Immune parameters associated with early treatment effects of high-dose intravenous methylprednisolone in multiple sclerosis.
To determine the immunological effects of high-dose intravenous methylprednisolone (IVMP) and elucidate immune measurements used for evaluation of its therapeutic effect, we analyzed lymphocyte subsets and humoral immune parameters in peripheral blood and cerebrospinal fluid (CSF) samples, before and within 2 weeks of treatment during 19 acute exacerbations in 16 relapsing-remitting multiple sclerosis (MS) patients. In addition to decreases in CSF albumin and IgG levels, treatment resulted in an increase of CD8(+)CXCR3(+) cells as well as a decrease in CD4(+) subsets expressing CD25, CD29, and CCR4 in the CSF. Further, the percentage of circulating CD4(+)CXCR3(+) Th1 cells also decreased. Clinical improvement was achieved following 15 of the 19 treatment occasions. Early (<2 weeks of treatment) clinical improvement was significantly associated with a decrease in CSF CD4(+)CD29(+) helper inducer T cells, whereas they were nearly unchanged in four patients who showed no improvement. Changes in other parameters following IVMP treatment were not different between the responder and non-responder groups.
Wang
Hui-Yun
HY
Department of Neurology and Clinical Research Center, Center for Neurological Diseases, Utano National Hospital, Ukyo, Kyoto 616-8255, Japan.
Matsui
Makoto
M
Araya
Shin-ichi
S
Onai
Nobuyuki
N
Matsushima
Kouji
K
Saida
Takahiko
T
D000328:Adult; D000368:Aged; D000893:Anti-Inflammatory Agents / Q000494:pharmacology / Q000627:therapeutic use; D000954:Antigens, Surface / Q000276:immunology; D002555:Cerebrospinal Fluid / Q000187:drug effects / Q000276:immunology; D004305:Dose-Response Relationship, Drug; D015536:Down-Regulation / Q000187:drug effects / Q000276:immunology; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000134:cerebrospinal fluid; D007275:Injections, Intravenous; D019012:Integrin beta1 / Q000276:immunology; D008297:Male; D008775:Methylprednisolone / Q000494:pharmacology* / Q000627:therapeutic use; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000188:drug therapy* / Q000276:immunology*; D011930:Reaction Time / Q000187:drug effects / Q000276:immunology; D054367:Receptors, CXCR3; D019707:Receptors, Chemokine / Q000276:immunology; D012709:Serum Albumin / Q000134:cerebrospinal fluid; D000075462:Serum Albumin, Human; D013601:T-Lymphocytes / Q000187:drug effects* / Q000276:immunology; D018417:Th1 Cells / Q000187:drug effects / Q000276:immunology
D000893:Anti-Inflammatory Agents; D000954:Antigens, Surface; C515187:CXCR3 protein, human; D007074:Immunoglobulin G; D019012:Integrin beta1; D054367:Receptors, CXCR3; D019707:Receptors, Chemokine; D012709:Serum Albumin; C402606:albumin Amsterdam; D008775:Methylprednisolone; D000075462:Serum Albumin, Human