Sex effects across the lifespan in women with multiple sclerosis

被引：67

作者：

Krysko, Kristen M. ^{[1
]}

Graves, Jennifer S. ^{[2
]}

Dobson, Ruth ^{[3
,4
]}

Altintas, Ayse ^{[5
]}

Amato, Maria Pia ^{[6
,7
]}

Bernard, Jacqueline ^{[8
]}

Bonavita, Simona ^{[9
]}

Bove, Riley ^{[1
]}

Cavalla, Paola ^{[10
]}

Clerico, Marinella ^{[11
]}

Corona, Teresa ^{[12
]}

Doshi, Anisha ^{[13
]}

Fragoso, Yara ^{[14
,15
]}

Jacobs, Dina ^{[16
]}

Jokubaitis, Vilija ^{[17
,18
]}

Landi, Doriana ^{[19
]}

Llamosa, Gloria ^{[20
]}

Longbrake, Erin E. ^{[21
]}

Maillart, Elisabeth ^{[22
]}

Marta, Monica ^{[23
]}

Midaglia, Luciana ^{[24
]}

Shah, Suma ^{[25
]}

Tintore, Mar ^{[24
]}

van der Walt, Anneke ^{[17
,18
]}

Voskuhl, Rhonda ^{[26
]}

Wang, Yujie ^{[27
]}

Zabad, Rana K. ^{[28
]}

Zeydan, Burcu ^{[29
]}

Houtchens, Maria ^{[30
]}

Hellwig, Kerstin ^{[31
]}

机构：

[1] Univ Calif San Francisco, Dept Neurol, UCSF Weill Inst Neurosci, 675 Nelson Rising Lane,Suite 221, San Francisco, CA 94158 USA

[2] Univ Calif San Diego, Dept Neurosci, UCSD ACTRI, La Jolla, CA 92093 USA

[3] Queen Mary Univ London, Prevent Neurol Unit, Wolfson Inst Prevent Neurol, London, England

[4] Royal London Hosp, Dept Neurol, London, England

[5] Koc Univ, Sch Med, Dept Neurol, Istanbul, Turkey

[6] Univ Florence, Sect Neurosci, Dept NEUROFARBA, Florence, Italy

[7] IRCCS Don Gnocchi Fdn, Florence, Italy

[8] Oregon Hlth & Sci Univ, Dept Neurol, Portland, OR USA

[9] Univ Campania Luigi Vanvitelli, Dept Adv Med & Surg Sci, Naples, Italy

[10] City Hlth & Sci Univ Hosp Torino, Dept Neurosci & Mental Hlth, Turin, Italy

[11] Univ Torino, San Luigi Gonzaga Hosp, Dept Clin & Biol Sci, Turin, Italy

[12] Natl Inst Neurol & Neurosurg Mexico, Clin Lab Neurodegenerat Dis, Mexico City, DF, Mexico

[13] Univ Coll London UCL Inst Neurol, Queen Sq Multiple Sclerosis Ctr, Dept Neuroinflammat, London, England

[14] Multiple Sclerosis & Headache Res Inst, Santos, SP, Brazil

[15] Univ Metropolitana Santos, Dept Neurol, Santos, SP, Brazil

[16] Hosp Univ Penn, Dept Neurol, 3400 Spruce St, Philadelphia, PA 19104 USA

[17] Monash Univ, Dept Neurosci, Melbourne, Vic, Australia

[18] Alfred Hlth, Dept Neurol, Melbourne, Vic, Australia

[19] Tor Vergata Univ & Hosp, Multiple Sclerosis Ctr & Res Unit, Dept Syst Med, Rome, Italy

[20] Neurol Integral Tlalpan, Mexico City, DF, Mexico

[21] Yale Univ, Dept Neurol, New Haven, CT USA

[22] Hop La Pitie Salpetriere, Dept Neurol, Paris, France

[23] Queen Mary Univ London, Barts & London Sch Med & Dent, Blizard Inst, Neurosci & Trauma Ctr, London, England

[24] Vall Hebron Univ Hosp, Multiple Sclerosis Ctr Catalonia, Dept Neurol Neuroimmunol, Barcelona, Spain

[25] Duke Univ, Dept Neurol, Durham, NC USA

[26] Univ Calif Los Angeles, Dept Neurol, Los Angeles, CA 90024 USA

[27] Johns Hopkins Univ, Dept Neurol, Baltimore, MD 21218 USA

[28] Univ Nebraska Med Ctr, Dept Neurol Sci, Omaha, NE USA

[29] Mayo Clin, Dept Radiol, Rochester, MN USA

[30] Harvard Med Sch, Brigham & Womens Hosp, Partners MS Ctr, Dept Neurol, Boston, MA 02115 USA

[31] Ruhr Univ Bochum, St Josef Hosp, Dept Neurol, Bochum, Germany

来源：

THERAPEUTIC ADVANCES IN NEUROLOGICAL DISORDERS | 2020年 / 13卷

关键词：

breastfeeding; multiple sclerosis; pregnancy; sex differences; sex hormones; women; QUALITY-OF-LIFE; PREGNANCY DECISION-MAKING; DISEASE-MODIFYING DRUGS; ORAL-CONTRACEPTIVE USE; LONG-TERM DISABILITY; POSTPARTUM RELAPSES; GLATIRAMER ACETATE; VITAMIN-D; AUTOIMMUNE ENCEPHALOMYELITIS; POSTMENOPAUSAL WOMEN;

D O I：

10.1177/1756286420936166

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Multiple sclerosis (MS) is an autoimmune inflammatory demyelinating central nervous system disorder that is more common in women, with onset often during reproductive years. The female:male sex ratio of MS rose in several regions over the last century, suggesting a possible sex by environmental interaction increasing MS risk in women. Since many with MS are in their childbearing years, family planning, including contraceptive and disease-modifying therapy (DMT) counselling, are important aspects of MS care in women. While some DMTs are likely harmful to the developing fetus, others can be used shortly before or until pregnancy is confirmed. Overall, pregnancy decreases risk of MS relapses, whereas relapse risk may increase postpartum, although pregnancy does not appear to be harmful for long-term prognosis of MS. However, ovarian aging may contribute to disability progression in women with MS. Here, we review sex effects across the lifespan in women with MS, including the effect of sex on MS susceptibility, effects of pregnancy on MS disease activity, and management strategies around pregnancy, including risks associated with DMT use before and during pregnancy, and while breastfeeding. We also review reproductive aging and sexual dysfunction in women with MS.

引用

页数：30

共 273 条

[1] Immunoregulatory factors in multiple sclerosis patients during and after pregnancy: relevance of natural killer cells [J].