Lymphocyte subpopulation in the peripheral blood and cerebrospinal fluid of patients with multiple sclerosis

The structural basis of multiple sclerosis are perivascular inflammatory foci in the white matter of the CNS. In the development of these foci participate to a major extent lymphocytes which express various surface signs (CD markers). They pass from the peripheral blood into the compartment of the CNS, produce various anti-inflammatory factors, mediate the destruction of myelin. The surface markers of lymphocytes can be detected by means of monoclonal antibodies, two signs concurrently can be examined by means of a flow cytometer. The objective of the present study was examination of lymphocyte subpopulations in the peripheral blood and cerebrospinal fluid in patients with exacerbation of multiple sclerosis during secondary progression and in patients with lumboischiadic syndrome (LS) and to assess the dynamics in relation to treatment with methylprednisolone and cytosine arabinoside in patients with multiple sclerosis. After elaboration of the method for examination of CD markers in lymphocytes in the CSF the authors found an increased ratio of CD3+, CD4+, CD8+ and CD57+ cells in CSF and a drop after treatment with methylprednisolone, furthermore a reduced ratio of CD4+CD45RA+ cells in CSF and a rise of these cells after treatment. In the peripheral blood a lower percentage of CD8+CD57+ cells and decline of the percentage of CD57+ cells after treatment was found. The percentage of CD28+ cells in patients with multiple sclerosis is permanently elevated, after treatment with methylprednisolone a rise of CD8+CD281, CD191 and CD23+ cells occurs; there is a decline of NK cells and CD19+CD5 cells. The other examined subpopulations did not differ in the investigated groups. The assessed abnormalities in CSF and in the peripheral blood support the idea of a persistent inflammatory activation in the compartment of the CNS as well as in the peripheral bloodstream of patients also in the initial years of secondary chronic progression of multiple sclerosis.