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The Maternal-Foetal Interface and Gestational Chimerism: The Emerging

Importance of Chimeric Bodies

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DOI: 10.1080/09505431.2011.628014

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The Maternal–Foetal Interface and

Gestational Chimerism: The Emerging
Importance of Chimeric Bodies
a
Susan Elizabeth Kelly
a
ESRC Centre for Genomics in Society (EGENIS) and Department
of Sociology and Philosophy, University of Exeter, Exeter, UK

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Gestational Chimerism: The Emerging Importance of Chimeric Bodies, Science as Culture,
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The Maternal – Foetal Interface and

Gestational Chimerism: The Emerging
Importance of Chimeric Bodies

SUSAN ELIZABETH KELLY

Downloaded by [University of Exeter] at 01:39 21 February 2012

ESRC Centre for Genomics in Society (EGENIS) and Department of Sociology and Philosophy,
University of Exeter, Exeter, UK

ABSTRACT The science of gestational cell transfer—research into the transfer of cells
between a pregnant woman and foetus during gestation—and subsequent mingling of
transferred cells, or microchimerism, is bringing new attention to the maternal/foetal
interface. These findings challenge previous biological understandings of a barrier
between the body of a pregnant woman and developing foetus, a barrier maintaining
the identity integrity as it were, of two beings, two separate subjects. In this sense, the
maternal – foetal interface is an interesting bio-political object, predicated upon
understandings of individuals as discrete and bounded organisms, an understanding
that has been strongly implicated in immunology, as Donna Haraway, Emily Martin
and others have argued. Findings of cellular transfer across this interface raise
questions about intermingling and permeability of human organism boundaries.
However, these findings are important not only for insight into gestational biology, but
because they are emerging in a broader biomedical context of the development of
cellular therapies and regenerative medicine. These therapeutic strategies call attention
to chimerism as a naturally occurring and iatrogenic biological state, highlighting the
permeability and permissiveness of bodies to the intermingling of cells, an idea that
runs counter to biological, political and social understandings of selves as
individuated, discrete and purely self. A theoretical framework of immuno-politics
raises implications of trouble at the maternal/foetal interface, and suggests that
chimeric, permeable bodies are of increasing value as cellular therapeutic strategies
gain in importance for human health.

KEY WORDS : Chimerism, immuno-politics, foetal –maternal relations

Correspondence Address: Dr Susan Elizabeth Kelly, ESRC Centre for Genomics in Society (EGENIS) and
Department of Sociology and Philosophy, University of Exeter, Byrne House, St German’s Road, Exeter EX4
4PJ, UK. Email: s.e.kelly@exeter.ac.uk

0950-5431 Print/1470-1189 Online/12/000001-25 # 2012 Process Press

http://dx.doi.org/10.1080/09505431.2011.628014
 2 S. E. Kelly

Introduction
Novel developments in reproductive medicine, some more widely known than
others, are bringing renewed attention to the relationship between pregnant
women and foetuses, for example, recent media reports of the development of
blood tests for non-invasive prenatal diagnosis of Down Syndrome and other
genetic conditions (e.g. Pollack, 2008; Roberts, 2011). These tests access foetal
genetic material directly from the mother’s blood, avoiding the need for more
risky, invasive methods of diagnosing foetal genetic conditions. The science
behind such tests is advancing rapidly and non-invasive diagnostic tests for
Down Syndrome are anticipated to be clinically available within the next five
years (Lo and Chiu, 2007).1 Their clinical imminence represents a technological
development with potentially profound implications for the politics and ethics
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of maternal – foetal relations, as well as the social experience of pregnancy.

Their development follows on decades of biomedical research directed toward iso-
lating foetal cells from maternal blood during gestation.
Perhaps most salient to rethinking the politics and ethics, as well as the biology,
of maternal/foetal relationality are findings of cellular transfer, and subsequent
cellular persistence or chimerism, that occurs between maternal and foetal
bodies during gestation. (Chimerism refers to the intermingling of cells from
two or more genetically distinct organisms.) These findings challenge previous
biological understandings of a barrier between the body of a pregnant woman
and the developing foetus, a barrier maintaining the identity integrity as it were,
of two beings, two separate subjects. In this sense, the foetal/maternal interface
is an interesting bio-political object, predicated upon understandings of individ-
uals as discretely bounded organisms. Findings of cellular transfer across this
interface raise questions about genetic intermingling and permeability of human
organism boundaries. However, they are important not only for insight into gesta-
tional biology, but because they are emerging into a broader biomedical context of
the development of cellular therapies and regenerative medicine. These thera-
peutic strategies call attention to chimerism as a naturally occurring and iatrogenic
biological state, highlighting the permeability and permissiveness of bodies to the
intermingling of cells, an idea that runs counter to biological, political and social
understandings of selves as individuated, discrete and purely self.
Past scholarship on maternal – foetal relationality from political, feminist and
historical perspectives (e.g. Petchesky, 1987; Duden, 1993; Ginsberg and Rapp,
1995; Casper, 1998; Morgan and Michaels, 1999; Tong, 1999) has focused on
the emergence of the foetus as an individuated moral and social subject, increas-
ingly endowed with personhood (e.g. Addelson, 1999), and on conflicts between
maternal and foetal subjects in terms of autonomy and rights. The erasure, or
establishment, of connections between maternal and foetal bodies and subjects
has been the subject of sustained ethical and legal analysis [see for example
Annas (1986, pp. 13–14) on women as foetal containers]. Yet the material,
 The Maternal – Foetal Interface and Gestational Chimerism 3

physiological interface between the bodies of pregnant women and foetuses has
remained in the background, relatively unexamined in all but a few narrow
areas of biology.2 What implications for maternal –foetal relationality, for the
politics of maternal and foetal bodies, might follow from findings of gestational
cell transfer, that call attention to this interface in new and interesting ways?
This attention may have troubling implications for how pregnant women and
foetuses are understood as subjects. What implications for the immuno-politics
of maternal and foetal bodies and subjects follow from findings of cellular
exchange across a permeable interface, rather than immunological tensions
between two genetically different individuals, the separation of ‘two entities’?
More broadly, can gestational chimerism serve as a lens into the further question
of the emerging importance of chimeric bodies in biomedicine, as a questioning of
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the unitary organism and subject?

