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43 - Sex hormones and other pregnancy-related factors with therapeutic potential in multiple sclerosis

from Section III - Clinical trials of multiple sclerosis therapies

Published online by Cambridge University Press:  05 December 2011

By
Rhonda R. Voskuhl
Edited by
Jeffrey A. Cohen  and
Richard A. Rudick
Jeffrey A. Cohen
Affiliation:
Cleveland Clinic
Richard A. Rudick
Affiliation:
Cleveland Clinic
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Summary

Since mechanisms of action of the approved therapies for multiple sclerosis (MS) involve anti-inflammatory effects, and since these treatments result primarily in a reduction in relapse rates, it is logical to hypothesize that mechanisms of action of the protective effect of pregnancy on MS relapses involve anti-inflammatory effects. Two estrogens (estradiol and estriol) and progesterone each increase progressively during pregnancy. Levels of estrogens that are in oral contraceptives or hormone replacement therapy may not be high enough to be protective in MS. Numerous factors other than sex hormones have been identified in sera during pregnancy and have been shown to be immunosuppressive either in cultures of immune cells in vitro or in experimental autoimmune encephalomyelitis (EAE) models. The combined anti-inflammatory and neuroprotective state of pregnancy, perhaps aimed at protecting the fetus, may be precisely what is needed to protect the central nervous system (CNS) of a mother with MS.

Keywords

laquinimodrelapsing-remitting multiple sclerosisplacebo groupsecondary progressive multiple sclerosisaxonal lossdemyleinationautoimmune encephalomyelitisgadolinium enhancing lesions
Type
Chapter
Information
Multiple Sclerosis Therapeutics , pp. 498 - 507
Publisher: Cambridge University Press
Print publication year: 2011

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