Multiple sclerosis, pregnancy, maternity, and breastfeeding

Česká verzia

Authors: O. Zapletalová ¹; J. Krejsek ²
Authors place of work: Neurologická klinika FN Ostrava a LF OU Ostrava ¹; Ústav klinické imunologie a alergologie, LF UK a FN Hradec Králové ²
Published in the journal: Cesk Slov Neurol N 2019; 82(2): 161-165
Category: Review Article
doi: https://doi.org/10.14735/amcsnn2019161

Summary

Conception, pregnancy and delivery are recognized today as an immune phenomena. Both local and systemic immune responses in pregnant woman are downregulated during these physiological processes to tolerate the fetus as the fetus is displaying the characteristics of a semiallograft in the context of transplantation immunology. This tolerance and physiological development of the fetus is achieved by the complex changes of immune reactivity during pregnancy. These includethe switch from Th1 reactivity to Th2 reactivity. The number and activity of Treg T cells are increased. It is not surprising that physiological pregnancy in the majority of females suff ering from MS induces remission of the disease as abnormal infl ammation in MS patients is Th1 and Th17 T cell regulator subset driven together with a decrease in Treg T cells activity. The physiological delivery could be recognized as the physiological infl ammatory reactivity terminating pregnancy which is followed by the subsequent switch to the preconception immune reactivity frequently associated with the exacerbation of MS. The profound changes in individual immune reactivity are accompanied by substantial changes in hormonal regulation. Breastfeeding is irreplaceable for optimal and proper development of the baby in the early period after birth. Only breast milk contains the whole spectrum of substances supporting all functions of the infant. Clinical studies have shown that exclusive breastfeeding is benefi cial for both the baby and the mother. The hormonal changes during breast feeding are positively modulating the infl ammation in females with MS.

The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manuscript met the ICMJE “uniform requirements” for biomedical papers.

Keywords:

pregnancy – breastfeeding – Multiple sclerosis – immunoreactivity

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