For several decades, and in pursuit of techniques of non-invasive prenatal diag-
nosis, a small group of researchers has examined the transfer of cells between
maternal and foetal bodies during pregnancy, and the persistence in host tissues
of some of these transferred cells (maternal and foetal microchimerism). Accord-
ing to Rinkevich (2001), genetically non-homogenous organisms are established
by the incorporation of somatic mutations (mosaicism) or via chimerism, where
an individual is composed, simultaneously, of cell populations originating from
two distinct fertilization products (Figure 1). Chimeras may develop through
natural processes, or as the result of experimental manipulation or an iatrogenetic
act such as tissue (blood, organ, cell) transplantation. The term microchimerism
was first used in 1977 by Liégeois et al. to describe the long-term retention of
foetal cells in the marrow of postpartum female mice, in which cells that
carried a paternally inherited cytogenetic marker were able to survive and
proliferate without inducing graft-vs-host disease (Liégeois et al., 1977; see also
Liégeois et al., 1981). (Foetal/maternal microchimerism has been associated with
implications for therapeutic transplantation since at least these reports.)
Chimerism, not only of maternal and foetal bodies but of bodies more generally
(Figure 2), is of increasing relevance as therapeutic paradigms such as tissue trans-
plantation, regenerative medicine and cell-based therapies become ever more
available (see, for example, Gottweiss et al., 2009; Meyer et al., 2009). Tracing
the migration of cells and molecules through permeable bodies has come to
assume wide significance in biomedicine. To this end, I place emerging under-
standings of the maternal –foetal interface in the context of broader biologic
and therapeutic understandings of cellular and immunologic plasticity. Interrog-
ation of this interface between subjects/bodies is converging with the increasing
importance of identity plasticity in biomedicine, an interesting and important
shift from previous immune discourses that have represented and valued bodies
as distinct, defended selves (e.g. Cohen, 2009).
This article first sets out the analytic perspective of immuno-politics with which
this question is framed, drawing particularly on previous attention to the problem
 4 S. E. Kelly
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Figure 1. Chimera painted on dish. Credit: http://en.wikipedia.org/wiki/File:Chimera_Apulia_

Louvre_K362.jpg.

Figure 2. Sheep/goat chimera by Dr Gary B. Anderson. Credit: http://en.wikipedia.org/wiki/UC_

Davis.
 The Maternal – Foetal Interface and Gestational Chimerism 5

of maternal –foetal relationality in the work of Martin and Haraway. It then moves
to present an historical account of the modern discovery of gestational cell transfer
and the invisibility of the biological maternal – foetal interface to much of repro-
ductive medicine, with the exception of the immunological paradox of preg-
nancy—that is, the problem posed to immunology by the tolerance of the
maternal immune system to the presence of the foetus. The article then turns to
contemporary understandings of maternal –foetal microchimerism and impli-
cations for understandings of health, gestational biology, and the broader signifi-
cance of genetically heterogeneous and permeable bodies.
The material presented in this paper draws from a larger project examining the
ontological potentials of microchimerism, within the fields of gestational cell
transfer science and related developments in prenatal testing and women’s
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health. The project examines the history and ongoing development of such
science, focusing on the period from the 1970s to the present, and examining
the production of evidence and arguments from the perspective of research scien-
tists. It is methodologically pluralistic, combining ongoing review of the relevant
scientific literature, participant observation at relevant scientific conferences, and
interviews with scientists and other key actors whose work is well represented in
the literature. Data presented in this paper were obtained from all of these sources.

Analytical Perspectives: Immuno-politics and the Maternal – Foetal

Relationship
This paper draws upon, and is intended as a contribution to, the literature on
immuno-politics, in which the maternal –foetal relationship has long been recog-
nized as a paradox. Nonetheless, whereas a large part of scholarship on immuno-
politics has been inspired by the importance immunology (and autoimmunity) has
assumed with global traumas, including the Nazi state, the human immuno-
deficiency virus (HIV) epidemic, and more recent events of war and terror [for
example, the useful essay by Campbell (2006) and work by Esposito (2008)], revi-
siting this area of scholarship in the context of gestational cell transfer reflects the
current biomedical preoccupation with cellular therapies and regenerative medi-
cine. These therapeutic regimes directly and indirectly challenge the modern
subject as defended individual, bounded and impermeable. The job of immune
discourses, according to Haraway (1991, p. 208) is the construction of an organ-
ism’s boundaries; organisms are made, constructs at the near-identity between
technology, body and semiosis. I take this to be an important way of thinking
about the articulation of political, cultural and biological forms of thought,
imperatives and discourses that do their work by the conceptual co-constitution
they invoke. As Haraway (1991, p. 96) and others since (e.g. Cohen, 2009)
have argued, biology has intrinsically been a branch of political discourse, not a
compendium of objective truth. Haraway (1991, p. 98) makes the further point
that noting connections between biological and political discourses is not a
 6 S. E. Kelly

commentary on the quality of the science or suggestion of mere ideological under-

pinnings, but runs deeper into connections between the biological constitution and
nature of those very subjects upon which modern political systems are organized
and whose governance, whose relationship to state and to other, is continually
contested. Descriptions of what have foundationally been conceptualized as
autonomous human subjects, both biologically and politically, invoke political
discourse and constitution as they describe organisms, cells and biological pro-
cesses [or, as Van Dijk (1998) has argued, are brought in to describe them].
According to Haraway (1991, p. 204), addressing the relationship between bio-
logical description and immuno-politics, the immune system is a map drawn to
guide recognition and misrecognition of self and other in the dialectics of
Western bio-politics, and a plan for meaningful action to construct and maintain
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the boundaries for what may count as self and other in the crucial realms of the
normal and the pathological.
Similarly, Emily Martin (1990) provided a foundational examination of political
imagery of the body and immune system deployed in scientific and popular litera-
tures on immunology, in which the body was likened to a defended nation-state.
Martin identified the productively constitutive warfare imagery employed through-
out immunological science, depicting the body as under constant threat of invasion
by pathological organisms. More recently, Cohen (2009, p. 8), tracing the concept
of immunity historically, writes that, ‘After the advent of immunity-as-defence,
bioscience affirms that living entails a ceaseless problem of boundary mainten-
ance’. Cohen argues that, against previous (‘less modern’) ideas about organisms
co-existing in shared ecologies, sometimes to mutual benefit, modern biomedical
dogma has assumed that life vitally depends upon the defence of self against intru-
ders, and in this move, the modern science of immunity ‘betrays its unacknow-
ledged debt to modern philosophies of personhood’ (2009, p. 8). Cohen’s thesis
is that this understanding of immunity and the organism (as self-interiorizing
and defensive) has moved from politics and law into medicine and biology, and
‘percolates through political, legal, philosophical, economic, administrative, gov-
ernmental, scientific and medical discourses’ (2009, p. 9).
While Cohen emphasizes the emergence of the atomized modern subject and
organism, no longer understood as contiguous with its environment or ecologi-
cally enmeshed, Martin argues for the particular importance this ontology has
had for understanding the bodies of women, which are threatened with the need
to maintain the status of ‘all self’ during gestation. Martin (1998) examined
language used in medical textbooks and science reporting to describe the
immune paradox of pregnancy, in which the foetus is likened to an ‘intruder in
the womb’, extending her previous discussions of underlying assumptions in
immunology of the body as possessing internal purity and homogeneity.
The idea of tolerance of self together with the imagery of aggressive
immuno-warfare against the foreign focuses on the body that is all of one
 The Maternal – Foetal Interface and Gestational Chimerism 7

