Cytokine profile during pregnancy predicts puerperium relapses in multiple sclerosis: a prospective cohort study
ECTRIMS Online Library. Cuello J. 09/13/19; 278351; P1149
Juan Pablo Cuello
Juan Pablo Cuello
Contributions
Abstract

Abstract: P1149

Type: Poster Sessions

Abstract Category: Clinical aspects of MS - Pregnancy in MS

J.P. Cuello1, A. Tejeda-Velarde2, M.L. Martínez Ginés1, S. Medina Heras2, J.M. García Domínguez1, S. Garcia-Tizon Larroca1, J. de Leon-Ruiz1, A. Lozano Ros1, R. Delgado Fernando1, Y. Higueras1, A. Meldaña Rivera1, H. Goicochea Briceño1, J.I. Fernández Velasco2, M.I. Domínguez-Mozo3, S. Pérez Pérez3, R. Álvarez Lafuente3, C. de Andrés1, L.M. Villar2

1Hospital General Universitario Gregorio Marañón, Neurología, 2Hospital Universitario Ramón y Cajal, 3Grupo de Investigación de Esclerosis Múltiple, Instituto de Investigación Sanitaria San Carlos (IdISSC) / Hospital Clínico San Carlos, Madrid, Spain

Objective: In multiple sclerosis (MS), pregnancy reduces the annualized relapse rate (ARR), while it is temporarily increased at puerperium. The exact mechanism underlying this clinical observation remains unknown. We aimed to explore different serum cytokine profiles during pregnancy in MS patient to assess any potential correlation between the immunological changes induced during pregnancy and the occurrence of postpartum relapses.
Methods: We consecutively included 74 pregnant women, 53 with MS (P-MS) and healthy pregnant women (HCW), followed at Hospital Universitario Gregorio Marañón between 2007-2018. Patients were evaluated at every trimester of pregnancy and in the puerperium. The following serum cytokines were measured by ELISA: Interferon (IFN)-gamma, Tumor necrosis factor (TNF)-alpha, interleukin (IL)-17, granulocyte/macrophage-colony stimulating factor (GM-CSF), activin-A, IL-10, and programmed death ligand(PDL)-1.
Results: No differences in pregnancy and delivery data were observed between P-MS and HCW. MS patients had lower levels of GM-CSF during the first trimester (p: 0.0075), and lower activin-A during the second trimester of pregnancy (p: 002) compared to HCW. At postpartum, HCW had lower activin-A values (p: 0.0033). Most notably, MS patients showed lower PDL-1 levels throughout the whole pregnancy and puerperium. Low levels of activin-A (p=0.04) and IL-10 (p=0.02) during the first trimester were associated with postpartum relapses (OR 10.5 [1.12-97.96] p=0.03 and 9.2 [1.0-85.8] p=0.039, respectively). Conversely, high values of IL-10 or activin-A at the first trimester of pregnancy, associated with a low probability of relapses after delivery.
Results: Our data suggest that, during pregnancy, MS patients experience significant differences in the serum cytokine profile compared to HCW. Most importantly, IL-10 and Activin-A levels during pregnancy predicted postpartum relapses.
Disclosure: Juan Pablo Cuello, nothing to disclose
Amalia Tejeda-Velarde, nothing to disclose
María Luisa Martínez Ginés, nothing to disclose
Silvia Medina Heras, nothing to disclouse
José Manuel García Domínguez, nothing to disclose
Santiago Garcia-Tizon Larroca, nothing to disclose
Juan de Leon-Ruiz, nothing to discloue
Alberto Lozano Ros, nothing to disclose
Romero Delgado Fernando, nothing to disclose
Yolanda Higueras, nothing to disclose
Ariana Meldaña Rivera, nothing to disclose
Haydee Goicochea Briceño, nothing to disclose
José Ignacio Fernández Velasco, nothing to disclose
Maria Inmaculada Domínguez-Mozo, nothing to disclose
Silvia Pérez Pérez, nothing to disclose
Roberto Álvarez Lafuente, nothing to disclose
Clara de Andrés, nothing to disclose
Luisa María Villar, nothing to disclose

