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

Eur J Neurol. 2000 May;7(3):281-9. doi: 10.1046/j.1468-1331.2000.00074.x.


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-beta1, 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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acute Disease
  • Administration, Oral
  • Adult
  • Anti-Inflammatory Agents / administration & dosage*
  • Anti-Inflammatory Agents / pharmacology*
  • Antigens / blood
  • Antigens / cerebrospinal fluid
  • CD4-Positive T-Lymphocytes / immunology
  • CD4-Positive T-Lymphocytes / physiology
  • Dose-Response Relationship, Drug
  • Female
  • Flow Cytometry
  • Humans
  • Immune System / drug effects*
  • Immunoglobulin G / biosynthesis
  • Immunoglobulin G / blood
  • Leukocyte Count / drug effects
  • Male
  • Matrix Metalloproteinase 9 / drug effects
  • Methylprednisolone / administration & dosage*
  • Methylprednisolone / pharmacology*
  • Multiple Sclerosis / drug therapy
  • Multiple Sclerosis / immunology*
  • Myelin Basic Protein / cerebrospinal fluid
  • Optic Neuritis / drug therapy
  • Optic Neuritis / immunology*
  • Randomized Controlled Trials as Topic
  • Spinal Cord / metabolism
  • Spinal Puncture
  • Transforming Growth Factor beta / cerebrospinal fluid


  • Anti-Inflammatory Agents
  • Antigens
  • Immunoglobulin G
  • Myelin Basic Protein
  • Transforming Growth Factor beta
  • Matrix Metalloproteinase 9
  • Methylprednisolone