Birk K, Ford C, Smeltzer S, Ryan D, Miller R, Rudick R A
Department of Obstetrics and Gynecology, Genesee Hospital, Rochester, NY.
Arch Neurol. 1990 Jul;47(7):738-42. doi: 10.1001/archneur.1990.00530070026007.
Eight women with multiple sclerosis were followed up through pregnancy. Clinical conditions, T-cell subsets, and levels of immunoactive pregnancy-associated proteins were measured twice during the pregnancy and twice during the first postpartum year. None of the women's conditions worsened during pregnancy, although one woman reported a slight increase of symptoms. Six of the eight women experienced relapses within the first 7 weeks after delivery. The number and percent of CD8 suppressor T cells were lower, and the CD4 helper-CD8 suppressor T-cell ratio was higher in the pregnant patients with multiple sclerosis compared with pregnant control women throughout pregnancy and the first 6 months post partum. There was no evident relationship between these parameters and clinical disease activity. Levels of alpha-fetoprotein, alpha 2-pregnancy-associated glycoprotein, and pregnancy-associated plasma protein A, all immunosuppressive proteins associated with pregnancy, were not significantly different in pregnant patients with multiple sclerosis and pregnant controls without multiple sclerosis. The study suggested that the risk of clinical relapse after delivery may be higher than has been reported previously. Furthermore, although there were differences in suppressor T cells, they were not predictably linked to changes in clinical disease activity.
对八名患有多发性硬化症的女性进行了孕期随访。在孕期和产后第一年分别进行了两次临床状况、T细胞亚群以及免疫活性妊娠相关蛋白水平的测量。尽管有一名女性报告症状略有加重，但在孕期没有女性的病情恶化。八名女性中有六名在分娩后的前7周内出现复发。在整个孕期和产后前6个月，与怀孕的对照女性相比，患有多发性硬化症的孕妇体内CD8抑制性T细胞的数量和百分比更低，而CD4辅助性T细胞与CD8抑制性T细胞的比例更高。这些参数与临床疾病活动之间没有明显关系。甲胎蛋白、α2妊娠相关糖蛋白和妊娠相关血浆蛋白A（所有这些都是与妊娠相关的免疫抑制蛋白）在患有多发性硬化症的孕妇和没有多发性硬化症的怀孕对照者之间没有显著差异。该研究表明，分娩后临床复发的风险可能比之前报道的更高。此外，尽管抑制性T细胞存在差异，但它们与临床疾病活动的变化没有可预测的关联。
