Transient immunomodulation by intravenous methylprednisolone treatment of multiple sclerosis.
The extent and duration of immunomodulation induced by high-dose corticosteroid treatment of clinical relapse of multiple sclerosis was investigated. Ten patients treated with a 5 day course of intravenous methylprednisolone (IVMP) (500 mg daily) were studied. Circulating lymphocyte subpopulations and mitogen-induced interleukin 2 (IL-2) and gamma-interferon (gamma-IFN) production were determined immediately before initiation of therapy (day 1), during therapy (24 h after first dose, day 2) and at 24 h and 1 week post therapy (days 6 and 12 respectively). T-cell subpopulation (CD3, CD4, CD8, CD4CD45RA, CD4CD45RO) levels fell within 24 h of initiation of therapy, rebounded above pretreatment levels at day 6 and normalised 1 week post therapy. Despite a reduction in total T-cell numbers during treatment, the gamma delta T-cell subpopulation was not significantly altered. HLA-DR expression on B cells and monocytes declined transiently on day 2 to approximately 50% of pretherapy levels. IL-2 and gamma-IFN production were reduced during therapy but returned to baseline levels by 24 h post therapy. The effects of IVMP on lymphocyte distribution and function appear to be short-lived and, therefore, may not be responsible for the rapid improvement associated with this form of treatment.
Crockard
A D
AD
Regional Immunology Laboratory, Royal Victoria Hospital, Queen's University of Belfast, Northern Ireland.
Treacy
M T
MT
Droogan
A G
AG
McNeill
T A
TA
Hawkins
S A
SA
D000276:Adjuvants, Immunologic / Q000627:therapeutic use*; D000328:Adult; D015703:Antigens, CD / Q000187:drug effects / Q000378:metabolism; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use*; D006684:HLA-DR Antigens / Q000096:biosynthesis / Q000187:drug effects; D006801:Humans; D007275:Injections, Intravenous; D007371:Interferon-gamma / Q000096:biosynthesis / Q000187:drug effects; D007376:Interleukin-2 / Q000096:biosynthesis; D018655:Lymphocyte Count / Q000187:drug effects; D016131:Lymphocyte Subsets / Q000187:drug effects / Q000276:immunology; D008297:Male; D008775:Methylprednisolone / Q000008:administration & dosage* / Q000627:therapeutic use*; D008875:Middle Aged; D008934:Mitogens / Q000494:pharmacology; D009103:Multiple Sclerosis / Q000188:drug therapy* / Q000276:immunology*; D016693:Receptors, Antigen, T-Cell, alpha-beta / Q000187:drug effects / Q000378:metabolism; D016692:Receptors, Antigen, T-Cell, gamma-delta / Q000187:drug effects / Q000378:metabolism; D013997:Time Factors
D000276:Adjuvants, Immunologic; D015703:Antigens, CD; D005938:Glucocorticoids; D006684:HLA-DR Antigens; D007376:Interleukin-2; D008934:Mitogens; D016693:Receptors, Antigen, T-Cell, alpha-beta; D016692:Receptors, Antigen, T-Cell, gamma-delta; D007371:Interferon-gamma; D008775:Methylprednisolone