“…Moreover, MS is accompanied by leukocyte infiltration to the central nervous system (CNS), which coincides with production of cytokines and vasoactive substances that in turn affect demyelination and neuronal degeneration (Göbel, Ruck, & Meuth, 2018). A thermoregulatory response to cytokine activation appears to be a disease tolerance defense strategy (Schieber & Ayres, 2016), while both pro- and anti-inflammatory cytokine release as correlates of thermoregulation act in a sex-dependent manner (Menees et al, 2021; Russi, Ebel, Yang, & Brown, 2018; van den Broek, Damoiseaux, De Baets, & Hupperts, 2005; Zhang et al, 2012) arguably via the influence of sex hormones (Klein & Flanagan, 2016). The significant splenomegaly in females may be indicative of modifications in the number and distribution of immune cells within the spleen (Menees et al, 2021) and/or more myeloid-derived suppressor cells (MDSCs) in the spleen that lead to a greater infiltration of the CNS (Melero-Jerez et al, 2020) in females.…”