Abstract
The possible influence of steroid hormones in multiple sclerosis (MS) has been a matter
of great interest. A first illustration comes from the analyses of the influence of
gender on susceptibility to MS and on MS severity. A series of arguments emerge in
favour of a possible influence of steroid hormones in MS. The menstrual cycle, and
even more pregnancy, may influence the clinical evolution of MS. In the PRIMS study,
there was a dramatic decrease in the relapse rate during pregnancy, especially in
the third trimester, with a rebound increase in the 3 months post partum. Animal studies
have provided further confirmatory results. Many experiments have shown that sex steroids
may have immunological effects, in preventing or treating experimental allergic encephalomyelitis.
They could also have an effect on myelinating and remyelinating the peripheral and
possibly the central nervous system. These clinical and experimental data have led
to consider sexual steroids as potential therapeutic tools for preventing relapses
in women with MS, in particular in the post-partum period.
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
- Course and prognosis of multiple sclerosis assessed by the computerized data processing of 349 patients.Brain. 1980; 103: 281-300
- The natural history of multiple sclerosis: a geographically based study: III. Multivariate analysis of predictive factors and models of outcome.Brain. 1991; 114: 1045-1056
- Early predictors and progression of irrerversible disability in multiple sclerosis: an amnesic process.Brain. 2003; 126: 770-782
- The management of multiple sclerosis: 3. Apparent suppression of symptoms by an estrogen-progestin compound.Mol Med. 1969; 66: 209-211
- Menstrually related worsening of symptoms in multiple sclerosis.J Neurol Sci. 1997; 149: 95-97
- Premenstrual exacerbations of multiple sclerosis.J Neurol Neurosurg Psychiatry. 1998; 65: 279-280
- A pilot study of the effect upon multiple sclerosis of the menopause, hormone replacement therapy and the menstrual cycle.J R Soc Med. 1992; 85: 612-613
- Correlation between sex hormones and magnetic resonance imaging lesions in multiple sclerosis.Acta Neurol Scand. 1999; 99: 91-94
- MRI in multiple sclerosis during the menstrual cycle: relationship with sex hormone patterns.Neurology. 1999; 53: 622-624
- Pregnancy in multiple sclerosis.J Neurol Neurosurg Psychiatry. 1993; 56: 1043-1045
- Multiple sclerosis and pregnancy: cflinical issues.Rev Neurol. 1999; 155: 186-191
- Rate of pregnancy-related relapse in multiple sclerosis.N Engl J Med. 1998; 339: 285-291
- Pregnancy and multiple sclerosis (PRIMS) study: clinical predictors of post-partum relapse.Brain. 2004; 127: 1353-1360
- Magnetic resonance evaluation of disease activity during pregnancy in multiple sclerosis.Neurology. 1994; 44: 327-329
- Effect of pregnancy on experimental allergic encephalomyelitis in guinea pigs and rats.J Neurol Sci. 1978; 38: 317-326
- Suppressive effect of pregnancy on the development of experimental allergic encephalomyelitis in rabbits.J Am Reprod Immunol. 1984; 5: 109-113
- The ameliorating effect of pregnancy on chronic atrophic (infectious rheumatoid) arthritis, fibrositis, and intermittent hydrarthrosis.Proc Staff Meet Mayo Clinic. 1938; 13: 161-167
- Systemic lupus eythematosus in pregnancy.Lancet. 1991; 338: 756-757
- Effects of estrogen, progestin and combined estrogen-progestin oral contraceptive preparations on experimental allergic encephalomyelitis.Trans Am Neurol Assoc. 1969; 94: 54-58
- Suppression of acute experimental allergic encephalomyelitis by the synthetic sex hormone 17-alpha-etinylestradiol: an immunological study in the lewis rat.Int Arch Allergy Immunol. 1993; 102: 133-140
- Estriol ameliorates autoimmune demyelinating diseases. Implications for multiple sclerosis.Neurology. 1999; 52: 1230-1238
