Kulu Uğur, Tiftikcioğlu Bedile İrem, Zorlu Yaşar, Çetiner Mustafa, Şener Ufuk, Tuna Gamze, Kirkali Güldal
Clinic of Neurology, Tepecik Training and Research Hospital, İzmir, Turkey.
Department of Medical Biochemistry, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey.
Noro Psikiyatr Ars. 2017 Mar;54(1):57-61. doi: 10.5152/npa.2016.12382. Epub 2016 Mar 28.
Relapses of multiple sclerosis (MS) are usually treated with high-dose intravenous methylprednisolone (IVMP), given over 3-10 days. There is no consensus on the optimal duration of treatment. In this study, we aimed to investigate whether longer treatment provides additional short-term clinical benefits assessed by the change in plasma cytokine levels and EDSS scores in patients with relapsing-remitting MS (RRMS).
Forty RRMS patients during relapse were grouped into 3 and treated with 1 g/day of IVMP for either 5, 7, or 10 consecutive days.
Levels of IL-10 and IL-12 were analyzed, and EDSS scores were noted before treatment, after treatment (on days 6, 8, or 11) and at the 4 week. IVMP treatment significantly induced anti-inflammatory IL-10 levels but had no effect on IL-12 levels. IVMP treatment for 7 or 10 consecutive days was not significantly different than that for 5 days in terms of the change in IL-12, IL-10 levels or clinical outcome.
In conclusion, pulse high-dose IVMP treatment enhances functional recovery in patients with acute relapses of RRMS. In addition, IVMP treatment significantly increases the levels of IL-10 but has no effect on the levels of IL-12 in the short term.
多发性硬化症（MS）复发通常采用大剂量静脉注射甲基泼尼松龙（IVMP）治疗，疗程为3 - 10天。关于最佳治疗时长尚无共识。在本研究中，我们旨在调查延长治疗时间是否能通过复发缓解型多发性硬化症（RRMS）患者血浆细胞因子水平变化和扩展残疾状态量表（EDSS）评分评估带来额外的短期临床益处。
40例复发期RRMS患者被分为3组，连续5天、7天或10天接受每日1克IVMP治疗。
分析了白细胞介素-10（IL-10）和白细胞介素-12（IL-12）水平，并记录了治疗前、治疗后（第6天、第8天或第11天）以及第4周时的EDSS评分。IVMP治疗显著诱导了抗炎性IL-10水平，但对IL-12水平无影响。就IL-12、IL-10水平变化或临床结局而言，连续7天或10天的IVMP治疗与5天治疗无显著差异。
总之，脉冲式大剂量IVMP治疗可促进RRMS急性复发患者的功能恢复。此外，IVMP治疗可显著提高IL-10水平，但短期内对IL-12水平无影响。
