Two key problems of allo-tolerance during fetal-maternal co-existence are: 1) it's focus must be local, allowing the mother's continued peripheral immune competence to resist pathogens ubiquitously, and 2) it must propagate itself, i.e. continuously recruit new re-enforcements of the local tolerant state. Both are solved by the exosomal pathway of Tregs & Bregs. While the fetal-maternal accomodations of pregnancy terminate at the time of partrurition, geography, climate and the endemic pathogens of the environment surrounding the mother-baby pair would then define the short and long-term effects of their immunologic interaction.
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William J. Burlingham (2024) studied this question.
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