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Objective – To evaluate the influence of pregnancy and puerperium on the relapse rate of multiple sclerosis (MS). Methods – We determined retrospectively the yearly mean relapse rate (MRR) during pregnancies occurring in the course of relapsing–remitting MS. We compared the MRR of pregnancy-time with that of non-pregnancy time by paired t-test. Relative risk (RR) of relapses during the pregnancy-time was also compared with that of non-pregnancy time by χ2 analysis and 95% confidence intervals. Results – From a population of 351 women affected by clinically definite MS, only 70 reported pregnancies during their relapsing–remitting phase of MS for a total of 98 pregnancies. Both MRR (P = 0.006) and RR (RR = 0.63, 95% CI = 0.40–0.94) decreased during the three trimesters of pregnancy. RR increased in the first 3 months of puerperium, although this was not statistically significant (RR = 1.36, 95% CI = 0.79–2.20). Conclusion – Our study confirms that in MS the relapse rate decreases throughout pregnancy and increases during puerperium. This suggests a complex interplay between hormonal and immune factors.

A decrease of antioxidants, of neuroprotective and immunoregulatory vitamins and an increase of total-Homocysteine, Cholesterol, HDL-cholesterol, and of cellular stress markers [1] was reported in patients affected by Multiple Sclerosis. Recently, considering their unreliability, mainly due to the variability of the samples investigated, the attention focused on clinical relapse that results associated to a decrease of Uric acid and an increase of Cholesterol and stress markers. Aim. To identify the biochemical status during Multiple Sclerosis (MS) in a phase of clinical stability (PCS), we compared the blood levels of Urico acid (UA), Folic acid (FA), vitamins B12, A, and E, total-Homocysteine (t-Hcy), total Cholesterol (CHL) , HDL-CHL, and Triglycerides (TG) in 20 MS stable patients with those of 40 healthy controls. Methods. Consecutive MS patients, with relapsing-remitting or secondary-progressive courses, in a (PCS), were included. Plasma t-Hcy levels were determined by Ubbink method [1]. Technicon Immuno autoanalyser was used for serum FA and vitamin B12 assays. HPLC and fluorometry were used for UA, vitamin A and E, CHL, HDL-CHL, and TG assays. The ratio of E/CHL was valued. Results and Discussions. We found that MS patients in a PCS have higher blood levels of vitamin B12, t-Hcy, CHL, and HDL-CHL and lower blood levels of vitamin E and of the ratio E/CHL. The blood level of UA, FA, vitamin A, and TG do not differ from controls during this phase of MS. The increased level of CHL could be expression of both an its increased synthesis by neural cells and a chronic damage of myelin and axons. HDL-CHL concentration might arise to counteract the increase of CHL and assure its transport to the liver. Plasma levels of vitamin E, the major hydrophobic chain-breaking antioxidant, are decreased and our data confirm and support the view that it is consumed to counterbalance MS chronic neurodegeneration. Also, the increased levels of t-Hcy and vitamin B12 match previous studies performed in MS patients outside relapse. No significant differences in UA, FA, vitamin A, and TG levels appeared, making unprobable their involvement in the degenerative process of the stable phase of MS.

Multiple Sclerosis (MS) patients present a decrease of antioxidants and neuroprotective and immunoregulatory vitamins and an increase of total homocysteine (tHcy), cholesterol (CHL), HDL-cholesterol, and of cellular stress markers, variably associated with the different phases of the disease. We compared the blood levels of uric acid, folic acid, vitamins B12, A, and E, tHcy, CHL, HDL-cholesterol, and triglycerides in forty MS patients during a phase of clinical inactivity with those of eighty healthy controls, matched for age and sex. We found higher levels of tHcy (p = 0.032) and of HDL-cholesterol (p = 0.001) and lower levels of vitamin E (p = 0.001) and the ratio vitamin E/CHL (p = 0.001) in MS patients. In conclusion, modifications of some biochemical markers of cell damage were detected in MS patients during a phase of clinical inactivity.