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Serum leptin levels during pregnancy in multiple sclerosis

Department of Neurology, ErasmusMC, Rotterdam, The Netherlands; MS Centre ErasMS, Rotterdam, The Netherlands

E Verbraak

MS Centre ErasMS, Rotterdam, The Netherlands; Department of Immunology, ErasmusMC, Rotterdam, The Netherlands

JSA Voerman

MS Centre ErasMS, Rotterdam, The Netherlands; Department of Immunology, ErasmusMC, Rotterdam, The Netherlands

M van Meurs

MS Centre ErasMS, Rotterdam, The Netherlands; Department of Immunology, ErasmusMC, Rotterdam, The Netherlands

EAP Steegers

Department of Obstetrics and gynaecology, ErasmusMC, Rotterdam, The Netherlands

CJM de Groot

Department of Obstetrics and gynaecology, Medisch centrum Haaglanden, The Hague, The Netherlands

JD Laman

MS Centre ErasMS, Rotterdam, The Netherlands; Department of Immunology, ErasmusMC, Rotterdam, The Netherlands

RQ Hintzen

Department of Neurology, ErasmusMC, Rotterdam, The Netherlands; MS Centre ErasMS, Rotterdam, The Netherlands r.hintzen{at}erasmusmc.nl

Background

Disease activity in patients with multiple sclerosis (MS) is suppressed during pregnancy, whereas attack frequency increases after delivery. It is yet unclear, which immuno – endocrinological processes mediate these disease fluctuations. Leptin has been identified as a hormone that can influence inflammatory activity.

Objective

The aim of this study was to investigate whether pregnancy-induced fluctuations of serum leptin levels differed between patients with MS and controls and whether serum leptin levels correlate with periods of enhanced and diminished disease activity.

Methods

Women with MS and healthy women were prospectively followed during and after pregnancy. The MS group could be studied already at a timepoint before pregnancy. Serum leptin and soluble leptin receptor (SLR) levels were measured using enzyme-linked immunosorbent assay.

Results

Pre-pregnancy serum leptin levels were (mean ± SD) 22.9 ± 12.8 ng/ml in the MS group. These levels increased in the third trimester to 28.5 ± 15.0 ng/ml (P = 0.007). The third trimester serum leptin levels in healthy women were comparable, 29.4 ± 19.0 ng/ml. Serum leptin levels after delivery dropped to 18.5 ± 12.8 ng/ml in women with MS (P < 0.001) and to a lesser extend (22.0 ± 17.5 ng/ml) in healthy women (P = 0.04). SLR levels showed the same pattern. Remarkably, women with the highest relative decrease in serum leptin levels after delivery had more often a postpartum relapse (P = 0.008).

Conclusion

In women with MS, leptin increased during late pregnancy. A postdelivery drop in leptin levels was observed in both the MS and control group. The postdelivery drop was associated with the occurrence of postpartum relapse.

Key Words: autoimmunity • leptin • multiple sclerosis • postpartum relapse • pregnancy • self tolerance

Multiple Sclerosis, Vol. 15, No. 8, 907-912 (2009)
DOI: 10.1177/1352458509106515


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