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【medical-news】【资讯翻译】Annals of Neurol:生育治疗或可加重多发性硬化

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http://www.news-medical.net/news/20121008/Fertility-treatment-may-increase-MS-disease-activity.aspx
Fertility treatment may increase MS disease activity
Findings published in Annals of Neurology suggest that assisted reproduction technology (ART) treatment increases multiple sclerosis (MS) disease activity.

Sex hormones and gonadotropin-releasing hormone (GnRH) have both been found to play a role in autoimmune disorder pathogenesis. Small studies have shown that ART treatments for infertility, which involve hormone manipulation, increase the risk for exacerbation of MS and other autoimmune conditions. However, there has been little information to date on immunologic responses in patients with MS after ART.

Jorge Correale (Raul Carrea Institute for Neurological Research, Foundation Against Neurological Disease in Childhood, Buenos Aires, Argentina) and colleagues conducted a 5-year prospective study of 16 patients with MS who had been given 26 cycles of ART.

Seventy-five percent of patients had exacerbations of their MS after ART treatment, and during the 3-month period following ART, clinical relapses were noted in 58% of the ART cycles. The average numbers of relapses was 0.42 in a 3-month period before ART versus 3.28 in the 3 months after, representing a sevenfold increase.

Likewise, ART treatment was associated with a ninefold increase in radiologic activity, with patients having an average of 0.36 new or enlarging T2 lesions before treatment versus 1.99 after it, and 0.23 versus 1.27 gadolinium-enhancing lesions.

In the 3 months after treatment, immunologic parameters were significantly increased during cycles with relapses. There was a three- to eightfold increase in estrogen and progesterone levels, as well as elevated levels of T cells, cytokines, and antibodies against myelin-oligodendrocyte glycoprotein.

The complex and dynamic interactions between hormonal and immune factors that occur during ART treatment may affect the course of autoimmune diseases, which could explain the increased MS activity seen in this study, note Correale et al.

Given these data, when deciding which infertility treatment to administer to a patient with MS, "different hormonal approaches can be used, the choice of which depends on ART specialist recommendations," they say.

"However, neurologists should be aware of this risk, and discuss pros and cons of the procedure with MS patients."

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2012-10-09 18:58 浏览 : 1253 回复 : 4

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“认领本文翻译，48小时内未完成，请其他战友认领！

2012-10-09 19:30

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粗译：敬请指导！
Findings published in Annals of Neurology suggest that assisted reproduction technology (ART) treatment increases multiple sclerosis (MS) disease activity.
发表在《神经学年鉴》上的一项研究结果提示辅助生殖技术（ART）治疗加重多发性硬化症（MS）的病情。
Sex hormones and gonadotropin-releasing hormone (GnRH) have both been found to play a role in autoimmune disorder pathogenesis. Small studies have shown that ART treatments for infertility, which involve hormone manipulation, increase the risk for exacerbation of MS and other autoimmune conditions. However, there has been little information to date on immunologic responses in patients with MS after ART.
性激素和促性腺激素释放激素在自身免疫性疾病的发病过程中都发挥作用。已有小型研究表明，涉及激素调控的辅助生殖技术治疗增加多发性硬化症和其他自身免疫性疾病病情恶化的风险。然而，至今关于多发性硬化症患者接受辅助生殖技术治疗后的自身免疫反应方面的信息还很少。
Jorge Correale (Raul Carrea Institute for Neurological Research, Foundation Against Neurological Disease in Childhood, Buenos Aires, Argentina) and colleagues conducted a 5-year prospective study of 16 patients with MS who had been given 26 cycles of ART.
Jorge Correale 博士（Raul Carrea神经研究协会，阿根廷布宜诺斯艾利斯的儿童神经疾病基金会）和他的同事们进行了一项关于接受了26个周期的ART治疗的多发性硬化症患者的5年前瞻性研究。
Seventy-five percent of patients had exacerbations of their MS after ART treatment, and during the 3-month period following ART, clinical relapses were noted in 58% of the ART cycles. The average numbers of relapses was 0.42 in a 3-month period before ART versus 3.28 in the 3 months after, representing a sevenfold increase.
75%的患者在接受ART治疗后多发性硬化症病情恶化，在ART治疗3个月的随访过程中，多发性硬化症在58%ART治疗周期时复发。ART治疗前3个月内多发性硬化症复发平均数为0.42，相比之下，治疗后3个月复发平均数为3.28有七倍升高。
Likewise, ART treatment was associated with a ninefold increase in radiologic activity, with patients having an average of 0.36 new or enlarging T2 lesions before treatment versus 1.99 after it, and 0.23 versus 1.27 gadolinium-enhancing lesions.
同样，ART治疗涉及放射活性的九层升高，治疗前患者的平均有0.36新的或扩大T2损伤，而治疗后的为1.99；治疗前钆增强损伤为0.23，治疗后升至1.27。,

