ABSTRACT
It has been appreciated for decades that symptoms of patients with autoimmune diseases are affected by pregnancy and the postpartum period. The most well characterized observations include those in multiple sclerosis (MS), rheumatoid arthritis (RA) and psoriasis. These patients experience clinical improvement during pregnancy, with a temporary ‘rebound’ exacerbation postpartum1-8. This chapter focuses on possible mechanisms which may underlie the disease protection during pregnancy in MS. This phenomenon of an improvement in disease during pregnancy is a unique opportunity to gain insight into MS disease pathogenesis, and to capitalize on a naturally occurring situation in which the disease is down-regulated. Understanding diseasemodifying mechanisms during pregnancy may lead to the identification of factors with therapeutic potential for MS. Further, the therapeutic potential of an identified factor might be beneficial not only in MS, but also in other autoimmune diseases characterized by significant improvement during pregnancy.
