Franciotta D, Piccolo G, Zardini E, Bergamaschi R, Cosi V
Laboratory of Neuroimmunology, Neurological Institute C. Mondino Foundation, University of Pavia, Italy.
Acta Neurol Scand. 1997 May;95(5):275-9. doi: 10.1111/j.1600-0404.1997.tb00209.x.
We studied the effects of large doses of 6-methylprednisolone (6-MP) on serum and cerebrospinal fluid (CSF) soluble CD8 (sCD8) and intercellular adhesion molecule-1 (sICAM-1) levels in clinically active multiple sclerosis (MS) patients.
Paired serum and CSF samples were from 16 patients with definite MS, treated with 6-MP (1 g daily for 6 d) during an active phase of the disease. sCD8 and sICAM-1 levels were determined with ELISA before and after the therapy.
Before 6-MP treatment, sCD8 levels in CSF were higher in MS patients than in patients with noninflammatory neurological disease and in healthy controls; sICAM-1 levels in serum and in CSF were higher in MS patients than in the two control groups. Ten of the 16 patients showed clinical improvement at the end of the treatment. After the therapy, serum and CSF sCD8 levels increased, whereas serum and CSF sICAM-1 levels decreased. There was no correlation between clinical improvement and laboratory parameters. We evaluated sCD8 and sICAM-1 in serum samples from 10 patients 6 months after the 6-MP treatment, when the disease was clinically silent. Neither sCD8 nor sICAM-1 levels differed from those of the control groups.
Our results suggest that high doses of 6-MP can influence serum and CSF sCD8 and sICAM-1 levels in active MS. At least part of the efficacy of corticosteroid treatment in MS might be ascribed to its effect both on the suppressive circuits of immune response, and on the expression of an adhesion molecule that favours lymphocyte trafficking across the blood-brain barrier.
我们研究了大剂量6-甲基泼尼松龙（6-MP）对临床活动期多发性硬化症（MS）患者血清和脑脊液（CSF）中可溶性CD8（sCD8）及细胞间黏附分子-1（sICAM-1）水平的影响。
配对的血清和脑脊液样本来自16例确诊为MS的患者，这些患者在疾病活动期接受6-MP治疗（每日1 g，共6天）。在治疗前后采用酶联免疫吸附测定法（ELISA）测定sCD8和sICAM-1水平。
在6-MP治疗前，MS患者脑脊液中的sCD8水平高于非炎性神经系统疾病患者和健康对照者；MS患者血清和脑脊液中的sICAM-1水平高于两个对照组。16例患者中有10例在治疗结束时临床症状改善。治疗后，血清和脑脊液中的sCD8水平升高，而血清和脑脊液中的sICAM-1水平降低。临床改善与实验室参数之间无相关性。我们在6-MP治疗6个月后对10例患者的血清样本进行了sCD8和sICAM-1评估，此时疾病处于临床静止期。sCD8和sICAM-1水平均与对照组无差异。
我们的结果表明，高剂量的6-MP可影响活动期MS患者血清和脑脊液中的sCD8和sICAM-1水平。皮质类固醇治疗MS的疗效至少部分可能归因于其对免疫反应抑制回路以及对有利于淋巴细胞穿越血脑屏障的黏附分子表达的影响。
