Systemic Lupus Erythematosus (SLE) is an autoimmune disease that mainly affects women, especially between the ages of 15 and 45, but men can also develop SLE (about 1 in 10 patients is male). Symptoms vary widely. One characteristic is the butterfly rash, a red rash that spreads over the nostrils and cheeks. Other common symptoms include fatigue and arthritis, but also inflammation of the kidneys, inflammation of the pericardium, and in rare cases even psychosis can be found in SLE. The versatility of the symptoms makes SLE a challenging condition to recognize and treat. 

Defective mechanism causes complications 

Dankers focuses on the process by which the mother's immune system accepts the baby and placenta despite genetic differences. In women with SLE, this process seems disturbed. 'The placenta belongs to the baby and is actually a foreign body in a woman's body. Normally, the placenta causes the mother's immune system to calm down and accept the foreign body’, Dankers explained. 'In SLE, that mechanism may be defective and therefore complications such as preeclampsia and preterm birth occur.' 

In some autoimmune diseases, symptoms decrease during pregnancy. A striking feature of SLE is that this does not happen; the disease activity does not decrease during pregnancy. This makes it all the more important to understand how SLE affects the interaction between the immune system and the placenta. 

Spheres mimic outer layer of placenta 

Dankers is building an advanced model of the placenta in the laboratory to study these interactions. 'We grow placenta cells on spheres in a bioreactor that mimic the outer layer of the placenta,' she explains. 'To this we add immune cells from SLE patients to study how these cells respond to placental signals.' 

Currently, the model is built with placenta cells from a type of cancer. Dankers wants to move from there to more representative cells that more closely resemble real placental cells. 'We want to see if the immune cells of SLE patients respond differently than those of healthy women’, Dankers said. 

Treatments that prevent or alleviate pregnancy complications  

The research offers hope for breakthroughs in the care of women with SLE. 'If we understand what goes wrong, we may be able to predict who develops complications and even try to correct this process’, Dankers said. In the longer term, this could lead to treatments that prevent or alleviate pregnancy complications. 
In addition, the research has potential to extend beyond SLE. 'We hope to extend our findings to other autoimmune diseases and even to the role that the immune system plays in healthy pregnancies’, she adds. 

Laying foundation for valuable research model 

Dankers's research is made possible in part by the AUF Startup Scholarship, a grant that supports cutting-edge research. 'This grant allows me to hire an analyst to help me set up the models’, she says. It gives her the opportunity to lay the groundwork for a valuable research model in one year.  

‘I think this model can give an enormous boost to my research and the broader field of reproductive immunology’, she says. Dankers has big ambitions. 'I want to expand this research further and contribute to the development of a model that can really make a difference for patients’, she says. Her dream is to put reproductive immunology firmly on the map, not only for SLE, but also for other disorders: 'Every step we take brings us closer to a future where pregnancies are safer for women with SLE. That's the ultimate reward.'