Abstract
The role of pregnancy in multiple sclerosis (MS) is of importance because many patients with MS are young women in the childbearing age who require information to inform their reproductive decisions. Pregnancy is now well-known to be associated with fewer relapses of MS and reduced activity of autoimmune encephalomyelitis (EAE). However, in women with multiple sclerosis, this benefit is not always sufficient to protect against a rebound of disease activity if disease-modulating therapy is ceased for pregnancy. There is concern that use of assisted reproductive therapies can be associated with relapses of MS, but more data are required. It is thought that the beneficial effects of pregnancy are due to the pregnancy-associated changes in the maternal immune system. There is some evidence of this in human studies and studies of EAE. There is also evidence that having been pregnant leads to better long-term outcome of MS. The mechanism for this is not fully understood but it could result from epigenetic changes resulting from pregnancy or parenthood. Further studies of the mechanisms of the beneficial effects of pregnancy could provide information that might be used to produce new therapies.
Highlights
Multiple sclerosis (MS) is a common inflammatory disease of the central nervous system (CNS) [1,2]
In DA rats, EAE induced with bovine brain homogenate was less severe when disease was induced in pregnancy there were relapses post-partum [107]
No differences were noted in the production of interferon -gamma (IFN-γ), interleukin 2 (IL-2), interleukin 4 (IL-4), and interleukin 5 (IL-5). These results suggest that when an antigen is introduced during pregnancy, an immunoregulatory rather than an immunosuppressive or Th2 environment predominates
Summary
Multiple sclerosis (MS) is a common inflammatory disease of the central nervous system (CNS) [1,2]. In the peripheral blood of patients with MS, there is evidence of immune activation This includes increased levels of T cells reactive with CNS antigens, and increased activated T cells [8,9]. It has been found that the gut microbiota influences the development of MS, possibly through immune effects [10], and that MS patients can have poor health for some years before presentation with neurological symptoms (this has been termed the “MS prodrome”) [11,12,13] These findings of a role for the gut microbiota and as MS prodrome suggest that we need to reconsider the origins of MS. It is thought that the changes in maternal physiology during pregnancy and lactation are mediated through the effects of pregnancy hormones [35].
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
