Impact of sex hormones on immune function and multiple sclerosis development

Abstract

Multiple sclerosis (MS) is a chronic inflammatory disease of the central nervous system (CNS) affecting young people and leading to demyelination and neurodegeneration. The disease is clearly more common in women, in whom incidence has been rising. Gender differences include: earlier disease onset and more frequent relapses in women; and faster progression and worse outcomes in men. Hormone-related physiological conditions in women such as puberty, pregnancy, puerperium, and menopause also exert significant influence both on disease prevalence as well as on outcomes. Hormonal and/or genetic factors are therefore believed to be involved in regulating the course of disease. In this review, we discuss clinical evidence for the impact of sex hormones (estrogens, progesterone, prolactin, and testosterone) on MS and attempt to elucidate the hormonal and immunological mechanisms potentially underlying these changes. We also review current knowledge on the relationship between sex hormones and resident CNS cells and provide new insights in the context of MS. Understanding these molecular mechanisms may contribute to the development of new and safer treatments for both men and women.

Incidence, clinical features, and outcomes of COVID-19 in Canada: Impact of sex and age

“…These differences in immune response may explain the different COVID-19 incidence and clinical outcomes between sexes. Although the mechanisms underlying the sex-differences in immune responses are not well understood, sex hormone receptors, notably the estrogen and androgen receptors (ER and AR respectively), are widely expressed in immune cells and play a role in regulating immunity (28). Estrogens have been reported to have immunostimulatory or immunosuppressive effects depending on concentration and cell types, while testosterone is immunosuppressive (29).…”

Recurrent Stroke-Like Symptoms After Cesarean Section Deliveries in a Female Patient With X-Linked Charcot-Marie-Tooth Type 1

“…However, how does the puerperium after cesarean delivery trigger CNS symptoms in the female patient with CMTX1? We speculated that hormonal changes that physiologically occur in puerperium (abrupt drop in estrogen and progesterone levels) would hamper the proliferation and maturation of oligodendrocyte progenitor cells to mature oligodendrocytes (18)(19)(20). Thus, the female patient with CMTX1 who had fragile oligodendrocyte gap junction coupling due to Cx32 mutation may be more vulnerable in puerperium, leading to recurrent stroke-like symptoms.…”

Getting older, getting worse: menopause as a turning-point for women living with multiple sclerosis

“…Being a woman is the strongest risk factor for MS, by virtue of the sex alone. The existence of a gender bias is well known, since MS occurs more frequently in women than in men 1 2. Moreover, this predilection has increased almost worldwide, over the last few decades, and is the highest in Western countries situated in northern latitudes.…”