Sex ratio of multiple sclerosis and clinical phenotype

Ramagopalan, Sreeram; Byrnes, Jake; Orton, Sarah-Michelle; Dyment, David A.; Guimond, Colleen; Yee, Irene M.; Ebers, George C.; Sadovnick, A. Dessa

doi:10.1111/j.1468-1331.2009.02850.x

Cited by 62 publications

(45 citation statements)

References 24 publications

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“…On the other hand, gender appears to play critical roles in the development, progression and treatment of MS. As for the rest of autoimmune diseases, females have a higher risk of suffering MS and the female:male ratio has been increasing for the last 50 years [23] and is currently at 2.6∶1 [24]. Several genetic elements have also been found to confer risk for MS in a gender-specific manner [25], [26].…”

Section: Discussionmentioning

confidence: 99%

Transcriptomic Profile Reveals Gender-Specific Molecular Mechanisms Driving Multiple Sclerosis Progression

et al. 2014

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BackgroundAlthough the most common clinical presentation of multiple sclerosis (MS) is the so called Relapsing-Remitting MS (RRMS), the molecular mechanisms responsible for its progression are currently unknown. To tackle this problem, a whole-genome gene expression analysis has been performed on RRMS patients.ResultsThe comparative analysis of the Affymetrix Human Gene 1.0 ST microarray data from peripheral blood leucocytes obtained from 25 patients in remission and relapse and 25 healthy subjects has revealed 174 genes altered in both remission and relapse, a high proportion of them showing what we have called “mirror pattern”: they are upregulated in remission and downregulated in relapse or vice versa. The coexpression analysis of these genes has shown that they are organized in three female-specific and one male-specific modules.ConclusionsThe interpretation of the modules of the coexpression network suggests that Epstein-Barr virus (EBV) reactivation of B cells happens in MS relapses; however, qPCR expression data of the viral genes supports that hypothesis only in female patients, reinforcing the notion that different molecular processes drive disease progression in females and males. Besides, we propose that the “primed” state showed by neutrophils in women is an endogenous control mechanism triggered to keep EBV reactivation under control through vitamin B12 physiology. Finally, our results also point towards an important sex-specific role of non-coding RNA in MS.

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Section: Discussionmentioning

confidence: 99%

Transcriptomic Profile Reveals Gender-Specific Molecular Mechanisms Driving Multiple Sclerosis Progression

et al. 2014

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“…[1011] The reason for this female preponderance in the present sample should be evaluated in view of the disproportionate increase in the incidence of multiple sclerosis in women in recent studies. [1213]…”

Section: Discussionmentioning

confidence: 99%

Clinical profile of acute disseminated encephalomyelitis in children

Jayakrishnan

Krishnakumar

2010

J Pediatr Neurosci

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Aim:To study the clinical profile of acute disseminated encephalomyelitis (ADEM) in children.Materials and Methods:All children admitted with ADEM during a period of one and a half years were included in the study. The diagnosis of ADEM was made based on the clinical presentation and suggestive MRI findings. All children were treated with intravenous methyl prednisolone, followed by oral prednisolone and followed up for varying periods up to three and a half years.Results:The sample consisted of 14 children with 11(79%) girls and 3 (21%) boys. The oldest child was 12 years and the youngest was a six-month-old infant. Acute febrile illness preceded the onset of neurological symptoms in 64% of children. The interval between the preceding illness and symptoms of ADEM varied from 7 days to 28 days (mean 12 days). The common presenting symptoms were fever, vomiting, headache, gait disturbance and generalized seizures. Neurological manifestations included altered sensorium, multiple cranial nerve involvement, quadriplegia and paraplegia, dystonia and choreiform movements, nystagmus, bladder involvement (both incontinence and retention), speech defect and double vision. Facial nerve was the most common cranial nerve involved. Psychological manifestations included aggressive behavior, psychotic symptoms and mood changes. One child each had features of acute psychotic episode and depressive episode. All children recovered fully. One child had multiphasic disseminated encephalomyelitis (MDEM) on follow up.Conclusion:Despite the serious neuropsychiatric manifestations, ADEM in children generally has good immediate outcome. Children with ADEM need long-term follow up for cognitive impairments.

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“…A large body of evidence suggests that gender influences the susceptibility and the clinical course of the disease. A higher prevalence of women with the RR-MS and a female-specific increase in the incidence of the disease has been documented, mainly from an increase in the number of female patients with RR-MS [2]. Gender-related differences in clinical severity, immunological features and brain damage have also been reported, suggesting an effect of sex hormones [3,4].…”

Section: Introductionmentioning

confidence: 86%

Oral contraceptive use and clinical outcomes in patients with multiple sclerosis

Sena¹,

Couderc²,

Vasconcelos³

et al. 2012

Journal of the Neurological Sciences

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Experimental and clinical data suggest a role of sex steroids in the pathogenesis of multiple sclerosis (MS). Scant information is available about the potential effect of oral contraceptive (OC) use on the prognosis of the disease. We aimed to evaluate this. The study population consisted of 132 women with relapsing-remitting MS before receiving disease modifying treatment and a mean disease duration 6.2 (SD 5.1) years. Three groups of patients were distinguished according to their OC behavior: [1] never-users, patients who never used OC [2] past-users, patients who stopped OC use before disease onset, and [3] after-users, those who used these drugs after disease onset. Multiple linear and logistic regression models were used to analyze the association between oral contraceptive use and annualized relapse rates, disability accumulation and severity of the disease. After-user patients had lower Expanded Disability Status Scale (EDSS) and Multiple Sclerosis Severity Score (MSSS) values than never users (p b 0.001 and p = 0.002, respectively) and past users (p = 0.010 and p = 0.002, respectively). These patients were also more likely to have a benign disease course (MSSS b 2.5) than never and past users together (OR: 4.52, 95%CI: 2.13-9.56, p b 0.001). This effect remained significant after adjustment for confounders, including smoking and childbirths (OR: 2.97, 95%CI: 1.24, 6.54, p = 0.011 and for MSSS β: − 1.04; 95% C.I. − 1.78, − 0.30, p = 0.006). These results suggest that OC use in women with relapsing-remitting MS is possible associated with a milder disabling disease course.

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Sex ratio of multiple sclerosis and clinical phenotype

Cited by 62 publications

References 24 publications

Transcriptomic Profile Reveals Gender-Specific Molecular Mechanisms Driving Multiple Sclerosis Progression

Transcriptomic Profile Reveals Gender-Specific Molecular Mechanisms Driving Multiple Sclerosis Progression

Clinical profile of acute disseminated encephalomyelitis in children

Oral contraceptive use and clinical outcomes in patients with multiple sclerosis

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