title: Immunological monitoring of azathioprine treatment in multiple sclerosis patients.
abstract: Despite the longstanding clinical use of azathioprine as an immunosuppressive agent in multiple sclerosis, little is known about the action of this drug on a number of parameters of putative pathogenic relevance in the disease. Eleven patients with multiple sclerosis, treated with azathioprine 2.5-3 mg/kg per day, and six untreated patients were studied with serial blood sampling for 1 year. The following immunological parameters were investigated: peripheral blood lymphocyte subsets, natural killer activity, serum IgG, IgM, ICAM-1 and tumour necrosis factor alpha (TNF-alpha). The most relevant changes included a decrease in CD3- CD56+ cells, an increase in CD4+ CD45RA+ cells and a decrease in TNF-alpha levels only in treated patients, while no changes occurred in untreated patients over a 1-year period. The decrease in TNF-alpha levels and the increase in "suppressor-inducer" lymphocytes could reduce chronic inflammation in multiple sclerosis, and paralleled an overall favourable clinical response to azathioprine treatment in our patients.
authors.affiliation: Instituto Nazionale Neurologico C. Besta, Milan, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Salmaggi
authors.forename: E
authors.initials: E
authors.lastname: Corsini
authors.forename: L
authors.initials: L
authors.lastname: La Mantia
authors.forename: A
authors.initials: A
authors.lastname: Dufour
authors.forename: M
authors.initials: M
authors.lastname: Eoli
authors.forename: C
authors.initials: C
authors.lastname: Milanese
authors.forename: A
authors.initials: A
authors.lastname: Nespolo
mesh_terms: D001379:Azathioprine / Q000627:therapeutic use*; D001402:B-Lymphocytes / Q000276:immunology; D016207:Cytokines / Q000097:blood*; D016903:Drug Monitoring / Q000379:methods*; D005260:Female; D006801:Humans; D016130:Immunophenotyping; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D018799:Intercellular Adhesion Molecule-1 / Q000097:blood; D007694:Killer Cells, Natural / Q000276:immunology; D008297:Male; D009103:Multiple Sclerosis / Q000188:drug therapy* / Q000276:immunology; D018709:Statistics, Nonparametric; D050378:T-Lymphocytes, Regulatory / Q000276:immunology*
chemical_list: D016207:Cytokines; D007166:Immunosuppressive Agents; D018799:Intercellular Adhesion Molecule-1; D001379:Azathioprine