Th1, Th2 and Th17 Cytokine Profile in Patients with Multiple Sclerosis Following Treatment with Rapamycin

Background: Management of multiple sclerosis (MS) is based on the usage of immunosuppressive and immune-modulating medications. Cytokines play an important role in the pathogenesis of MS. Objective: To evaluate the effects of rapamycin on the concentrations of Th1/Th2/Th17 serum cytokines in patients with MS. Methods: Six patients with relapsing remitting MS as a case group and 6 healthy individuals as a control group were enrolled. The patients have been receiving 2 mg rapamycin daily for 6 months. The individuals in control group received nothing during 6 months of the experiment. Enzyme linked immunosorbent assay (Simultaneous Multi-Analyte ELISA) technique was used for determination of serum concentrations of IL-2, IL-4, IL-5, IL-6, IL-10, IL-12, IL-13, IL-17, IFN-gamma, TNF-alpha, G-CSF and TGF-beta before and after therapy with rapamycin. Results: The mean absorbance of 10 out of the 12 studied cytokines showed reduction after the therapy with rapamycin including IL-2, IL-4, IL-5, IL-6, IL-10, IL-12, IL-13, IL-17, IFN-gamma and TNF-alpha. The only statistically significant reduction was observed in the absorbance of IFN-gamma (p=0.028). Two cytokines illustrated increase in the patients sera after the therapy, including G-CSF and TGF-beta, but only increase in TGF-beta was statistically significant (p=0.046). None of the studied cytokines in the control group varied significantly after 6 months. Conclusion: Based on the findings of this study, rapamycin has some immunosuppressive effects, such as decreasing IFN-gamma, which can improve the quality of life of the patients with multiple sclerosis. Also the increased level of TGF-beta may also have benefits on the disease, which needs further clinical studies.