Abstract
Demyelinating diseases of the central nervous system comprise a heterogeneous group of autoimmune disorders characterized by myelin loss with relative sparing of axons occurring on a background of inflammation. Some of the most common demyelinating diseases are multiple sclerosis, acute disseminated encephalomyelitis, and neuromyelitis optica spectrum disorders. Besides showing clinical, radiological, and histopathological features that complicate their diagnosis, demyelinating diseases often involve different immunological processes that produce distinct inflammatory patterns. Evidence of demyelination diseases derives mostly from animal studies of experimental autoimmune encephalomyelitis (EAE), a model that relies on direct antibody–antigen interactions induced by encephalitogenic T cells. Pregnancy is characterized by non-self-recognition, immunomodulatory changes and an altered Th1/Th2 balance, generally considered a Th2-type immunological state that protects the mother from infections. During pregnancy, the immune response of patients with autoimmune disease complicated with pregnancy is different. Immune tolerance in pregnancy may affect the course of some diseases, which may reach remission or be exacerbated. In this review, we summarize current knowledge on the immune status during pregnancy and discuss the relationship between pregnancy-related immune changes and demyelinating diseases of the central nervous system.
Highlights
Demyelinating diseases of the central nervous system (CNS) comprise a group of autoimmune disorders, including multiple sclerosis (MS), acute disseminated encephalomyelitis (ADEM), neuromyelitis optica spectrum disorders (NMOSD), and other secondary CNS inflammatory demyelinating diseases [1, 2]
Pregnancy may worsen or have no effect on autoimmune diseases related to antibody-mediated immunity, such as systemic lupus erythematosus (SLE) [35, 36]
Pregnancy is associated with changes in the immune system, which can affect the outcome of various diseases, those of the CNS
Summary
Demyelinating diseases of the central nervous system (CNS) comprise a group of autoimmune disorders, including multiple sclerosis (MS), acute disseminated encephalomyelitis (ADEM), neuromyelitis optica spectrum disorders (NMOSD), and other secondary CNS inflammatory demyelinating diseases [1, 2]. The levels of serum Th2 cytokines IL-6 and IL-10 were found to be significantly higher than in patients with recurrent spontaneous abortion, TABLE 2 | Normal changes in immune molecules in normal pregnancy. Pregnancy may worsen or have no effect on autoimmune diseases related to antibody-mediated immunity, such as systemic lupus erythematosus (SLE) [35, 36].
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