Maternal-fetal cellular trafficking: clinical implications and consequences

• Published in: Current opinion in pediatrics Vol. 26; no. 3; pp. 377 - 382
• Main Authors: Jeanty, Cerine, Derderian, S Christopher, Mackenzie, Tippi C
• Format: Journal Article
• Language: English
• Published: United States 01-06-2014
• Subjects: Adult; Aneuploidy; Autoimmune Diseases - diagnosis; Autoimmune Diseases - genetics; Chimerism - embryology; Female; Fetal Therapies - methods; Graft Rejection - genetics; Graft Rejection - immunology; Histocompatibility, Maternal-Fetal - immunology; Humans; Immune Tolerance; Infant, Newborn; Maternal-Fetal Exchange - immunology; Pregnancy; Pregnancy Complications - diagnosis; Pregnancy Complications - genetics; Pregnancy Complications - immunology; Prenatal Diagnosis
• ISSN: 1040-8703; 1531-698X
• DOI: 10.1097/MOP.0000000000000087

Maternal-fetal cellular trafficking (MFCT) is the bidirectional passage of cells between mother and fetus during pregnancy. This results in the presence of fetal cells in the maternal circulation, known as fetal microchimerism, and maternal cells in the fetal circulation, known as maternal microchimerism. The biologic role of this transplacental cellular trafficking during pregnancy is not known, although it has been implicated in development of the fetal immune system, tolerance mechanisms during pregnancy, tissue repair in autoimmune disease and cancer, and immune surveillance.
Clinical utility of MFCT has been identified in prenatal testing for aneuploidies and prediction of pregnancy complications. Additionally, this transplacental passage of cells has been implicated in the delicate balance between immunologic priming and tolerance, which can influence the occurrence of autoimmune disease and transplantation outcomes. Ongoing studies are evaluating the utility of microchimerism in predicting the risk of graft rejection in transplantation.
In this review, we will discuss the clinical implications of MFCT in pregnancy, fetal surgery, autoimmune disease, transplantation, and cancer.