Multiple sclerosis: why women are more likely to get sick

Christiane Fux studied journalism and psychology in Hamburg. The experienced medical editor has been writing magazine articles, news and factual texts on all conceivable health topics since 2001. In addition to her work for, Christiane Fux is also active in prose. Her first crime novel was published in 2012, and she also writes, designs and publishes her own crime plays.

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MunichAccording to recent results, women suffer from multiple sclerosis almost four times as often as men - why was previously unknown. A first step towards solving the medical riddle now opens up new therapeutic possibilities - also for male patients.

Key point on the blood vessels

A certain protein molecule in the brain apparently plays a decisive role in this difference between men and women. S1PR2 is a so-called receptor molecule. It sits on the blood vessels that supply the thinking organ. The research team led by Robyn Klein from Washington University found out what function the receptor has in terms of the development of multiple sclerosis (MS).

To do this, the scientists first examined the gene activities in the brains of female and male mice. The animals were genetically programmed to develop MS, and the females more often than their male counterparts - as in humans.

Female brains work differently

The researchers were particularly interested in the activity of the genes in brain regions that are particularly badly affected by MS - but also in those areas that are largely spared from multiple sclerosis. The researchers found a total of 20 genes that ticked differently in female and male MS brains - including S1PR2, which was significantly more active in the heads of the female mice.

“It was a 'bingo!' Moment - our investigation led us straight to this receptor,” says study author Klein. “When we examined its function in the mice, we found that it determines whether immune cells can get into the brain via the blood vessels. These cells trigger inflammation, which in turn causes MS. "

The receptor is thus apparently an important part of the so-called blood-brain barrier. These are structures in the blood vessels that regulate exactly which substances get into the brain and which do not. The mechanism serves to protect the sensitive organ from pollutants and pathogens to a particularly high degree.

Smuggled gunmen

S1PR2 is apparently responsible for introducing immune cells. They are needed in the brain - as in the rest of the body - to ward off pathogens and to remove dead body materials. In the central nervous system of people with multiple sclerosis, however, they are misdirected - instead of attacking pests, they attack the protective myelin layer that surrounds the nerve cells. These ignite and eventually perish. Among other things, there are symptoms of paralysis and discomfort, visual and speech disorders.

In female brains, the blood vessels are apparently particularly rich in S1PR2 proteins. Therefore, more immune cells get into the female thinking organ. The danger that immune cells running amok will be smuggled in is correspondingly greater.

Tissue examinations of 20 deceased have shown that this mechanism also plays a role in the development of MS in the human body. The researchers found increased levels of S1PR2 in the brains of MS patients than in those of deceased people who had not had MS during their lifetime. In addition, the number of S1PR2 receptors in the brains of female patients was greater than that of the deceased male MS patients.

Approach to new therapies

Study leader Klein now wants to develop a way to monitor the S1PR2 level in the living organ of thought. She hopes to clarify exactly how S1PR2 contributes to the development of MS.

"This is an exciting first cut to understand why MS is so dramatically more common in women," says Klein. The knowledge also opens up new approaches to better control the symptoms of the nerve disease.

Attacked nerve cells

Multiple sclerosis (MS) is a chronic disease that affects the central nervous system. The inflammation of nerve structures leads to various complaints such as visual and sensory disturbances, pain or paralysis. The autoimmune disease usually begins in early adulthood between 20 and 40 years. According to projections, around 130,000 people live with multiple sclerosis in Germany. Women are far more likely to develop MS than men.

Source: Klein RS. Et al: Sexually S1PR2 expression enhances susceptibility to CNS autoimmunity; The Journal of Clinical Investigation, online May 8, 2014.

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