Abstract Details

Pregnancy in MS patients is associated with a reduction of disease relapses due to the down-regulation of inflammation functional to fetal tolerance.  In the post-partum inflammatory rebound may occur as the result of immunocompetence restoration. Such hormonal-driven immunological adaptation is thought to involve T cell compartment. Nevertheless, B cell subset dynamic, whose role in MS disease pathogenesis is now well established, have been poorly explored during pregnancy and post-partum. 

Preliminary results on 6 women followed up at least until T3 show that absolute number and percentage of circulating total CD19⁺ B cells decrease during pregnancy overall. Looking at subpopulations, while CD24⁺CD38⁺ naive transitional immature B cells and CD27⁺ memory cells drop, CD27^- mature naïve B cells increase. CD27⁺ memory cells also reorganize as the IgG/IgA switched memory cells increase while the less differentiated IgM cells decrease. Consistently, antibody producing CD27^hiCD38^hi plasmablasts are rapidly and dramatically augmented in peripheral blood of pregnant women. All these changes are rapidly reverted after delivery.

In MS women pregnancy induces specific B cell depletion and reorganization with a dramatic reassortment in subpopulation composition; such immunological adaptations are rapidly reverted after delivery. If B cell dynamic during pregnancy and post-partum is associated with disease remission and rebound has to be elucidated.