Immunological effects of oral high-dose methylprednisolone in acute optic neuritis and multiple sclerosis

Abstract

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‐β1, 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.

Part of CIRS Nexus · Curated by Lauren Lowenstein, The Biotoxin Lady