Immunological effects of oral high-dose methylprednisolone in acute optic neuritis and multiple sclerosis.
The immunological effects of high-dose methylprednisolone in attacks of multiple sclerosis and acute optic neuritis have only been examined in a few randomized, controlled trials. We studied immunological changes in 50 patients with optic neuritis or multiple sclerosis who underwent lumbar puncture before and 1 week after completing a 15-day course of oral high-dose methylprednisolone treatment. Treatment resulted in a decrease in the concentration of myelin basic protein, a decrease in the serum concentration of immunoglobulin G (IgG) and intrathecal IgG synthesis, an increase in the cerebrospinal fluid concentration of transforming growth factor-beta1, and changes in the expression of CD25, CD26, and human leukocyte antigen-DR (HLA-DR) on CD4 T-cells. No effect was seen on the cerebrospinal fluid leucocyte count or the cerebrospinal fluid activity of matrix metalloproteinase-9 (MMP-9). The lack of a persistent effect on cerebrospinal fluid leucocyte recruitment and MMP-9 activity, despite changes in IgG synthesis, T-cell activation, and cytokine production, suggests that modulation of the function of inflammatory cells may contribute to the clinical efficacy of oral high-dose methylprednisolone treatment in optic neuritis and multiple sclerosis.
Sellebjerg
F
F
Department of Neurology, University of Copenhagen, Glostrup Hospital, Denmark. sellebjerg@dadlnet.dk
Christiansen
M
M
Jensen
J
J
Frederiksen
J L
JL
D000208:Acute Disease; D000284:Administration, Oral; D000328:Adult; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage* / Q000494:pharmacology*; D000941:Antigens / Q000097:blood / Q000134:cerebrospinal fluid; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology / Q000502:physiology; D004305:Dose-Response Relationship, Drug; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D007107:Immune System / Q000187:drug effects*; D007074:Immunoglobulin G / Q000096:biosynthesis / Q000097:blood; D007958:Leukocyte Count / Q000187:drug effects; D008297:Male; D020780:Matrix Metalloproteinase 9 / Q000187:drug effects; D008775:Methylprednisolone / Q000008:administration & dosage* / Q000494:pharmacology*; D009103:Multiple Sclerosis / Q000188:drug therapy / Q000276:immunology*; D004676:Myelin Basic Protein / Q000134:cerebrospinal fluid; D009902:Optic Neuritis / Q000188:drug therapy / Q000276:immunology*; D016032:Randomized Controlled Trials as Topic; D013116:Spinal Cord / Q000378:metabolism; D013129:Spinal Puncture; D016212:Transforming Growth Factor beta / Q000134:cerebrospinal fluid
D000893:Anti-Inflammatory Agents; D000941:Antigens; D007074:Immunoglobulin G; D004676:Myelin Basic Protein; D016212:Transforming Growth Factor beta; D020780:Matrix Metalloproteinase 9; D008775:Methylprednisolone