kind, all purely self. The pure body is the normal body; hence, the normal
woman would destroy her foetus to return to a normal state of internal
purity. . . . In addition to the mixing of self and other in pregnancy,
(women) are said to be statistically more prone to autoimmune diseases
(Martin, 1990, p. 418).
The latter point suggests that the maternal body develops certain antibodies to
the ‘foetal intruder’ yet does not destroy it—clearly foetal material reaches the
maternal immune system, crossing the placental boundary that separates the
two entities (Martin, 1990, p. 134).

There are recent indications that an extreme version of the defended-self

model is edging out the view of the mother ‘tolerating’ or ‘allowing’ the
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foetus to live. This view . . . appeared in the 1980s. In this view, the foetus
is thought of not as an inert passenger in pregnancy but rather, as in
command of it . . . the foetus is responsible for solving the immunological
problems raised by its intimate contact with the mother (1990, p. 134).

More recently, the active foetus line of thinking about maternal –foetal relation-
ships has generated explanations such as that for the condition eclampsia as an
extreme form of a strategy used by foetuses to enhance their uterine environment
(Zimmer, 2006).
As the evolutionary (for example, Mercier et al., 2011) and therapeutic signifi-
cances of chimerism continue to gain attention, the transfer and movement of cells
across boundaries and within bodies, naturally and iatrogenically, come further
into focus. Cellular therapies such as stem cell transplantation are, in social and cul-
tural terms, in line with biomedical harnessing of cells as instrumental and agentic,
separated from bodies, identified particularly by Hannah Landecker (2007).

Empirical Analysis
Discovery of Gestational Cell Transfer
In 1969, Janina Walknowska, a visiting fellow at the University of California,
San Francisco, and colleagues published a paper in The Lancet describing
finding cells with Y chromosomes circulating in the blood of women who were
pregnant with male foetuses (Walknowska et al., 1969). The implication of this
finding, they reported, was that foetal cells are common in the maternal blood
as early as the fourteenth week in pregnancy. They identified these cells as
foetal lymphocytes, a type of cell not deriving from the placenta but most likely
from the foetal circulation itself. The researchers proposed that foetal cells
present in the mother’s blood could be targeted for improved prenatal genetic
diagnosis, particularly with the emerging application of computer technology to
chromosome analysis. They noted, however, among other potentially confounding
 8 S. E. Kelly

factors, the unresolved question of persistent chimerism of the mother with the
implantation and multiplication of foetal lymphocytes in maternal tissues
(Walknowska et al., 1969, p. 1121). Further, noting that much work has been
done on the problem of why the mother’s immune system fails to reject the
foetus, they suggested that the presence of foetal cells contributes to acceptance
of the foetus during gestation (1969, p. 1122).
The Walknowska et al. paper was followed by a widely cited paper by Stanford
researchers providing further evidence that, during gestation, cells cross from the
foetus to the maternal circulating blood (Herzenberg et al., 1979). Some years
later, one of these researchers published evidence that foetal cells persist in the
maternal body long after a pregnancy, sometimes for decades (Bianchi et al.,
1996). Later studies have suggested that foetal cells may enter the maternal
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blood stream and travel to diseased tissues in her body, and that these may be
stem cells, capable of differentiating into fat, muscle, nerves and bone (O’Dono-
ghue et al., 2004; Bianchi, 2007).
The Walknowska paper represented an important moment in biomedical think-
ing about boundaries between maternal and foetal bodies; a moment at which the
functional separation of maternal and foetal bodies, particularly circulations, was
overshadowed by the implications of leakages—of permeability—between them.
It set off efforts to capitalize on the presence of foetal cells in maternal blood for
development of non-invasive prenatal diagnostic testing of foetal genetic material;
and it set the stage for further biomedical examination of the maternal – foetal
interface, to establish among other things whether it is permeable in healthy preg-
nancies, thus allowing routine access to foetal cells from the pregnant woman’s
blood, or whether such transfer occurs only in the context of pathology or injury.
Contemporary biomedical understandings of maternal and foetal bodies and
subjects identify them as biological individuals, endowed with related but distinct
genetic identities as reflected in unique and fundamentally antagonistic immune
selves. The Walknowska et al. paper initiated a field of research that challenges
traditional teachings that maternal and foetal circulations are separated by a
barrier; this view is called into question by physiological and clinical findings
of regular cellular traffic between bodies, and biological intermingling. These
are findings that, in the words of one researcher, challenge the traditional teaching
that the foetal and maternal circulations are separated by a generally impermeable
chorionic barrier (Bianchi, 1998). They sit uneasily with reproductive practices
such as gestational surrogacy, but also the nature/culture categorization of auton-
omous bio-social selves.

The Maternal –Foetal Barrier and Gestational Cell Transfer Science

Maternal and foetal bodies have traditionally been described as separated by a
selective and protective barrier between maternal and foetal circulations. The
developing foetus has been understood to be both nurtured and protected from
 The Maternal – Foetal Interface and Gestational Chimerism 9

environmental harms via the barrier functions of the placenta, although histori-
cally theories about these functions have been contentious (De Witt, 1959). In
the mid-eighteenth century, John and William Hunter demonstrated the indepen-
dence of the maternal and foetal circulations (Longo and Meschia, 2000). Founda-
tional work into understanding the functioning of the placenta as an organ of
limited exchange, vital for foetal respiration, but separating maternal and foetal
circulations, was carried out in the early twentieth century. There were very
few centres of reproductive research anywhere in the world during this time, as
reproductive researchers struggled with a status of contested legitimacy (Clarke,
2004, p. 84). Medical attention to reproductive physiology was dominated by
obstetrics and gynaecology, largely attending to surgical procedures, and the
shift to scientific medicine in gynaecology and obstetrics was largely from surgi-
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cal anatomy to reproductive physiology. It involved the development of functional

