of Rheumatology, Fujian Medical University Union Hospital, Fuzhou 350001, China
  Division of Rheumatology and Immunology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
  Sinopharm Dongfeng General Hospital (Hubei Clinical Research Center of Hypertension), Hubei Key Laboratory of Wudang Local Chinese Medicine Research, Hubei University of Medicine, Shiyan 442000, Hubei, China
  Fujian Institute of Clinical Immunology, Fuzhou 350001, China
  Department of Immunology, School of Medicine, Yangtze University, Jingzhou 434023, Hubei, China
  Division of Hematology, Department of Internal Medicine, James Comprehensive Cancer Center, the Ohio State University Wexner Medical Center, Columbus, OH 43210, USA
  Division of Cardiology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
  Key Laboratory of Vascular Aging (HUST), Ministry of Education, Wuhan 430030, China
- Author bio：
  
  *Ying-Ying Wei, yying_wei@126.com;
  Xiao-Quan Rao, xqrao@tjh.tjmu.edu.cn;
  Ji-Xin Zhong, zhongjixin620@163.com
- Funds：
- DOI：10.1016/j.mmr.2026.100015
  CLC：
- Received：21 February 2025，
  
  Accepted：06 March 2026，
  
  Published：2026-04
- Accepted：
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Ma ZJ, Chen J, Yang CX, Lin SP, Gong Q, Braunstein Z, et al. Immune microenvironment dynamics in pregnant patients with concomitant autoimmune diseases: mechanisms, challenges, and clinical significance. Mil Med Res. 2026;13(1):100015.
DOI：

Ma ZJ, Chen J, Yang CX, Lin SP, Gong Q, Braunstein Z, et al. Immune microenvironment dynamics in pregnant patients with concomitant autoimmune diseases: mechanisms, challenges, and clinical significance. Mil Med Res. 2026;13(1):100015. DOI： 10.1016/j.mmr.2026.100015.

摘要

Abstract

Throughout pregnancy

the immune microenvironment undergoes dynamic changes in patients with concomitant autoimmune diseases (AIDs). These alterations not only affect disease activity and clinical manifestations

but also play a pivotal role in sustaining maternal-fetal immune tolerance and pregnancy outcomes. Extensive preclinical studies have elucidated the mechanisms of immune regulation in normal pregnancy

whereas the dynamic immune changes in pregnancies complicated by AIDs remain poorly understood. Recent studies have revealed significant variations in immune responses to pregnancy among individuals with AIDs

which may contribute to distinct patterns of AIDs flares during this period. Despite substantial progress in immunology and reproductive medicine

comprehensive reviews addressing the dynamic changes in the immune microenvironment during pregnancy in the context of AIDs are lacking. In this review

we summarize existing knowledge and incorporate recent multidisciplinary findings

focusing on the dynamic changes in systemic immune adaptation and maternal-fetal immune interactions in the context of AIDs during pregnancy. We emphasize the clinical significance of these immune dynamics for optimizing management and therapeutic strategies. Additionally

we propose new perspectives and provide recommendations to guide future research and the development of personalized treatment approaches.

关键词

Keywords

references

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