Francesca Gilli
Geisel School of Medicine at Dartmouth, USA
Title: Sex and gender issues in multiple sclerosis
Biography
Biography: Francesca Gilli
Abstract
An interesting feature that multiple sclerosis (MS) shares with many other immune-mediated diseases is that susceptibility is higher in females than males. Accordingly, the risk of developing MS is estimated at least two to three times higher for women than for men. However, while men have a lower risk of developing MS, many historical studies suggest that males are associated with a poorer clinical outcome, especially in progressive MS. In this form of MS, male patients are reported to have a more rapid accumulation of disability, reach disability milestones more rapidly than their female counterparts, and overall display a more malignant form of disease. Sex differences in MS susceptibility have been shown to be due, at least in part, to the effects of sex hormones such as estrogen and testosterone. An additional role for sex chromosomes in this observed sex dimorphism has also been investigated. With this keynote lecture we will review the effects of gender from a genetic, immunological and clinical point of view. We will discuss the effects of sex on the clinical expression of MS and responses to therapy, as well as issues concerning pregnancy.