In the 3 months after treatment, immunologic parameters were significantly increased during cycles with relapses. There was a three- to eightfold increase in estrogen and progesterone levels, as well as elevated levels of T cells, cytokines, and antibodies against myelin-oligodendrocyte glycoprotein.
治疗后3个月由于病情复发，免疫学参数在周期中显著增加。患者的雌激素孕激素水平有3-8倍的升高，T淋巴细胞，细胞因子和髓鞘少突胶质细胞糖蛋白多肽抗体也有所升高。

The complex and dynamic interactions between hormonal and immune factors that occur during ART treatment may affect the course of autoimmune diseases, which could explain the increased MS activity seen in this study, note Correale et al.
ART治疗期间发生的激素和免疫因素之间复杂和动态的相互作用影响了自身免疫性疾病的病理过程，解释了Correale博士等人在研究中所观察到的ART治疗加重多发性硬化症这一现象。
Given these data, when deciding which infertility treatment to administer to a patient with MS, "different hormonal approaches can be used, the choice of which depends on ART specialist recommendations," they say.
“考虑到这些数据，当决定选择哪一种方法治疗多发性硬化症患者的不孕症时，有很多不同的激素方法可供选择，选择哪一种取决于ART治疗专家的推荐，”他们说。
"However, neurologists should be aware of this risk, and discuss pros and cons of the procedure with MS patients."

“然而，神经科专家应该意识到这种风险，与多发性硬化症患者讨论ART治疗的利弊关系。”

2012-10-11 10:12

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• 大腿占位，有病理~

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编译：641字

发表在《神经学年鉴》上的一项研究结果提示辅助生殖技术（ART）治疗加重多发性硬化症（MS）的病情。性激素和促性腺激素释放激素在自身免疫性疾病的发病过程中都发挥作用。已有小型研究表明，涉及激素调控的辅助生殖技术治疗增加多发性硬化症和其他自身免疫性疾病病情恶化的风险。然而，至今关于多发性硬化症患者接受辅助生殖技术治疗后的自身免疫反应方面的信息还很少。
Jorge Correale 博士（Raul Carrea神经研究协会，阿根廷布宜诺斯艾利斯的儿童神经疾病基金会）和他的同事们进行了一项关于接受了26个周期的ART治疗的多发性硬化症患者的5年前瞻性研究。
75%的患者在接受ART治疗后多发性硬化症病情恶化，在ART治疗3个月的随访过程中，多发性硬化症在58%ART治疗周期时复发。ART治疗前3个月内多发性硬化症复发平均数为0.42，相比之下，治疗后3个月复发平均数为3.28有七倍升高。同样，ART治疗涉及放射活性的九层升高，治疗前患者的平均有0.36新的或扩大T2损伤，而治疗后的为1.99；治疗前钆增强损伤为0.23，治疗后升至1.27。,

I治疗后3个月由于病情复发，免疫学参数在周期中显著增加。患者的雌激素孕激素水平有3-8倍的升高，T淋巴细胞，细胞因子和髓鞘少突胶质细胞糖蛋白多肽抗体也有所升高。

ART治疗期间发生的激素和免疫因素之间复杂和动态的相互作用影响了自身免疫性疾病的病理过程，解释了Correale博士等人在研究中所观察到的ART治疗加重多发性硬化症这一现象。
“考虑到这些数据，当决定选择哪一种方法治疗多发性硬化症患者的不孕症时，有很多不同的激素方法可供选择，选择哪一种取决于ART治疗专家的推荐，”他们说。“然而，神经科专家应该意识到这种风险，与多发性硬化症患者讨论ART治疗的利弊关系。”

2012-10-11 10:14

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