Abstract
Pregnancy in multiple sclerosis (MS) patients is associated with a lower risk of progression
and lower rate of exacerbation. These beneficial effects are reversed postpartum.
Considering that the pathogenesis of MS appears to involve cell-mediated immune reactivity,
and that pregnancy is accompanied by a depressed cell-mediated immunity, it has been
proposed that the lower relapse rate and risk of progression of MS during pregnancy
may be due to a pregnancy-associated down-regulation of cell-mediated immunity. In
addition, pregnancy results in a shift towards a T helper (Th) 2 cytokine profile,
which is presumably protective for MS. This study was aimed at investigating the relationship
between clinical status of MS and cytokine levels in eight patients with MS who were
followed through pregnancy and after delivery. Peripheral blood lymphocytes from these
women were stimulated with a mitogen at different time points during and after gestation
and the levels of Th1 cytokines (IFNγ, TNFα) and Th2 cytokines (IL-4, IL-10) were
estimated by ELISA. It was established that six of the eight MS patients studied showed
a distinct shift from a Th2 cytokine bias during pregnancy towards a Th1 cytokine
bias after delivery. These results suggest a possible association between decreased
incidence of exacerbation of MS in pregnancy and a pregnancy-induced shift towards
Th2 cytokine bias.
Keywords
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Article info
Publication history
Accepted:
March 26,
2004
Received in revised form:
February 23,
2004
Received:
August 26,
2003
Identification
Copyright
© 2004 Published by Elsevier Inc.