(physiological) understandings of reproductive systems and processes to increase
potential non-surgical therapeutics (Clarke, 2004, p. 87). A leading figure in
developing understandings of placental blood flow was Elizabeth Ramsey at the
Carnegie Institute of Washington, working on the problem of ‘how the maternal
arterial and venous bloods are kept separate in the amorphous intervillous space
of the hemochordial placenta’ (Clarke, 2004, p. 98). In writing this history
Clarke has observed, ‘A large literature has emerged on the separation of the
foetus and mother known as “maternal/foetal conflict”. Ramsey’s . . . research
can be viewed as early articulations of that separation’ (Clarke, 2004, p. 99).
Nonetheless, reports suggesting permeability of the maternal –foetal barrier to
the transfer of cells between maternal and foetal bodies have appeared in the
medical literature since at least 1893, when the renowned German pathologist
Christian Georg Schmorl identified foetal (trophoblast) cells in the lungs of preg-
nant women who had died from eclampsia (Davies and Coupland, 1967; Lapaire
et al., 2007). Contact between maternal and foetal circulations was also suggested
by the problem of Rhesus (Rh) hemolytic disease in pregnancy. In Rh hemolytic
disease, maternal – foetal blood type incompatibility induces maternal antibodies
to be directed against foetal red blood cells. Understanding and developing treat-
ments for Rh hemolytic disease was a major focus in obstetrics during the mid-
twentieth century. A number of papers reporting foetal cells in the maternal
blood during pregnancy were published in the scientific literature during this
period. For example, in the early 1960s Clayton et al. (1964) attempted to establish
a normative quantification of foetal red blood cells in the blood of pregnant
women at various stages of pregnancy, in order to aid diagnosis. Nonetheless,
the notion of a maternal –foetal barrier, permeable to some substances but not
those of blood or identity, appeared in major medical texts of the time. The
1967 edition of Gray’s Anatomy describes it as follows: ‘a permeable barrier
and allows water, oxygen and other nutritive substances, and hormones to pass
from the mother to the foetus and some of the products of excretion to pass
from the foetus to the mother’ (Davies and Coupland, 1967, p. 130).
 10 S. E. Kelly

The identification of foetal cells (or, in most experiments, cells with a Y

chromosome) in blood from pregnant women was taken up as novel decades
later. Following the Walknowska paper, several groups of researchers engaged
seriously in the task of taking advantage of foetal cells in maternal circulating
blood for developing techniques of non-invasive prenatal diagnosis. Diana
Bianchi, who remains a leading researcher in this field, joined a research group
brought together by Leonard Herzenberg at Stanford University. Herzenberg envi-
sioned the separation of foetal from maternal cells for prenatal diagnostics as a
potential use of a powerful, newly developed tool for sorting lymphocyte cell
types, the fluorescence-activated cell sorter (FACS) (see Herzenberg et al.,
1979; Keating and Cambrosio, 2003). A 1979 paper by Herzenberg and the
Stanford team (Herzenberg et al., 1979, p. 1453) begins with the comment:
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Although the maternal –foetal barrier is generally considered to be effective

in limiting cell transfer from foetus to mother, there have been several
reports over the last 10 years suggesting that blood samples from pregnant
women contain nucleated cells derived from the foetus.

Researchers have continued to pursue the goal of prenatal genetic diagnosis

using foetal cells in maternal circulation, identifying various target cell types,
isolation and enrichment techniques, and also positing mechanisms of cell trans-
fer, in research that has been supported by the National Institutes of Health
among other governmental funding bodies (Wachtel et al., 2001; Bianchi et al.,
2002; Bianchi and Hanson, 2006). This line of inquiry has brought renewed
attention to mechanisms by which cell transfer occurs, that is, attention to the
physiology and functions of the maternal – foetal interface. For example, a
review of maternal –foetal cell transfer science and possibilities of prenatal
diagnosis, published in 1994, included two papers on maternal –foetal interface
physiology. One by a renowned fertility specialist describes the placenta as
open and vast like a ‘frontier’, and active in ‘moving living cells into the
mother’ (Beer et al., 1994, p. 21); far from the traditional teaching of a barrier
maintaining the rigid integrity of two bodies (but maintaining the connection
between cells and whole, distinct subjects of mother and foetus that has framed
attempts to reliably differentiate and isolate foetal cells from a background of
maternal cells).
Nonetheless, the goal of replacing existing prenatal screening techniques in
terms of accuracy, reliability and ease of implementation across heterogeneous
health systems and locations has proven elusive, beset by both technological
and physiological challenges (Bianchi and Hanson, 2006). An important impedi-
ment is the persistence of cells from a previous pregnancy, as suggested by the
Walknowska paper; yet another is the lack of universal foetal-specific cell
markers (that is, independent of confirmation by sex chromosome or known
paternal genetic contribution).
 The Maternal– Foetal Interface and Gestational Chimerism 11

Numerous researchers have now reported that, during pregnancy, bi-directional

cell traffic between the foetus and pregnant woman is a normal occurrence, and
that such cells can persist in their new host. In one well-cited paper, Bianchi
and colleagues reported finding male cells (bearing a Y chromosome), putatively
foetal, in the blood of healthy non-pregnant women, one of whom had given birth
to a son 27 years earlier (Bianchi et al., 1996). Other researchers have presented
evidence that a woman who has been pregnant is likely to be a chimera; that is, to
contain a mixture of her own cells and those of her foetuses (see Johnson and
Bianchi, 2004). Cells of apparently maternal origin have also been found in the
tissues of children (Nelson, 2008).
Another research group reported finding Y-chromosome-bearing cells in the
livers of female children and foetuses, and concluded that it is likely that these
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cells may not only have been transmitted by the mother, but acquired by her
from an earlier pregnancy or her own foetal life (Guettier et al., 2005). In other
words, the maternal –foetal interface may be the site of transmission of cells
from one sibling to another (horizontal transmission) as well as between gener-
ations (vertical transmission). According to these interpretations of evidence,
the boundaries between bodies are messy indeed!

