52 msfocusmagazine.org Breastfeeding may reduce MS risk According to a new study, mothers who breastfeed for a total of at least 15 months over one or more pregnancies may be less likely to develop multiple sclerosis compared with those who don't breastfeed at all, or do so for up to four months. The researchers noted the study does not prove that breast- feeding is responsible for the reduced risk of MS, it only shows an association. The findings werepublishedintheonlineissueofNeurology. Dr. Thrower: While this study has some limitations, it once again points out that, in women, there is a dance between the immune system and hormones.Autoimmune diseases like MS represent an immune system gone awry. Some mistakenly think of MS as an underactive immune system, when in fact it is a relatively overactive immune system that is attacking normal tissue (myelin and axons). It has long been noted that MS typically becomes less active during pregnancy, especially during the second and third trimesters. Some studies have also suggested that MS may be less active in women who breast-feed after delivery. Other autoimmune diseases have also been noted to become less active during pregnancy. Systemic lupus may be the exception to this rule. Lupus may actually worsen during pregnancy. One could think of the developing fetus as a “foreign body” in the mother’s body. To prevent the rejection of this foreign body, the mother’s immune system must become more tolerant. This could explain why autoimmune diseases become less active during pregnancy. Research also suggests that a hormone called estriol may be partly responsible for this calming effect on autoimmune diseases. Another way that pregnancy may have long-term effects on autoimmune disease is through the concept of microchimerism. This means that cells from the developing fetus cross into the mother and actually persist for long periods of time. These “foreign” cells may actually help calm autoimmune diseases. This new study suggests that there may be long-term benefits to breast-feeding, separate from those seen with pregnancy itself. The authors mention some of the limitations of this study and more research will be needed. Data review offers new insights into Alemtuzumab A new review of phase III trial datasets of Alemtuzumab helps explain the drug’s effects and side effects. Researchers say this new information will help contribute to the effective management of people with MS, firstly during the decision-making process Medicine & Research Doctor’s Notes The Doctor’s Notes column includes analysis from Ben Thrower, M.D., MS Focus senior medical advisor. Dr. Thrower draws from the top news stories of the quarter and explains what the news means to you, the person with MS.