Puberty onset and pediatric multiple sclerosis activity in boys

Area of Science:

• Pediatric Neurology
• Immunology
• Endocrinology

Background:

• Sex steroid hormones influence immune responses, but their impact on pediatric multiple sclerosis (MS) in boys is unclear.
• Previous research indicated a link between menarche and relapse risk in girls with MS.
• The influence of age and pubertal status on disease course in boys with MS requires investigation.

Purpose of the Study:

• To investigate the association between the age of disease onset and pubertal status with relapse rates in boys diagnosed with pediatric multiple sclerosis (MS).

Main Methods:

• A retrospective study included male pediatric patients diagnosed with MS before age 18.
• Patients were categorized into pre-pubertal (<11 years), peri-pubertal (11-14 years), and post-pubertal (>14 years) onset groups.
• Negative binomial regression analysis was employed to assess the relationship between pubertal status at onset and relapse rate.

Main Results:

• Boys with peri-pubertal onset of MS showed a 2.4-fold increased relapse rate compared to those with post-pubertal onset.
• This association remained significant after adjusting for race, ethnicity, and disease-modifying therapy.
• No significant difference in relapse rate was observed between pre-pubertal and post-pubertal onset groups.

Conclusions:

• Onset of multiple sclerosis during puberty in boys may be associated with an elevated risk of relapses.
• Further research is needed to elucidate the complex interplay between pubertal development and MS pathophysiology in males.