Maternal – Foetal Cell Transfer: Implications for Regenerative Medicine

Drawing gestational cell transfer research directly to regenerative medicine,
researchers Diana Bianchi and Nicholas Fisk have argued that microchimerism
of gestational origin (as identified primarily through sex-mismatching chromo-
some signal evidence) should be understood to complicate efforts to identify
engraftment of stem cells in regenerative medicine contexts. They cite evidence
that what would conventionally be considered an adult stem cell population is actu-
ally composed of foetal and adult stem cells. Although the ratios seem small, they
are not different from those reported for microchimerism after stem cell therapy
(Bianchi and Fisk, 2007, p. 1490). In other words, there are a number of sites in
current biomedical practice and therapeutic development where microchimerisms
from various sources, both iatrogenic and natural, overlap and in which chimeric
(permeable) bodies are ‘made’ (in Haraway’s sense).
While previous investigations of foetal cells in maternal bodies were conducted
in the context of maternal –foetal incompatibility and potential pathological out-
comes, a more recent framework for investigation of foetal cell transfer and micro-
chimerism is both instrumental and therapeutic, shaped by scientific and cultural
transformations of cells into therapeutic objects, outside of and separate from
bodies (Landecker, 2007). Foetal cells in the bodies of women who have been
pregnant have been interpreted as reserve populations of stem and progenitor
cells that aid in the body’s response to disease or injury. Studies have identified
(putatively) foetal cells in solid organs of women who have been pregnant,
suggesting their capacity to migrate from the circulation, home to various tissue
 12 S. E. Kelly

types, and differentiate or fuse (Johnson and Bianchi, 2004, p. 501). As one
review article suggests, these results suggest that the overall health effect of
pregnancy is a positive one, and may be due to the acquisition of foetal cells
with therapeutic potential. Women who have never been pregnant lack this
source of cells and therefore have to rely on endogenous cells for tissue repair,
which leads to more severe disease consequences (Johnson and Bianchi,
2004, pp. 499– 500). Bianchi (2007) has termed such cells ‘pregnancy associated
progenitor cells’ (PAPCs), bringing microchimeric foetal cells into alignment with
adult and embryonic stem cells, and the therapeutic promises associated with these
entities. Foetal cells have also been suggested as targets for gene therapy strat-
egies, capitalizing on their stem cell properties (Chan et al., 2005). An attractive
goal for such therapeutic applications is in utero transfusion of manipulated foetal
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stem cells to treat anticipated postnatal disease, with the goal of widespread
chimerism in the receiving foetus (see O’Donoghue and Fisk, 2004; Chan
et al., 2005).
A number of studies have suggested that the permeability of the boundary
between maternal and foetal bodies results in the potential inscription of any preg-
nancy into a woman’s body, whether or not it resulted in birth, and hence the pres-
ence of some genetic material from the father in her body. According to these
interpretations, the permeability of maternal – foetal boundaries may mean that
some medical tests or procedures, such as those associated with stem cell transplan-
tation, will require full disclosure of a woman’s reproductive history for evaluation
of results (Bianchi and Fisk, 2007). These possibilities are suggested by a study that
was interpreted as demonstrating conclusively that cells from a terminated foetus
can persist in the mother and differentiate into cells in a mature organ in the
maternal body (Johnson et al., 2002). The researchers analysed a liver biopsy
from a woman with hepatitis C who was a control subject in a study looking at
the association of foetal cells with maternal disease. The woman had given birth
to one child, a son. The researchers found that a part of her liver contained thou-
sands of male cells, and that DNA in the male cells appeared related to the
female DNA in the liver. However, this DNA did not match that of her son.
Upon investigation of her reproductive history, they identified that she had had
four additional pregnancies, including two terminations and two miscarriages.
The researchers were able to obtain DNA from two of the men involved in these
pregnancies, and found one to be a biological match for the male cells in her
liver. They hypothesized that pregnancy to be the source of these cells. Interest-
ingly, the researchers reported that she did well clinically in spite of not following
the prescribed treatment regime, suggesting beneficial activity of these microchi-
meric cells (interview, gestational cell transfer scientist, June 2008).
A second branch of gestational microchimerism science examines maternal to
foetal cell transfer and microchimerism. Female cells of presumed maternal origin
have since been found in skin and organs of infants, children and adults with and
without various diseases (Nelson, 2008). Maternal to foetal microchimerism is
 The Maternal– Foetal Interface and Gestational Chimerism 13

less well characterized but has also been identified with intriguing implications for
postnatal development of autoimmune diseases.
In brief, then, maternal –foetal cell transfer and microchimerism science has
drawn attention to the maternal –foetal interface not as a barrier separating and
maintaining distinctions between maternal and foetal bodies and genetic selves,
but as a permeable interface across which a great deal of intermingling of identity
markers occurs. Furthermore, the cells that transfer between bodies are interpre-
tively situated in this scientific arena within current and emerging cellular thera-
peutic modalities, particularly those of regenerative medicine. Maternal and foetal
cells do not only circulate across a porous boundary; they maintain critical
markers of subject identity (i.e. maternal and foetal as both universal subject cat-
egories and individuated genetic selves). As such, they provide evidence of further
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troubled body boundaries or interfaces, particularly those between sexual partners,

siblings and across generations. The integrity of these boundaries is intimately tied
to contemporary Western understandings of the individual subject and associated
forms of autonomy, relationality and community (see Esposito, 2008). Barriers
that are understood to prevent traffic of such identity bearing matter as cells are
also implicated and inscribed in a range of scientific practices, including current
and powerful understandings and practices of the genetic individual and prevailing
understandings of the immune self (Howes, 2008a).

Maternal Bodies, Foetal Cells and Immune Conundrums of Pregnancy

The Walknowska paper discussed above signalled that cell transfer across the
maternal –foetal boundary was connected to broader questions of the immune
relationship between pregnant women and foetuses, invoking the paradox of preg-
nancy long puzzled over by immunologists (Howes, 2008b). Peter Medawar, in
the 1950s, described the foetus as a semi-allograft, having inherited one half of
its genes from its father, a concept that persists in immunological literature
(Medawar, 1953; see for example, Blackburn, 2007, p. 481).3 In immunology,
maternal and foetal bodies are often conceptualized as warring entities battling
for control (Howes, 2008b, p. 283).
Again, the notion of barrier between the foetus and pregnant woman has tra-
ditionally been invoked to explain the tolerance of the foetus by the maternal
immune system. Trouble at the maternal –foetal interface, as identified by the
Walknowska paper and others, therefore prefigured current interest in rethinking
the immune paradox of pregnancy, a particularly interesting development in light
of re-evaluation of the self/non-self immunological paradigm occurring within
the field of immunology itself (e.g. Tauber, 2000, 2006). As scientist and philoso-
pher Alfred Tauber has written:

the self is polymorphous and ill-defined. Contemporary transplantation

biology and autoimmunity have demonstrated phenomena that fail to
 14 S. E. Kelly

allow strict adherence to such a dichotomy of self/non-self, and as new

models are emerging, the self has been left exposed as a metaphor, whose
grounding philosophically and scientifically is unsteady (Tauber, 2006, p. 1).

