Dr Pamela McCombe

Royal Brisbane and Women’s Hospital

Project

How does pregnancy affect MS?

Co-Investigators

Dr Judith Greer, University of Queensland
Dr Robyn Wallace, Queensland Brain Institute

Funding

$85,000 in 2009 from Capanes and Canvas (Brisbane)with further funding dependent on outcomes

Project Summary

In many patients with multiple sclerosis, disease activity is reduced during pregnancy. After pregnancy, there is often increased disease activity. The improvement during pregnancy is thought to be due to changes in the immune system of the mother. After the baby is born, these changes are reversed. The changes in the immune system during pregnancy are due to changes in hormone levels. These changes are not fully understood. This project will study animals with a disease similar to multiple sclerosis. It will study the changes before and after pregnancy, looking at the cells that cause disease and the genes that are activated in the spinal cord.

During pregnancy, there are fewer relapses of multiple sclerosis (MS) in many patients. Studies show that this is associated with changes in the white blood cells in the circulation of the mother. In humans it is not possible to study the changes of the white blood cells in the brain. We have previously shown that pregnancy leads to changes in the cells and cytokines in the nervous system in experimental autoimmune encephalomyelitis (EAE), the best available animal model of multiple sclerosis. Since those initial studies, there have been advances in our understanding of the pathogenesis of MS and EAE. We will perform new studies of the changes in the types of cells and cytokines in the nervous system in 2 different types of EAE, one of which is mediated just by T cells, and the other of which requires both T cells and antibody for development of EAE. Understanding of these models may provide further insight into how pregnancy ameliorates MS in some patients but not in others.

The significance of this project is that pregnancy is a time when MS goes into remission in many women, and the post-partum period is a time of disease exacerbation. Understanding the cause of these changes during pregnancy could lead to strategies to reproduce these effects as therapy for multiple sclerosis.