Abstract

The bout of multiple sclerosis implies activation of autoreactive mononuclear cells of peripheral blood and increased expression of adhesive cells on cerebral vessel endothelium. This results in the migration of cells and consequently, in the formation of perivascular infiltrations consisting of lymphocytes and macrophages, as well as the destruction of myelin in the brain and spinal cord. Steroid-therapy reduces clinical symptoms of MS bout, while nuclear magnetic resonance reveals the decrease of demyelinization foci after treatment. The aim of the present work was to evaluate the effect of methylprednisolone therapy upon the activation of immune system and clinical status estimated on EDSS scale. In our study, concentrations of sIL-2R alpha, sICAM-1 and sVCAM-1 were investigated in blood serum with the use of ELISA immunoenzyme assay. The study was performed in the group of 15 patients with the first bout of multiple sclerosis, who received intravenous infusion of methylprednisolone (1g) daily for 5 consecutive days. Neurological examinations as well as the determination of serum levels of cellular differentiation antigens listed above were performed before the start of therapy and 4 weeks after its completion. Control group was formed of 20 healthy persons. In patients with the first bout of the disease, mean serum concentrations of sIL-2R, sICAM-1 and sVCAM-1 were significantly higher when compared with the results obtained in control group. 4 weeks after therapy with methylprednisolone, a considerable improvement of neurological status was observed in patients from the study group. At that time, return to normal serum levels of mean sVCAM-1 concentration and a considerable decrease of mean sICAM-1 concentration were observed, while mean level of sIL-2R alpha did not change in a significant way. The improvement on EDDS scale after treatment correlated with the decrease of sICAM-1 in blood serum. The results of our study suggest that a beneficial clinical effect of steroid therapy in patients with multiple sclerosis may partly result from its inhibiting influence on the expression of adhesive cells, which consequently may lead to reduced migration of activated cells of immune system to central nervous system.

Keywords: Immune System, steroid therapy, Multiple Sclerosis