Maternal – foetal cell transfer findings, including findings of persistent micro-

chimerism, are being viewed as an additional challenge to the self/non-self
paradigm of immunology, in research that examines the role of cell traffic in auto-
immune diseases, and in a range of approaches toward gaining new traction on
the immune paradox of pregnancy (see for example Adams and Nelson, 2004;
Apari and Rzsa, 2009). The intermingling of maternal and foetal cells has made
the question of maternal tolerance even more complex; according to a recent
paper by maternal –foetal cell transfer researchers, the process by which maternal
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and foetal cells coexist during pregnancy without evidence of rejection or graft-
versus-host disease is unknown (Adams et al., 2007).
As historian Moira Howes (2008a) argues, a model of the foetus as foreign has
underlain a significant portion of research in reproductive immunology. The
foreign intruder model is implicated in evolutionary versions of the unique
human gestational condition as one of conflict between two distinct individuals
with distinct evolutionary objectives (Howes, 2008a, p. 258), in which mother
and foetus each seeks to maximize their nutritional advantage. In contrast, Howes
(2008a, p. 262) champions what she terms a relational model of reproductive immu-
nology that resists the notion of mother and foetus as two unitary immune selves as
well as the notion that they can be collapsed into one unitary self. Most importantly,
the relational model posits maternal–foetal immunological relations as mutually
beneficial, more an intricately coordinated dance than warfare, defence or conflict.
Howes relational model of reproductive immunology, as well as challenges to
the self/non-self distinction suggested by maternal – foetal microchimerism,
appear to resonate with changing understandings in immunology more broadly,
as reflected by Tauber:

We are witnessing a significant challenge to immunology’s basic tenet, the

immune self. Such an ‘entity’ is increasingly regarded as polymorphous
and ill defined as transplantation biology and autoimmunity have demon-
strated phenomena that fail to allow faithful adherence to a strict dichotomy
of self/nonself discrimination . . . When the character of the immune ‘object’
is determined by the context in which it appears, not its character as ‘foreign’
per se, self/nonself discrimination recedes as a governing principle. In such
context-based models, ‘ecologic’ controls arise from the entire organism in
which the immune system is fully integrated. In these systems, subject –
object relationships become blurred (Tauber, 2000, p. 241).

What Howes terms the transplant model takes the view that the foetus is to the
pregnant maternal body in essence an organ transplant, and mechanisms are
 The Maternal– Foetal Interface and Gestational Chimerism 15

needed that protect the foetus from the immune defences of the pregnant body that
would otherwise result in rejection of the transplant. This model is reflected, for
example, in recent research into the role of T regulator cells in the immune
system. These cells, according to some researchers, regulate the potential of the
immune system to attack itself, and may also play a role in pregnancy and the
tolerance of the maternal body to the presence of the foetal allograft (Fehervari
and Sakaguchi, 2006).
Howes (2008a, p. 264) argues that the persistence of intruder and transplant
models of the maternal –foetal relationship are deeply inscribed in experimental
systems (Rheinberger, 1997) in immunology, shaping both material practices
and theoretical contexts of knowledge production. Like the concept of the
maternal –foetal interface as a barrier, these models are based on unexamined
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assumptions of maternal and foetal bodies as rigid conceptual containers. In

essence, she is suggesting that these models entwine the material, ontological,
epistemic and cultural in producing frames of knowledge about bodies and
subjects. They matter in the sense that they are embedded in and reinforce exper-
imental systems and absorb attention that might otherwise be focused on more
empirically adequate experimental models (Rheinberger, 1997, p. 265). Impor-
tantly, maternal and foetal immune-self differences have played a significant
role in the experimental systems designed to identify presumed foetal cells in
maternal blood, particularly in the form of immune-genetic techniques (e.g.
Johnson and Bianchi, 2004).
A similar relationship between ontological models and experimentation is found
in competing representations of the implications of gestational cell transfer
between maternal and foetal bodies. Specifically, discoveries of foetal and maternal
cells where they are not expected to be, having crossed the interface between the
rigid conceptual containers of maternal and foetal bodies/subjects, have been
accompanied by hypotheses concerning the pathological or beneficial effects of
such intermingling. It is difficult to separate these narratives from either the instru-
mentalism through which cells, as techno-ontological objects, are understood, or
from the relationship of cells to the notion of discrete maternal and foetal subjects.
That subject identity (maternal, foetal) is inscribed in, and treated as constitutive
of, cells, and is discoverable through appropriate applications of technology,
remains a background assumption of experimental strategies in the field.

Foetal –Maternal Microchimerism: The Good, the Bad and the Indifferent
The permeability of bodies and subjects is further read through narratives of con-
sequence and agency, in particular whether foetal/maternal microchimerism is
pathogenic or beneficial, both, or neither. The field of maternal –foetal microchi-
merism science is shaped by several competing hypotheses regarding what
maternal and foetal microchimeric cells are doing (Johnson and Bianchi, 2004,
p. 501). That is, the transfer of cells across the maternal –foetal boundary is
 16 S. E. Kelly

being interpreted by many researchers as aligning with the normal and patho-
logical—having implications for health and potentially for therapeutic uses. The
attribution of agentic and instrumental properties to microchimeric cells reflects
important developments in contemporary biomedical sciences and their cultural
resonances (Landecker, 2007). Stem cells are a particularly potent example, circu-
lating beyond bodies of origin and into host organisms, cells as technologies, their
therapeutic potential depending upon host permeability.
The research group of Lee Nelson in Seattle has, since 1996, followed the
hypothesis that maternal –foetal cell traffic is implicated in autoimmune diseases,
which are more prevalent in women than men (Nelson, 1996). The proposed
mechanisms of this bad hypothesis have to do with immune response similar to
graft-versus-host disease. It is hypothesized that transferred cells may attack
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host tissue, or that host tissue immune cells may attack transferred cells. Nelson
has investigated and written about maternal to foetal traffic as a central concern
as well, with an additional hypothesis that mothers’ cells are older, and therefore
may be likely to lead to malignancies (Nelson, 2008). Conditions including scler-
oderma, neonatal lupus and Type 1 diabetes have been examined for the role of
maternal cells in triggering autoimmune response and disease.
Diana Bianchi (2007, p. 14) tells a narrative of the ‘aha moment’ in their
research leading to the ‘good’ hypothesis—that foetal cells in the maternal
body function as reserves of stem cell-like cells capable of migrating to sites of
maternal tissue injury and behaving like ‘normal cells’, contributing to tissue
repair/injury response. She has argued that stem cells acquired during pregnancy
challenge another bit of ‘prevailing wisdom’. This is

that there are predominantly 2 types of stem cells, embryonic and adult . . .
We hypothesize that during pregnancy, women acquire cells from their
foetuses that are retained for decades. Some of these foetal cells are stem or
progenitor cells that have the capacity to repair maternal organs. Therefore,
sex matters in any discussion regarding the pluripotency of adult stem cells.

