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Authors
Abstract(s)
Introdução: A Esclerose Múltipla é uma doença infamatória crónica que afeta o sistema
nervoso central, causando desmielinização e perda axonal. Tal como outras doenças
autoimunes, afeta mais mulheres que homens e existem disparidades na progressão e na
atividade inflamatória. Pressupõe-se, assim, que o início e o curso da Esclerose Múltipla
possivelmente são influenciados pelas hormonas sexuais.
Objetivos: Análise dos mecanismos pelos quais as hormonas sexuais femininas
influenciam a Esclerose Múltipla e abordagem dos perfis clínicos resultantes dessa
influência.
Materiais e Métodos: A informação utilizada foi recolhida de livros de texto e de artigos
obtidos na PubMed®. Fator de impacto, número de citações e data de publicação foram
considerados. Apenas foram incluídos artigos publicados na última década. A
acessibilidade e o idioma não foram limitação.
Resultados: Na puberdade, com a exposição a hormonas sexuais, as recidivas aumentam
nas raparigas durante a perimenarca. Uma menarca precoce aumenta o risco e o início
precoce da doença. Na gravidez, hormonas produzidas pela placenta, como estriol e
progesterona, influenciam o sistema imunológico e a taxa de recaída anual diminui.
Verifica-se um aumento da taxa de recidiva nos primeiros 3 a 6 meses após o parto, devido
à queda abrupta dos níveis de estrogénio e progesterona. Na menopausa, dada a privação
de esteroides gonadais, as manifestações exacerbam os sintomas da Esclerose Múltipla e a
progressão da incapacidade persiste.
Conclusão: As observações atuais refletem a complexa interação de fatores genéticos,
hormonais e ambientais na Esclerose Múltipla. Há evidências crescentes de que as
hormonas sexuais influenciam esta doença. Deste modo, podem eventualmente contribuir
para o desenvolvimento de novos tratamentos.
Introduction: Multiple Sclerosis is a chronic inflammatory disease that affects the central nervous system, causing demyelination and axonal loss. Like other autoimmune diseases, it affects more women than men, and there are disparities in both progression and inflammatory activity. As a result, it is assumed that the onset and course of Multiple Sclerosis are possibly influenced by sex hormones. Aims: Analysis of the mechanisms by which female sex hormones influence Multiple Sclerosis and interpretation of the clinical profiles resulting from this influence. Materials and Methods: The information was collected from textbooks and articles obtained from PubMed®. The impact factor, number of citations and publication date were considered. Solely articles published in the last decade were included. Neither accessibility nor language was a limitation. Results: As sex hormones exposure begins at puberty, relapses increase in girls during the perimenarche. Early menarche increases both the risk and early onset of the disease. During pregnancy, hormones produced by the placenta, such as estriol and progesterone, affect the immune system and the annual relapse rate decreases. Due to the abrupt drop in estrogen and progesterone levels, an increase in the rate of relapse during the first 3 to 6 months occurs, after childbirth. During menopause, the manifestations exacerbate the symptoms of Multiple Sclerosis and the disability progression persists due to the deprivation of gonadal steroids. Conclusion: Current observations reflect the complex interaction of genetic, hormonal and environmental factors in Multiple Sclerosis. There is growing evidence that sex hormones influence this disease. In this way, it may eventually contribute to the development of new treatments.
Introduction: Multiple Sclerosis is a chronic inflammatory disease that affects the central nervous system, causing demyelination and axonal loss. Like other autoimmune diseases, it affects more women than men, and there are disparities in both progression and inflammatory activity. As a result, it is assumed that the onset and course of Multiple Sclerosis are possibly influenced by sex hormones. Aims: Analysis of the mechanisms by which female sex hormones influence Multiple Sclerosis and interpretation of the clinical profiles resulting from this influence. Materials and Methods: The information was collected from textbooks and articles obtained from PubMed®. The impact factor, number of citations and publication date were considered. Solely articles published in the last decade were included. Neither accessibility nor language was a limitation. Results: As sex hormones exposure begins at puberty, relapses increase in girls during the perimenarche. Early menarche increases both the risk and early onset of the disease. During pregnancy, hormones produced by the placenta, such as estriol and progesterone, affect the immune system and the annual relapse rate decreases. Due to the abrupt drop in estrogen and progesterone levels, an increase in the rate of relapse during the first 3 to 6 months occurs, after childbirth. During menopause, the manifestations exacerbate the symptoms of Multiple Sclerosis and the disability progression persists due to the deprivation of gonadal steroids. Conclusion: Current observations reflect the complex interaction of genetic, hormonal and environmental factors in Multiple Sclerosis. There is growing evidence that sex hormones influence this disease. In this way, it may eventually contribute to the development of new treatments.
Description
Keywords
Amamentação Esclerose Múltipla Gravidez Hormonas Sexuais
Femininas Menarca Menopausa Puberdade Puerpério