Remyelination needs sex hormones

Bielecki B, Mattern C, Ghoumari AM, Javaid S, Smietanka K, Abi Ghanem C, Mhaouty-Kodja S, Ghandour MS, Baulieu EE, Franklin RJ, Schumacher M, Traiffort E.Unexpected central role of the androgen receptor in the spontaneous regeneration of myelin.Proc Natl Acad Sci U S A. 2016 Dec 7. pii: 201614826. [Epub ahead of print]

Lost myelin can be replaced after injury or during demyelinating diseases in a regenerative process called remyelination. In the central nervous system (CNS), the myelin sheaths, which protect axons and allow the fast propagation of electrical impulses, are produced by oligodendrocytes. The abundance and widespread distribution of oligodendrocyte progenitors (OPs) within the adult CNS account for this remarkable regenerative potential. Here, we report a key role for the male gonad, testosterone, and androgen receptor (AR) in CNS remyelination. After lysolecithin-induced demyelination of the male mouse ventral spinal cord white matter, the recruitment of glial fibrillary acidic protein-expressing astrocytes was compromised in the absence of testes and testosterone signaling via AR. Concomitantly, the differentiation of OPs into oligodendrocytes forming myelin basic protein (MBP)+ and proteolipid protein-positive myelin was impaired. Instead, in the absence of astrocytes, axons were remyelinated by protein zero (P0)+ and peripheral myelin protein 22-kDa (PMP22)+ myelin, normally only produced by Schwann cells in the peripheral nervous system. Thus, testosterone favors astrocyte recruitment and spontaneous oligodendrocyte-mediated remyelination.  The testosterone dependency of CNS oligodendrocyte remyelination may have roots in the evolutionary history of the AR, because the receptor has evolved from an ancestral 3-ketosteroid receptor through gene duplication at the time when myelin appeared in jawed vertebrates.

Testosterone promotes astrocytes and remyelination, interestingly  men do worse than females.

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  • It'll be interesting to see MS diagnosis rates vs age in men and women. Maybe it gets more equal as age goes up and testosterone levels fall in men.

  • What about women using hormonal contraceptives?
    Would they have more difficulty with remyelination, since progesterone is androgenic?

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