Steiner I, Brenner T, Mizrachi-Kol R, Abramsky O
Department of Neurology, Hadassah University Hospital, Jerusalem, Israel.
Isr J Med Sci. 1991 Jul;27(7):365-8.
Glucocorticoids are frequently employed as immunosuppressive agents. Following clinical reports of occurrence and exacerbation of neurological immune-mediated conditions in patients receiving steroids, we studied the course of experimental allergic encephalomyelitis (EAE) in rats receiving methylprednisolone prior to and during disease induction and after the appearance of clinical signs. High methylprednisolone dose given prior to EAE induction significantly increased disease duration and the number of days at maximal disability. When the drug was given prior to and during the induction phase, both moderate and high doses exacerbated the EAE course. In contrast, treatment with methylprednisolone after the onset of clinical disease had a markedly beneficial effect. Thus, time of initiation, dosage and duration of treatment may differentially affect the course of EAE. Moreover, the natural course of a neurological immune-mediated condition may be worsened when it is triggered while the patient is under steroid treatment.
糖皮质激素常被用作免疫抑制剂。在有临床报告称接受类固醇治疗的患者出现神经免疫介导疾病并病情加重后，我们研究了在疾病诱导前、诱导期间以及出现临床症状后接受甲泼尼龙治疗的大鼠实验性自身免疫性脑脊髓炎（EAE）的病程。在EAE诱导前给予高剂量甲泼尼龙显著延长了疾病持续时间以及最大残疾天数。当在诱导期之前和期间给予该药物时，中等剂量和高剂量都会加重EAE病程。相比之下，在临床疾病发作后用甲泼尼龙治疗具有明显的有益效果。因此，开始治疗的时间、剂量和治疗持续时间可能对EAE病程产生不同影响。此外，当神经免疫介导疾病在患者接受类固醇治疗期间被触发时，其自然病程可能会恶化。
