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Treatment of multiple sclerosis with the pregnancy hormone estriol
Abstract
Multiple sclerosis patients who become pregnant experience a significant decrease in relapses that may be mediated by a shift in immune responses from T helper 1 to T helper 2. Animal models of multiple sclerosis have shown that the pregnancy hormone, estriol, can ameliorate disease and can cause an immune shift. We treated nonpregnant female multiple sclerosis patients with the pregnancy hormone estriol in an attempt to recapitulate the beneficial effect of pregnancy. As compared with pretreatment baseline, relapsing remitting patients treated with oral estriol (8mg/day) demonstrated significant decreases in delayed type hypersensitivity responses to tetanus, interferon‐γ levels in peripheral blood mononuclear cells, and gadolinium enhancing lesion numbers and volumes on monthly cerebral magnetic resonance images. When estriol treatment was stopped, enhancing lesions increased to pretreatment levels. When estriol treatment was reinstituted, enhancing lesions again were significantly decreased. Based on these results, a larger, placebo‐controlled trial of estriol is warranted in women with relapsing remitting multiple sclerosis. This novel treatment strategy of using pregnancy doses of estriol in multiple sclerosis has relevance to other autoimmune diseases that also improve during pregnancy.
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“Interestingly, the administration of estriol to nonpregnant women with RRMS showed a reduction in the number of Th1 cells, which are involved in the autoimmune response, and also in the clinical score of the disease49.”
From Tamoxifen accelerates the repair of demyelinated lesions in the central nervous system (2016) · cites this paper as [49]
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Metadata
- Authors
- Sicotte, N. L., Liva, S. M., Klutch, R., Pfeiffer, P., Bouvier, S., Odesa, S., Wu, T. C. J., & Voskuhl, R. R.
- Affiliations
- University of California, Los Angeles (US)
- Corresponding author
- Voskuhl, Rhonda R.
- Venue
- Annals of Neurology
- Publisher
- Wiley
- Published
- 2002-08-19
- Volume
- 52
- Issue
- 4
- Pages
- 421-428
- ISSN
- 0364-5134 (ISSN-L)
- 1531-8249
- OpenAlex
- W2135551891
- Cited by
- 435
- References
- 41
- Citations by year
- 2026: 7 · 2025: 8 · 2024: 10 · 2023: 13 · 2022: 13 · 2021: 9 · 2020: 14 · 2019: 12 · 2018: 22 · 2017: 11 · 2016: 24 · 2015: 19 · 2014: 30 · 2013: 25 · 2012: 30
- FWCI
- 12.95
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Annals of Neurology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Clinical Neurology › Multiple Sclerosis Research Studies
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Pregnancy and Medication Impact
- Life Sciences › Immunology and Microbiology › Immunology › Psoriasis: Treatment and Pathogenesis
- Keywords
- multiple sclerosis, estriol, pregnancy hormones, relapsing-remitting multiple sclerosis, interferon-gamma, delayed-type hypersensitivity, gadolinium-enhancing lesions, disease-modifying therapy
- MeSH terms
- Adolescent, Adult, Estriol, Female, Humans, Hypersensitivity, Delayed, Magnetic Resonance Imaging, Middle Aged, Multiple Sclerosis, Pregnancy, Recurrence, Biomarkers, Th1 Cells, Cross-Over Studies
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