For example, in the context of investigating the possibility that foetal cells play
a role in maternal cases of autoimmune thyroiditis, Bianchi’s lab analysed surgical
specimens of thyroid tissue removed from a woman to treat an enlarged goiter.
They found that a section of the woman’s thyroid was composed entirely of
male cells, with normal thyroid specific appearance (using X and Y chromosome
probes). The woman had delivered a male baby in 1967 and a female in 1971 but
had no other sources of microchimerism (such as transplantation). They hypoth-
esized that she acquired a male stem cell during pregnancy which migrated to
her diseased thyroid and began to form new thyroid cells. Subsequent research
by this group has found presumed foetal (Y chromosome bearing) cells in
various organs in women’s bodies that expressed appropriate surface markers
for the type of tissue they were in (e.g. liver, thyroid) (Khosrotehrani et al., 2004).
 The Maternal– Foetal Interface and Gestational Chimerism 17

The ‘good’ hypothesis is supported by evidence regarding maternal cells in

offspring as well. While studying the potential role of maternal cells migrating
to the foetal pancreas and triggering an immune attack, Nelson and colleagues
(Nelson, 2008, p. 72) identified presumed maternal cells producing insulin in
the pancreases of diabetics and non-diabetics alike. They interpreted this
finding to suggest that ‘maternal cells in the pancreases of diabetics try to regen-
erate the diseased organ’ (emphasis added). In addition to this agentic claim,
Nelson further suggests that ‘microchimerism might one day be exploited for
therapeutic benefit—if a way could be found to induce the nonnative cells to
multiply and differentiate to restore damaged tissues’ (2008). The good hypothesis
thus includes hypotheses of both natural benefit from microchimerism, and
microchimeric cells as targets for therapeutic intervention.
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A third hypothesis, the bystander hypothesis, suggests that foetal –maternal

microchimerism occurs in healthy as well as diseased tissue and is a fairly
normal occurrence with no necessary implications for health (Gilliam, 2006).
Although this hypothesis does not have the same potential (nor produce the
same incentives) to drive experimentation, it is supported by conflicting data gen-
erated by experiments following the good or bad hypotheses, particularly that pre-
sumed foetal or maternal cells are often found in tissues of control subjects as well
as those affected by disease. Further, using the experimental technologies com-
monly employed, particularly fluorescent in situ hybridization (FISH) and poly-
merase chain reaction (PCR), analysis in archived specimens can be difficult to
interpret. A related hypothesis suggests that implications of microchimerism are
neither good nor bad but a continuum depending on a host of developmental,
genetic, immunologic and environmental factors; a position consonant with emer-
ging views of the immune system as evolving and ecological (Tauber, 2000;
Johnson and Bianchi, 2004; interview, gestational cell transfer scientist, June
2008). The bystander hypothesis, however, further suggests that intermingling
of organisms at the cellular level need not violate or challenge that organism’s
health or integrity.

Permissive Boundaries, Permissive Bodies

Martin’s previous work on immuno-politics and biomedical imagery identified the
defended nation-state with the notion of the body that is ‘all self’ (Martin, 1990).
Emerging imagery related to the science of gestational cell transfer and microchi-
merism, in both scientific papers and in writing directed toward a lay audience,
suggests a less defended view of boundaries of the self, and of the political
body; a shift of emphasis in immuno-politics to bodies as permeable and bound-
aries as permissive. Without overstating their significance, recent descriptions of
the permeability of the maternal –foetal interface to cells bearing individuated
identity markers (e.g. genetic material) as well as self elements (e.g. antigens)
have deployed images of migration and foreignness rather than invasion and
 18 S. E. Kelly

battle, pointing to a shift in the bio-political salience of purity and defence to ‘the
foreigner within’ (Girardi, 2009).
Scientific papers on gestational cell transfer routinely appropriate language of
trafficking and migration that evokes images of agentic cells not only crossing,
but transgressing, boundaries. In much of the scientific literature, foetal cells
are described as actively migrating, seeking, homing, localizing and differentiat-
ing to become like adult (host tissue) cells. Gestational cell transfer is frequently
referred to as traffic between maternal and foetal bodies in scientific reports, while
foetal cells are described as migrating into the maternal body and homing in on
sites of tissue injury or other locations where they are found to differentiate.
Chimeric cells are referred to as populations of cells, potentially capable of repo-
pulating host organs.
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This use of language subtly embeds technical descriptions of experimentation

and evidence with immuno-political meaning, a folding back of discourses from
the political arena, to biology, and back again. In the limited popular attention
to the intriguing evidence of intermingling reproductive bodies, language invok-
ing migration, foreignness and intermingling is more explicit. One image particu-
larly evocative of cellular therapies is that of the body as a landscape into which
foreign stem cells are seeded and may later grow (Nelson, 2008). Extending this
image, stem cells (with which, as discussed earlier, microchimeric cells have been
identified) settle into host tissue and differentiate appropriately, or provoke attack.
In a 2008 Scientific American (a science-popularizing publication) article,
scientist Lee Nelson evokes cell migration with particularly striking images:

That cells cross the placenta is not surprising. After all, the tissue that con-
nects mother and child is not an impenetrable barricade. It is more like a
selective border crossing, allowing passage, for instance, of materials
needed for the foetus’s development. What is remarkable, however, is the
extent to which the migrant cells can persist in their new host, circulating
in the blood and even taking up residence in various tissues. Better under-
standing of the actions of the transferred cells could someday allow clini-
cians to harness the stowaways’ beneficial effects while limiting their
destructive potential (Nelson, 2008, p. 72).

The imagery of this paragraph suggests that cells ‘taking up residence’ where
they should not be presents potential dangers to the host body. Nelson furthers
the immigration/assimilation metaphor of immunology in describing a potential
route through which maternal to foetal cell transfer may endanger her offspring:

Further, the results add to other findings indicating that some diseases con-
sidered to be autoimmune might instead occur when the host immune system
reacts badly, not to native tissues, but to acquired cells that have made a
home in those tissues (Nelson, 2008, p. 74).
 The Maternal– Foetal Interface and Gestational Chimerism 19

The mixing of bodies apparently permitted by the now leaky maternal – foetal
interface suggests a range of consequences arising from self/non-self messiness.
In the following passage, Nelson emphasizes the different states of development
of maternal and foetal immune systems and thus identities, furthering the immi-
gration metaphor to processes of assimilation or merging of foreign cultural
traits with the host culture. (Her research has emphasized the potentially negative
consequences for women of gestational cell transfer, such as the development of
autoimmune disorders which have higher prevalence in women than in men.)