Abstract: P1149

Type: Poster Sessions

Abstract Category: Clinical aspects of MS - Pregnancy in MS

J.P. Cuello1, A. Tejeda-Velarde2, M.L. Martínez Ginés1, S. Medina Heras2, J.M. García Domínguez1, S. Garcia-Tizon Larroca1, J. de Leon-Ruiz1, A. Lozano Ros1, R. Delgado Fernando1, Y. Higueras1, A. Meldaña Rivera1, H. Goicochea Briceño1, J.I. Fernández Velasco2, M.I. Domínguez-Mozo3, S. Pérez Pérez3, R. Álvarez Lafuente3, C. de Andrés1, L.M. Villar2

1Hospital General Universitario Gregorio Marañón, Neurología, 2Hospital Universitario Ramón y Cajal, 3Grupo de Investigación de Esclerosis Múltiple, Instituto de Investigación Sanitaria San Carlos (IdISSC) / Hospital Clínico San Carlos, Madrid, Spain

Objective: In multiple sclerosis (MS), pregnancy reduces the annualized relapse rate (ARR), while it is temporarily increased at puerperium. The exact mechanism underlying this clinical observation remains unknown. We aimed to explore different serum cytokine profiles during pregnancy in MS patient to assess any potential correlation between the immunological changes induced during pregnancy and the occurrence of postpartum relapses.
Methods: We consecutively included 74 pregnant women, 53 with MS (P-MS) and healthy pregnant women (HCW), followed at Hospital Universitario Gregorio Marañón between 2007-2018. Patients were evaluated at every trimester of pregnancy and in the puerperium. The following serum cytokines were measured by ELISA: Interferon (IFN)-gamma, Tumor necrosis factor (TNF)-alpha, interleukin (IL)-17, granulocyte/macrophage-colony stimulating factor (GM-CSF), activin-A, IL-10, and programmed death ligand(PDL)-1.
Results: No differences in pregnancy and delivery data were observed between P-MS and HCW. MS patients had lower levels of GM-CSF during the first trimester (p: 0.0075), and lower activin-A during the second trimester of pregnancy (p: 002) compared to HCW. At postpartum, HCW had lower activin-A values (p: 0.0033). Most notably, MS patients showed lower PDL-1 levels throughout the whole pregnancy and puerperium. Low levels of activin-A (p=0.04) and IL-10 (p=0.02) during the first trimester were associated with postpartum relapses (OR 10.5 [1.12-97.96] p=0.03 and 9.2 [1.0-85.8] p=0.039, respectively). Conversely, high values of IL-10 or activin-A at the first trimester of pregnancy, associated with a low probability of relapses after delivery.
Results: Our data suggest that, during pregnancy, MS patients experience significant differences in the serum cytokine profile compared to HCW. Most importantly, IL-10 and Activin-A levels during pregnancy predicted postpartum relapses.
Disclosure: Juan Pablo Cuello, nothing to disclose
Amalia Tejeda-Velarde, nothing to disclose
María Luisa Martínez Ginés, nothing to disclose
Silvia Medina Heras, nothing to disclouse
José Manuel García Domínguez, nothing to disclose
Santiago Garcia-Tizon Larroca, nothing to disclose
Juan de Leon-Ruiz, nothing to discloue
Alberto Lozano Ros, nothing to disclose
Romero Delgado Fernando, nothing to disclose
Yolanda Higueras, nothing to disclose
Ariana Meldaña Rivera, nothing to disclose
Haydee Goicochea Briceño, nothing to disclose
José Ignacio Fernández Velasco, nothing to disclose
Maria Inmaculada Domínguez-Mozo, nothing to disclose
Silvia Pérez Pérez, nothing to disclose
Roberto Álvarez Lafuente, nothing to disclose
Clara de Andrés, nothing to disclose
Luisa María Villar, nothing to disclose

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