Changes in T, B, and NK lymphocyte subsets during and after normal pregnancy.

PROBLEM: Pregnancy affects the maternal immune system and the clinical course of maternal diseases. Here we report the changes in the detailed lymphocyte subsets of helper T cells, suppressor T cells, CD5+ B cells, T cell receptor (TCR) alpha beta-positive T cells (T alpha beta cells), TCR alpha beta-negative T cell (T gamma delta cells), and other during and after pregnancy through to one year postpartum, and discuss the significance of the changes.

METHOD: The absolute numbers of helper T cells, suppressor T cells, cytotoxic T cells, TCR alpha beta-negative T cells (T gamma delta cells), CD5- B cells, CD5+ B cells, and NK cell subsets were examined by two-color flow cytometry in peripheral blood from 51 healthy non-pregnant women, 106 healthy pregnant women, and 148 healthy postpartum women.

RESULTS

In early pregnancy, the numbers of suppressor T cells and NK cells with strong cytotoxicity (NK+3 cells) increased, and the number of cytotoxic T cells decreased. In late pregnancy, the helper T cell and NK+3 cell numbers decreased. T alpha beta, CD5- B and CD5+ B cells decreased during pregnancy. After delivery, helper T cells and cytotoxic T cells increased from 1 to 4 months postpartum, and suppressor T cells increased at 7 months postpartum. TCR alpha beta-negative T cells increased at 4 to 10 months postpartum. Both CD5- and CD5+ B cells decreased further at 1 month postpartum, but CD5+ B cells increased markedly at 7 to 10 months postpartum.

CONCLUSIONS

These data indicate that 1) early increases of suppressor T cells and NK+3 cells during pregnancy may be related to the mechanism to accept or reject the fetus in early pregnancy, respectively; 2) late decreases of helper T cells and NK+3 cells may be related to the maintenance of pregnancy: 3) postpartum increases of helper T cells, cytotoxic T cells, TCR alpha beta-negative T cells (T gamma delta cells), and CD5+ B cells may be related to the postpartum aggravation of autoimmune diseases; and 4) the immunological effects of pregnancy remains until about 1 year after delivery.