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
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Journal of the Neurological SciencesAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Editorial: millennium reflections.Multiple Sclerosis. 2001; 7: 1-3
- Role of Th1 and Th2 cells in neurologic disorders.in: Romagnani S Th1 and Th2 cells in health and disease. Karger, Basel1996: 171-186
- The nature of inflammatory components during demyelination in multiple sclerosis.J. Neuroimmunol. 1988; 20: 203-209
- A pathogenic role for myelin-specific CD8+ T cells in a model for multiple sclerosis.J. Exp. Med. 2001; 194: 669-676
- Tc1/Tc2 and Th1/Th2 balance in Asian and Western types of multiple sclerosis.J. Neuroimmunol. 2001; 119: 297-305
- The clinical course of multiple sclerosis during pregnancy and the puerperium.Arch. Neurol. 1990; 47: 738-742
- Pregnancy and multiple sclerosis—a 3-year prospective study.J. Neurol. 1994; 241: 228-233
- Pregnancy is associated with a lower risk of onset and a better prognosis in multiple sclerosis.Brain. 1995; 118: 253-261
- Pregnancy and multiple sclerosis.Mayo Clin. Proc. 1997; 72: 977-989
- Rate of pregnancy-related relapse in multiple sclerosis.N. Engl. J. Med. 1998; 339: 285-291
- Bidirectional cytokine interactions in the maternal–fetal relationship: is successful pregnancy a Th2 phenomenon?.Immunol. Today. 1993; 14: 353-356
- Pregnancy: success and failure within the Th1/Th2/Th3 paradigm.Semin. Immunol. 2001; 13: 219-227
- Pregnancy and multiple sclerosis.Arch. Neurol. 1986; 43: 719-725
- The expanding universe of T-cell subsets.Immunol. Today. 1996; 7: 138-146
- Redirecting Th1 and Th2 subsets.Springer-Verlag, Berlin1999
- Th-cell modulation in multiple sclerosis.Immunol. Today. 1997; 18: 507-509
- Cytokine secretion profile of myelin basic protein-specific T cells in multiple sclerosis.Mult. Scler. 2000; 6: 69-77
- Single-cell analysis of cytokine production shows different immune profiles in multiple sclerosis patients with active or quiescent disease.J. Neruoimmunol. 2001; 121: 88-101
- New diagnostic criteria for multiple sclerosis: guidelines for research protocols.Ann. Neurol. 1983; 13: 227-231
- Rating neurologic impairment in multiple sclerosis: an expanded disability status scale (EDSS).Neurology. 1983; : 1444-1452
- Patterns of cytokine secretion by autoreactive proteolipid protein-specific T cell clones during the course of multiple sclerosis.J. Immunol. 1995; 154: 2959-2968
- Tumor necrosis factor-alpha synthesis by cerebrospinal-fluid-derived T cell clones from patients with multiple sclerosis.Clin. Exp. Immunol. 1991; 84: 97-102
- Multiple sclerosis: comparison of copolymer-1-reactive T cell lines from treated and untreated subjects reveals cytokine shift from T helper-1 to T helper 2 cells.Proc. Natl. Acad. Sci. 2000; 97: 7452-7457
- Progesterone favors the development of human T helper cells producing Th2 type cytokines and promotes IL-4 production and membrane CD30 expression in established Th1 cell clones.J. Immunol. 1995; 155: 203-217
- Steroid hormone regulation of cytokine secretion by proteolipid-specific CD4+ T cell clones from multiple sclerosis patients and normal control subjects.J. Immunol. 1998; 161: 3365-3374
- Treatment of multiple sclerosis with the pregnancy hormone estriol.Ann. Neurol. 2002; : 421-428
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.