- Oestrogen-induced suppression of collagen arthritis: IV. Progesterone alone does not affect the course of arthritis but enhances the oestrogen-mediated therapeutic effect.J Reprod Immunol. 1989; 15: 141-150
- A comparison of the effects of melengestrol acetate with a combination of hydrocortisone acetate and medroxyprogesterone acetate and with other steroids in the treatment of experimental allergic encephalomyelitis in Wistar rats.Acta Neuropathol. 1973; 23: 95-104
- Estrogen induces a potent suppression of experimental autoimmune encephalomyelitis and collagen-induced arthritis in mice.J Neuroimmunol. 1994; 53: 203-207
- Low-dose estrogen therapy ameliorates experimental autoimmune encephalomyelitis in two different inbred mouse strains.J Immunol. 2001; 166: 2080-2089
- Female sex hormones at supraphysiologic, but not physiologic, levels decrease EAE severity in female SJL mice.Neurology. 2001; 56: A70
- Exogenous androgen treatment decreases the severity of EAE in SJL male mice.Neurology. 2001; 56: A94
- Effect of estradiol on cytokine secretion by proteolipid protein-specific T cell clones isolated from multiple sclerosis patients and normal control subjects.J Immunol. 1997; 158: 446-451
- Estradiol potentiates poke-weed mitogen-induced B cell stimulation in multiple sclerosis and healthy subjects.Acta Neurol Scand. 1989; 79: 340-346
- Progesterone favors the development of human T helper cells producing Th2-type cytokines and promotes both IL4 production and membrane CD30 expression in established Th1 cell clones.J Immunol. 1995; 155: 128-133
- Steroid hormone regulation of cytokine scretion by proteolipid protein-specific CD4+ T cell clones isolated from multiple sclerosis patients and normal control subjects.J Immunol. 1998; 161: 3365-3374
- A progesterone-dependent immunomodulatory protein alters the Th1/Th2 balance.J Reprod Immunol. 1996; 31: 81-95
- Cyclooxygenase is involved in the effects of progesterone-induced blocking factor on the production of interleukin 12.J Am Obstetrics Gynecol. 2000; 183: 126-130
- Progesterone synthesis and myelin formation by Schwann cells.Science. 1995; 268: 1500-1503
- The neurosteroid progesterone increases the expression of myelin proteins (MBP and CNPase) in rat oligodendrocytes in primary culture.Cell Mol Neurobiol. 1996; 16: 439-443
- Glucocorticoids and progestins signal the initiation and enhance the rate of myelin formation.Proc Natl Acad Sci U S A. 1998; 95: 10459-10464
- Age-induced decrease of glycoprotein PO and myelin basic protein gene expression in the rat sciatic nerve. Repair by steroid derivatives.Neuroscience. 1998; 85: 569-578
- Biology and genetics of hereditary motor and sensory neuropathies.Ann Rev Neurosci. 1995; 18: 45-75
- Progesterone stimulates Krox-20 gene expression in Schwann cells.Mol Brain Res. 2001; 90: 75-82
- Krox-20 controls myelination in the peripheral nervous system.Nature. 1994; 37: 1796-1799
- Progesterone stimulates the activity of the promoters of peripheral myelin protein-22 and PO genes in Schwann cells.J Neurochem. 1998; 71: 1765-1768
- Estrogen-inducible progesterone receptor in primary cultures of rat glial cells.Exp Cell Res. 1991; 193: 12-19
- Progesterone and the oligodendroglial lineage: stage-dependent biosynthesis and metabolism.Glia. 2001; 36: 295-308
- Progesterone and its metabolites increase myelination in organotypic slice cultures of rat cerebellum.J Neurochem. 2003; 86: 848-859
- Systemic progesterone administration results in a partial reversal of the age-associated decline in CNS remyelination following toxin-induced demyelination in male rats.Neuropathol Appl Neurobiol. 2004; 30: 80-89
- Treatment of multiple sclerosis with the pregnancy hormone estriol.Ann Neurol. 2002; 52: 421-428
- Effects of raloxifene on bone mineral density, serum cholesterol concentrations, and uterine endometrium in postmenopausal women.N Engl J Med. 1997; 337: 1641-1647
Article Info
Identification
Copyright
© 2005 Elsevier B.V. Published by Elsevier Inc. All rights reserved.