Because maternal microchimerism becomes established during development

(when the foetus’s immune system is forming) and foetal microchimerism
occurs when the mother’s immune system is mature, the contribution of the
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two processes to the self may differ just as immigrants who arrive as a nation
is being formed may assimilate differently than those who arrive later. We
do not yet know very much about those differences. And we understand very
little about another intriguing frontier—whether women face unique conse-
quences from harbouring cells across generations, both from their own
mothers and from one or more of their children (Nelson, 2008, p. 78).

What is most striking in this passage, however, is not the immigration meta-
phor, but rather the elision of cells and organism identity, such that cells are
understood to originate from and retain the identity of the organism/subject of
origin (i.e. mothers, children, siblings, previous generations). This is the nature/
culture moment implicit in gestational cell transfer research; the obdurate yet
subtle continuity between cells, bodies and identities shapes experimental
systems and is made visible by them. That is, experimental systems in gestational
cell transfer science are designed to produce difference between the subject iden-
tities of foetal and maternal, on the basis of presumed differentials in cell identity
characteristics.4 This identity continuity drives research hypotheses in this area of
science, as described previously by Howes with regard to the science of immu-
nology. However, as discussed in a previous section of this paper, maternal –
foetal microchimerism and cell differentiation have been suggested as proof of
principle for stem cell transplantation (e.g. Bianchi, 2007).
Supporting the permissiveness of bodies to intermingling required by the
broader development of cell-based therapies (and iatrogenic microchimerism),
Nelson (2008, p. 78) states that:

Our findings and those of others in this new field support a redefinition that
embraces the naturally acquired microchimerism that is probably always
with us from the earliest moments of life well into our adulthood.

To return to immuno-politics, purity of the human organism—the organism as all

self—runs counter to the permissiveness these therapies require. Permeability in the
 20 S. E. Kelly

form of microchimerism is both increasingly made visible, and made valuable.

Permissive bodies bring trouble at the maternal–foetal boundary into focus, because
this is the site at which a foundational individuation has been thought to take place.

Conclusion
Recent biological science of gestational cell transfer has made visible per-
meability at the maternal –foetal interface that has overturned previous ortho-
doxies about the maternal –foetal barrier. It has the potential to bring renewed
attention to issues of relationality between pregnant women and foetuses, both
as bodies and as subjects. The under-examined notion of this interface as a
barrier has had political as well as physiological importance, as it formed the
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basis for understanding gestation as the process of individuation between two

distinct, and foundational, subjects. The bio-political separation of a pregnant
woman and foetus into discrete genetic and subject identities underlies under-
standings of pregnancy as positing a paradox to immunology. It underlies the
decades of effort to develop non-invasive techniques for prenatal genetic diagno-
sis, as well as experimental systems in gestational cell transfer science that are
designed to produce, or re-produce, the separate subject identities of mother and
foetus, and the discreteness of these identities to the cellular level. In and of
themselves, these are important understandings, with productive interfaces with
developments in immunology as well as cellular therapies, in addition to the
bio-politics of maternal – foetal relationality.
At the same time, gestational cell transfer science has drawn attention to forms of
chimerism—both naturally and iatrogenically produced—that have relevance for a
range of therapeutic approaches involving cell or tissue transplantation; that is, to
the importance of bodies as tolerant of alien or foreign cells, at least under some
circumstances. Evidence of foetal cell chimerism and engraftment are proof of
principle of mechanisms involved in stem cell therapies. Further, chimerism is
increasingly recognized as a natural state in other organisms, and may prove to
be the exception rather than the rule (Waters, 2011). Evidence of microchimerism
as a natural state loops out of, and into, understandings and material practices in
which cells are marked by subject identity, as well as being produced as isolated
artefacts and therapeutic objects. I argue that gestational cell transfer and
maternal –foetal microchimerism can be seen to presage a shift in immuno-politics
from defended boundaries to permissive, permeable bodies. This paper has
suggested the importance of attendance to the productive interfaces of unstable,
permeable, bodies and subjects, from stem cell therapy, to transplantation therapies,
to reproductive practices, to political discourses of sovereign bodies and subjects.
What implications for immuno-politics flow from this emerging chimeric para-
digm? If we return to the proposition offered by Haraway that the job of immune
discourses is the construction of an organism’s boundaries, then the technoscien-
tific production (and visibility) of chimerism can be seen as complicating the
 The Maternal– Foetal Interface and Gestational Chimerism 21

immuno-political notion of boundaries, and ontologies of subjects/organisms. A

chimeric paradigm sets interesting challenges not only to the defended self—
self that is ‘all self’—model of immunology, but to transformations of those
notions themselves that are turning attention to the biological and ecological
context of immune objects. Chimeric constitution—of bodies, organisms and sub-
jects—suggests an immuno-politics that must take seriously relationality to the
foreigner within. It must engage with notions of the permissive, the permeable,
the plastic. These ontologies would presumably have cultural, political and econ-
omic significance, not least as informing the broader field of promise for cellular
therapeutic interventions.
That is, to the extent that many tissue-based interventions and therapeutic appli-
cations, including stem cell-based applications, will rely on patterns of cell dis-
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persion, or migration, and tolerance, the model of chimeric cells integrating

themselves has acquired an increasingly positive and therapeutic potential. This
emergent chimeric paradigm may be reconstituting the bounded individual para-
digm (of impermeability and autonomy established through self-recognition) to
become one in which permeability is a necessary precondition for the plasticity
so associated with regenerativity and regrowth. This is particularly the case in
areas of gestational cell transfer science where microchimeric cells are concep-
tually elided with stem cells and promises of regenerative medicine.

Notes
1
As of October 2011, the US based company Sequenom has announced the launch of such a test.
2
One might make the argument that the material maternal/foetal interface is an object that falls
within the domains of several different sciences, depending on what questions are raised about it
(Toulmin, 1972, p. 149). Nonetheless, the argument I wish to make is that the relative invisi-
bility of the maternal/foetal boundary as an object of inquiry has been disturbed by evidence
produced in reproductive cell transfer science, evidence that challenges previously held
assumptions more taken for granted in some disciplines than others of the barrier functions
of that boundary.
3
Peter Medawar’s work on tissue graft rejection and acquired immune tolerance was critical to
the development of organ transplantation, and led to the award of the Nobel Prize in Physiology
or Medicine in 1960.
4
It is worth noting that efforts to develop non-invasive prenatal genetic diagnostic techniques
based on the presence of genetic material originating from the developing foetus in the
venous blood of the pregnant woman have turned nearly exclusively to cell-free foetal DNA
and RNA, and in many applications to quantitative rather than qualitative approaches, avoiding
this cell-identity conundrum (see, for example, Avent et al., 2008; Chiu et al., 2011). As stated
previously, the Y chromosome (or locations on the Y chromosome) remains the gold standard
for foetal cell identification.

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 22 S. E. Kelly

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