Título del libro: Women And Multiple Sclerosis
Título del capítulo: Multiple sclerosis in women: Diagnosis and quality of life
TERESITA CORONA VAZQUEZ; JULIO EVERARDO SOTELO MORALES;
Autores externos:
Idioma:
Inglés
Año de publicación:
2010
Resumen:
Multiple sclerosis, along with other well-recognized immunnologically-mediated diseases, has a strong female predominance, as it has long been studied throughout the years. Sexual dimorphism, specifically in MS, can be reviewed initially and considered the most primitive anatomical and physiological differences encountered in the human brain such as diminished white matter volume density and increased gray matter volumes in women, as well as a higher water content in women's white matter compared with men's. Endocrine and immunological aspects are exceedingly relevant where estrogen, specifically estriol at a high dose similar to that of a normal pregnancy, has been shown to decrease the volume and number of gadolinum-enhancing lesions in female brains, though side effects overcome its benefits. Progestins have been implied in an accelerated myelinization in vitro models. Recently, a preferential interferon gamma response to multiple myelin peptides in comparison to IL-5 response to the same myelin epitopes when compared to male subjects has been demonstrated. Pregnacy is another relevant topic whilst revewing women and MS. Great controversy has risen over the initial recommendation of therapeutic abortion. It is now clear that pregnancy induces a natural shift towards a humoral TH2 response as a result of an increase in TH2 favored cytokines, particularly IL-10 produced by the foetal-placental unit. In response, there is a decrease in IL-2 and IFN gamma, which in turn provides a protecting mechanism of pregnancy over disease evolution and severity. Unequivocal fluctuations of the disease's symptoms and signs such as depression, spasticity and paresis are accentuated during menses and post-menopause periods. Special considerations have to be made when referring to treatment options due to more severe side effects of disease-modifying agents in women. Physiological conditions known to increase relapse rates, the post partum period, need to be carefully evaluated when considering treatment options. Last, but not least, the impact of MS on quality of life and other psychosocial issues must be meticulously studied and cared for as are the remaining MS topics in women previously outlined. © 2010 Nova Science Publishers, Inc.
Entidades citadas de la UNAM:
ISBN:
9781616687113
Editorial:
Nova Science Publishers, Inc. Nombre de la publicación:
Multiple sclerosis in women: Diagnosis and quality of life
Página inicial:
63
Página final:
76
Tipo de producto:
Capítulo de un Libro
