Review
Clinical Neurology
Kerstin Hellwig, Elisabetta Verdun di Cantogno, Meritxell Sabido
Summary: This systematic review evaluated relapses of multiple sclerosis (MS) during pregnancy and postpartum, showing a complex relationship between disease-modifying therapy (DMT) use and relapse. Some studies suggested that the preconception use of natalizumab or fingolimod may increase the risk of relapses during pregnancy, highlighting the need for effective disease management in these high-risk patients.
THERAPEUTIC ADVANCES IN NEUROLOGICAL DISORDERS
(2021)
Article
Clinical Neurology
Annika Anderson, William Rowles, Shane Poole, Ayushi Balan, Carolyn Bevan, Rachel Brandstadter, Andrea I. Ciplea, Joanna Cooper, Michelle Fabian, Thomas W. Hale, Dina Jacobs, Mihir Kakara, Kristen M. Krysko, Erin E. Longbrake, Jacqueline Marcus, Pavle Repovic, Claire S. Riley, Andrew R. Romeo, Alice Rutatangwa, Timothy West, Kerstin Hellwig, Sara C. LaHue, Riley Bove
Summary: This study examined the transfer of anti-CD20 IgG1 monoclonal antibodies (mAb) into breastmilk and evaluated the outcomes for mothers with multiple sclerosis (MS) or neuromyelitis optica spectrum disorder (NMOSD) and their infants. The results showed minimal transfer of the antibodies into breastmilk, and postpartum treatment with the antibodies was found to be safe and well-tolerated for both mother and infant.
ANNALS OF CLINICAL AND TRANSLATIONAL NEUROLOGY
(2023)
Article
Clinical Neurology
Sabrina Haben, Andrea Ciplea, Marianne Tokic, Nina Timmesfeld, Sandra Thiel, Ralf Gold, Annette Magdalene Langer-Gould, Kerstin Hellwig
Summary: This study aimed to assess the association between four different postpartum strategies and relapse risk during the first 6 months postpartum. The results showed that early treatment with natalizumab/fingolimod reduced the hazard of postpartum relapse from month 3, but did not diminish the hazard of early postpartum relapse. Therefore, an early postpartum treatment strategy should be determined well before delivery for women with active multiple sclerosis.
JOURNAL OF NEUROLOGY NEUROSURGERY AND PSYCHIATRY
(2023)
Article
Clinical Neurology
Gabriel Bsteh, Harald Hegen, Katharina Riedl, Patrick Altmann, Franziska Di Pauli, Rainer Ehling, Gudrun Zulehner, Paulus Rommer, Fritz Leutmezer, Florian Deisenhammer, Thomas Berger
Summary: The study aims to generate and validate a risk score for disease reactivation in patients with relapsing multiple sclerosis (RMS) during pregnancy. By analyzing predictors including relapse occurrence, DMT type, DMT washout duration, EDSS at conception, and time until DMT restart postpartum, a predictive score was developed to identify patients at high, intermediate, and low risk of disease reactivation during pregnancy and up to 6 months postpartum.
FRONTIERS IN NEUROLOGY
(2022)
Review
Clinical Neurology
Charlotte Schubert, Lea Steinberg, Julia Peper, Caren Ramien, Kerstin Hellwig, Sascha Koepke, Alessandra Solari, Andrea Giordano, Stefan M. Gold, Tim Friede, Christoph Heesen, Anne Christin Rahn
Summary: The influence of pregnancy on the course of multiple sclerosis has long been controversial. Recent research shows that women with MS have a significantly increased relapse rate in the first 6 months postpartum, but a decreased relapse rate at 10-12 months postpartum. Disease-modifying therapies and exclusive breastfeeding play important roles in influencing postpartum relapse risk.
JOURNAL OF NEUROLOGY NEUROSURGERY AND PSYCHIATRY
(2023)
Article
Immunology
Helle Bach Sondergaard, Laura Airas, Jeppe Romme Christensen, Birgitte Romme Nielsen, Lars Bornsen, Annette Oturai, Finn Sellebjerg
Summary: Pregnancy can influence the disease course of MS, leading to changes in miRNA expression and immune cell phenotypes, such as downregulation of miRNAs and an increase in monocytes. Additionally, during pregnancy, there is a decrease in NK cells and CD8+ T cells, along with an increase in IL10, PDL1, and PDL2 expression.
FRONTIERS IN IMMUNOLOGY
(2021)
Article
Clinical Neurology
Stefan Bittner, Jiwon Oh, Eva Kubala Havrdova, Mar Tintore, Frauke Zipp
Summary: Blood-based serum neurofilament light chain (sNfL) is being investigated as a biomarker for prognosis and treatment response in multiple sclerosis patients. It reflects ongoing inflammatory-driven neuroaxonal damage and has the potential to guide individualized clinical decision-making.
Article
Clinical Neurology
Bernardita Soler, Ethel Ciampi, Reinaldo Uribe-San-Martin, Karina Keller, Macarena Astudillo, Valeria Charaf, Ana Reyes, Elizabeth Vergara, Claudia Carcamo
Summary: This study investigated pregnancy decision-making and outcomes in women with multiple sclerosis (MS) before and after diagnosis. The results showed that after MS diagnosis, women tend to have fewer children at an older age, with a higher rate of cesarean sections. However, there were no significant differences in newborn outcomes between the two groups.
