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Out of an estimated million people in the U.S. with multiple sclerosis (MS), around 100,000 have the progressive form of the disease, and symptoms become worse over time or over periods of remission.
"Progressive MS is profoundly challenging because it is relentless and treatment options are limited," Francisco P. Gomez, an MS and neuroimmunology specialist, said.
MS is believed to occur when the immune system attacks the protective sheath of the nerve fibers, disrupting the communication and causing the disease. It occurs more frequently in women, older-aged people, and people living in the northern latitudes.
Common symptoms are fatigue, numbness, and in some, cognitive issues, along with the more prevalent symptoms of the progressive form--problems with walking and balance. The progressive form of MS is also more prevalent in Black people.
At the Texas A&M University Health Science Center (Texas A&M Health) along with other colleagues, Gomez has identified two estrogens--estradiol and estriol--that demonstrate potential in alleviating the symptoms of progressive MS.
In their research featured in the Journal of Neuroimmunology, the group investigated the use of estriol and estradiol in corticoid treatments in the study involving a virus designed to imitate progressive MS.
"Testing potential therapies using virus models of the disease is crucial as we found out recently that Epstein-Barr virus plays a part in the development of MS through an autoimmune response in those genetically prone to the disease,” said study co-author Jane Welsh, Neuroimmunologist at Texas A&M College of Veterinary Medicine and Biomedical Sciences (VMBS) and Texas A&M Naresh K. Vashist College of Medicine.
She also noted that although MS is more common in women, the disease goes into remission for pregnant women with MS.
"This is due to high levels of estradiol and estriol, especially during the third trimester," said study co-author Candice Brinkmeyer-Langford, an expert in neurogenerative disease from Texas A&M School of Public Health. "Pregnant women with MS even on oral contraceptives have fewer symptoms and less relapses, which led us to study the effect of these hormones on the myelin sheath."
Estrogen refers to a group of hormones which also include those affecting the sex drive and reproductive development especially in women.
Estradiol’s potency makes it the choice for hormone replacement therapy in postmenopausal women. Conversely, estriol has various off-label uses and is only FDA-approved for the treatment of urinary incontinence in dogs.
Both types of estrogen decreased inflammation in the spinal cord, but only estradiol decreased damage to the myelin sheath. The investigators believe this propensity of estradiol will help develop therapeutic interventions for patients with progressive multiple sclerosis.
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