Background: Disease activity in patients with multiple sclerosis (MS) is suppressed during pregnancy, whereas attack frequency increases after delivery. It is yet unclear, which immuno - endocrinological processes mediate these disease fluctuations. Leptin has been identified as a hormone that can influence inflammatory activity. Objective: The aim ofthis study was to investigate whether pregnancy-induced fluctuations of serum leptin levels differed between patients with MS and controls and whether serum leptin levels correlate with periods of enhanced and diminished disease activity. Methods: Women with MS and healthy women were prospectively followed during and after pregnancy. The MS group could be studied already at a timepoint before pregnancy. Serum leptin and soluble leptin receptor (SLR) levels were measured using enzyme-linked immunosorbent assay. Results: Pre-pregnancy serum leptin levels were (mean ± SD) 22.9 ± 12.8 ng/ml in the MS group. These levels increased in the third trimester to 28.5 ± 15.0 ng/ml (P = 0.007). The third trimester serum leptin levels in healthy women were comparable, 29.4 ± 19.0 ng/ml. Serum leptin levels after delivery dropped to 18.5 ± 12.8 ng/ml in women with MS (P < 0.001) and to a lesser extend (22. ± 17.5 ng/ml) in healthy women (P = 0.04). SLR levels showed the same pattern. Remarkably, women with the highest relative decrease in serum leptin levels after delivery had more often a postpartum relapse (P = 0.008). Conclusion: In women with MS, leptin increased during late pregnancy. A postdelivery drop in leptin levels was observed in both the MS and control group. The postdelivery drop was associated with the occurrence of postpartum relapse.

Autoimmunity, Leptin, Multiple sclerosis, Postpartum relapse, Pregnancy, Self tolerance
dx.doi.org/10.1177/1352458509106515, hdl.handle.net/1765/25307
Multiple Sclerosis: clinical and laboratory research
Erasmus MC: University Medical Center Rotterdam

Neuteboom, R.F, Verbraak, E, Voerman, J.S, van Meurs, M, Steegers-Theunissen, R.P.M, de Groot, C.J.M, … Hintzen, R.Q. (2009). Serum leptin levels during pregnancy in multiple sclerosis. Multiple Sclerosis: clinical and laboratory research, 15(8), 907–912. doi:10.1177/1352458509106515