MULTIPLE SCLEROSIS AND RELATED DISORDERS
(2021)
Article
Immunology
Klaus Berek, Angelika Bauer, Dagmar Rudzki, Michael Auer, Robert Barket, Anne Zinganell, Magdalena Lerch, Livia Hofer, Astrid Grams, Paulina Poskaite, Sebastian Wurth, Thomas Berger, Franziska Di Pauli, Florian Deisenhammer, Harald Hegen, Markus Reindl
Summary: This study investigated the distribution of 65 different cytokines, chemokines, and related molecules in the cerebrospinal fluid (CSF) and serum of newly diagnosed people with multiple sclerosis (pwMS). The results showed that 29 cytokines and chemokines were significantly elevated in the CSF, while 15 were elevated in the serum. Additionally, associations were found between 34 analytes and sex, age, CSF, MRI parameters, and disease progression. These findings contribute to a better understanding of the pathophysiology of multiple sclerosis and its association with disease progression.
FRONTIERS IN IMMUNOLOGY
(2023)
Article
Medicine, General & Internal
Dorota Walkiewicz, Bozena Adamczyk, Michal Maluchnik, Jakub Perwieniec, Krzysztof Podwojcic, Mateusz Szelag, Michal Zakrzewski, Konrad Rejdak, Agnieszka Slowik, Marcin Wnuk, Monika Adamczyk-Sowa
Summary: This study assessed the impact of pregnancy on the course of multiple sclerosis (MS) by comparing the frequency of MS-related hospital admissions during pregnancy and postpartum periods with those before pregnancy. The study found that MS is diagnosed less often during pregnancy, and the number of MS-related hospital admissions decreased during pregnancy, especially in the third trimester. Unlike other studies, there was no observed increase in MS-related hospital admissions postpartum. The study also noted a decrease in the number of steroid injections and emergency department visits during pregnancy.
JOURNAL OF CLINICAL MEDICINE
(2022)
Article
Clinical Neurology
Claudio Gasperini, Luca Prosperini, Alex Rovira, Mar Tintore, Jaume Sastre-Garriga, Carla Tortorella, Shalom Haggiag, Simonetta Galgani, Ruggero Capra, Carlo Pozzilli, Xavier Montalban, Jordi Rio
Summary: The study aimed to develop and validate a scoring system combining baseline prognostic factors and 1-year variables of treatment response to predict the long-term risk of disability accumulation in patients with RRMS. The RoAD score showed to be a useful tool in predicting the risk of reaching a disability milestone and optimizing treatment strategy for RRMS patients.
EUROPEAN JOURNAL OF NEUROLOGY
(2021)
Review
Biochemistry & Molecular Biology
Deepali Mathur, Bikash Kumar Mishra, Soumyashree Rout, Francisco Jose Lopez-Iranzo, Gerardo Lopez-Rodas, Jayalakshmi Vallamkondu, Ramesh Kandimalla, Bonaventura Casanova
Summary: Multiple sclerosis (MS) is a complex disease of the central nervous system (CNS) with heterogeneous clinical subtypes, making diagnosis and treatment challenging. Biomarkers play a crucial role in simplifying diagnosis and prognosis, as well as evaluating treatment outcomes in different clinical courses of MS.
INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES
(2021)
Article
Obstetrics & Gynecology
Sunitha C. Suresh, Colleen Duncan, Harjot Kaur, Ariel Mueller, Avery Tung, Joana L. Perdigao, Kavia Khosla, Rohin Dhir, Karie Stewart, Kedra Wallace, Roy Ahn, Sarosh Rana
Summary: The hospital-wide, bundled quality-improvement initiative implemented for patients with hypertensive disorders of pregnancy successfully improved postpartum visit adherence and blood pressure control, showing positive effects on postpartum management.
OBSTETRICS AND GYNECOLOGY
(2021)
Article
Clinical Neurology
Pablo Arroyo Pereiro, Albert Munoz-Vendrell, Isabel Leon Moreno, Laura Bau, Elisabet Matas, Lucia Romero-Pinel, Antonio Martinez Yelamos, Sergio Martinez Yelamos, Pol Andres-Benito
Summary: This study investigates the potential role of serum biomarkers in long-term prognostication of multiple sclerosis, and suggests that serum neurofilament light chain levels may serve as a promising marker for long-term disability.
JOURNAL OF NEUROLOGY
(2023)
Article
Nutrition & Dietetics
Tonja R. Nansel, Jenna R. Cummings, Kyle Burger, Anna Maria Siega-Riz, Leah M. Lipsky
Summary: Low quality diet during pregnancy and postpartum can lead to negative health outcomes for both mothers and infants. This study examined the association between intake of ultra-processed foods and diet quality during pregnancy and postpartum. The findings suggest that reducing intake of ultra-processed foods can improve adherence to dietary guidelines in pregnant and postpartum populations.