The role of sex hormones in multiple sclerosis

Abstract

Biological differences associated with sexual dimorphism have an impact on many aspects of health, including disease susceptibility, course and prognosis. Significant differences in the incidence and severity of neurological diseases, especially those of autoimmune origin, were found between women and men. Although the reasons for the observed discrepancies are complex, research indicates the key role of sex hormones, which are known to be responsible for the differences in body structure, genitals and sexual behaviour in women and men. Recent data have drawn attention to their impact on the function of the immune and nervous systems, the brain and the spinal cord in particular. Multiple sclerosis is a chronic disease of the central nervous system that affects more than twice as many women as men. The etiopathogenesis of the disease is complex, with genetic and environmental factors playing an important role. There are three main components in the pathology of multiple sclerosis: inflammation, demyelination and neurodegeneration. Studies conducted so far have shown a significant influence of sex hormones, both male and female, on each of these elements. It has been shown in both clinical and experimental studies that sex hormones have not only a strong immunomodulatory, but also neuroprotective and neuroregenerative effect. Recent research on the role of sex hormones in multiple sclerosis has led to a better understanding of the mechanisms underlying the development of this disorder. They also gave hope for the introduction of sex hormones as diagnostic tools, i.e. biomarkers of progression and response to treatment, but above all, as breakthrough therapies.