Treatment with methylprednisolone in relapses of multiple sclerosis patients: immunological evidence of immediate and short‐term but not long‐lasting effects

• Published in: Clinical and experimental immunology Vol. 127; no. 1; pp. 165 - 171
• Main Authors: Martínez‐Cáceres, E. M., Barrau, M. A., Brieva, L., Espejo, C., Barberà, N., Montalban, X.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Science Ltd 01.01.2002; Blackwell; Oxford University Press; Blackwell Science Inc
• Subjects: adhesion molecules; Adult; Anti-Inflammatory Agents - administration & dosage; Anti-Inflammatory Agents - immunology; Anti-Inflammatory Agents - therapeutic use; Antigens, CD - immunology; Biological and medical sciences; CD4 antigen; CD45RO antigen; Female; Humans; IFN‐gamma; Immunomodulators; Immunophenotyping; Lymphocyte Subsets - drug effects; Lymphocyte Subsets - immunology; Male; Medical sciences; methylprednisolone; Methylprednisolone - administration & dosage; Methylprednisolone - immunology; Methylprednisolone - therapeutic use; Middle Aged; multiple sclerosis; Multiple Sclerosis - drug therapy; Multiple Sclerosis - physiopathology; Multiple sclerosis and variants. Guillain barré syndrome and other inflammatory polyneuropathies. Leukoencephalitis; Neurology; Original; Pharmacology. Drug treatments; Receptors, CCR5 - immunology; Receptors, Chemokine - immunology; Receptors, CXCR3; Recurrence; relapse; Time Factors; Short term; Human; Corticosteroid; Fas ligand; Nervous system diseases; Relapse; Multiple sclerosis; CCR5 receptor; Fas antigen; Cytokine; Cell adhesion molecule; Methylprednisolone; Adhesion; Long term; Inflammatory disease; Chemotherapy; Treatment; Immunological investigation; Central nervous system disease; T-Lymphocyte; CXCR3 receptor; Mechanism of action; High dose; Gamma interferon
• ISSN: 0009-9104; 1365-2249
• DOI: 10.1046/j.1365-2249.2002.01725.x

SUMMARY Relapses of multiple sclerosis (MS) are treated commonly with high‐dose intravenous methylprednisolone (MP) given over a period of 3–5 days. The mechanisms responsible for the beneficial effects of MP in attacks are not clearly established. It is also controversial whether this treatment may have a long‐term effect. Here, peripheral blood samples from relapsing–remitting MS patients in acute relapse were analysed by flow cytometry just before steroid treatment and at different time points after initiation of the therapy. We observed an immediate (day 3) decrease in the percentage of CD4+ lymphocytes, with a relative increase in the memory (CD4+CD45R0+) subpopulation. A longer standing effect of MP on IFN‐γ production, CD54, CCR5, CXCR3 and CD95 (Fas) expression was also observed on CD4+ cells after 1 month of treatment initiation. Six months after the therapy, during clinical remission, no changes due to ivMP therapy were detected. These results support that MP treatment of relapses induces immediate post‐treatment and short‐term effects on the immune system that could partly account for the clinical and radiological improvement observed in MS patients. However, no conclussion can be drawn as to a possible long‐term or even intermediate influence of ivMP treatment on the course of the disease.