Original Articles

Treatment of multiple sclerosis with the pregnancy hormone estriol

  1. Nancy L. Sicotte MD1,
  2. Stephanie M. Liva PhD1,
  3. Rochelle Klutch RN1,
  4. Paul Pfeiffer BS1,
  5. Seth Bouvier BS1,
  6. Sylvia Odesa BS1,
  7. T. C. Jackson Wu MD, PhD2,
  8. Rhonda R. Voskuhl MD1,*

Article first published online: 19 AUG 2002

DOI: 10.1002/ana.10301

Issue

Annals of Neurology

Annals of Neurology

Volume 52, Issue 4, pages 421–428, October 2002

Additional Information

How to Cite

Sicotte, N. L., Liva, S. M., Klutch, R., Pfeiffer, P., Bouvier, S., Odesa, S., Wu, T. C. J. and Voskuhl, R. R. (2002), Treatment of multiple sclerosis with the pregnancy hormone estriol. Annals of Neurology, 52: 421–428. doi: 10.1002/ana.10301

Author Information

  1. 1

    Department of Neurology, Reed Neurological Research Center, University of California Los Angeles, Los Angeles, CA 90095

  2. 2

    Department of Obstetrics and Gynecology, Center for Health Sciences, University of California Los Angeles, CA

*Department of Neurology, Reed Neurological Research Center, 710 Westwood Plaza, University of California Los Angeles, Los Angeles, CA 90095

Publication History

  1. Issue published online: 23 SEP 2002
  2. Article first published online: 19 AUG 2002
  3. Manuscript Accepted: 12 MAY 2002
  4. Manuscript Revised: 9 MAY 2002
  5. Manuscript Received: 12 DEC 2001

Funded by

  • National Multiple Sclerosis Society. Grant Number: RG3016
  • Colorado Chapter of the National MS Society (Denver, CO)
  • Tom Sherak Family Foundation (Los Angeles, CA)
  • National Multiple Sclerosis Society. Grant Numbers: JF2107, JF2094
  • Leonard and Dorothy Strauss scholarship

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Abstract

Multiple sclerosis patients who become pregnant experience a significant decrease in relapses that may be mediated by a shift in immune responses from T helper 1 to T helper 2. Animal models of multiple sclerosis have shown that the pregnancy hormone, estriol, can ameliorate disease and can cause an immune shift. We treated nonpregnant female multiple sclerosis patients with the pregnancy hormone estriol in an attempt to recapitulate the beneficial effect of pregnancy. As compared with pretreatment baseline, relapsing remitting patients treated with oral estriol (8mg/day) demonstrated significant decreases in delayed type hypersensitivity responses to tetanus, interferon-γ levels in peripheral blood mononuclear cells, and gadolinium enhancing lesion numbers and volumes on monthly cerebral magnetic resonance images. When estriol treatment was stopped, enhancing lesions increased to pretreatment levels. When estriol treatment was reinstituted, enhancing lesions again were significantly decreased. Based on these results, a larger, placebo-controlled trial of estriol is warranted in women with relapsing remitting multiple sclerosis. This novel treatment strategy of using pregnancy doses of estriol in multiple sclerosis has relevance to other autoimmune diseases that also improve during pregnancy.

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