T8 antigen density on peripheral blood lymphocytes remains unchanged during exacerbations of multiple sclerosis

Phenotyping analysis of peripheral blood leukocytes in patients with multiple sclerosis

Multiple sclerosis (MS) is a central nervous disease thought to be elicited by an autoimmune process. Many studies in recent years have concentrated on finding the alterations in the peripheral blood immune profile in MS patients that would reflect disease activity. In the present study, we investigated surface antigen expression on lymphocytes and granulocytes from MS patients and control subjects. We have studied 29 patients suffering from relapsing-remitting or relapsing-progressive forms of MS. The disease was diagnosed in all patients at least 12 months before inclusion into the study. All patients had no attack at the study entry date or within a previous month. The control group included 29 age-matched subjects. Phenotyping of peripheral blood leukocytes was carried out with different fluorescence-conjugated murine monoclonal antibodies. The analysis was performed with three-color flow cytometry. The following antigens were determined [cluster of definition (CD)]: leukocyte common antigen (LCA) (B220, T 200, Ly-5), CD45; LPS-R (lipopolysaccharide receptor), CD14; found on all T cells, CD3; LFA-2 (lymphocyte function associated antigen, T 11), CD2; coreceptor for MHC class II molecules, found on helper T cells, CD4; coreceptor for MHC class I molecules, found on suppressor/cytotoxic T cells, CD8; B4, found on all human B cells, CD19; NCAM (neural cell adhesion molecule), CD56; integrin beta2 subunit, associated with CD11a (CD11a/CD18, LFA-1, alphaLbeta2) and CD11b (CD11b/CD18, Mac-1,CR3, alphaMbeta2), CD18; alphaL, alpha subunit of integrin LFA-1 (alphaLbeta2, CD11a/CD18), CD11a; alphaM, alpha subunit of integrin Mac-1 (CR3, alphaMbeta2, CD11b/CD18), CD11b; ICAM-1 (intercellular adhesion molecule), CD54; H-CAM, Hermes antigen, Pgp-1, CD44; AIM (activation inducer molecule), early activation antigen, CD69; T-cell receptor gammadelta, TCR gammadelta. In the MS group, we have found a significant increased expression of CD54 and CD44 antigens on lymphocytes, and higher percentage CD54(+) and CD11a+CD54(+) lymphocytes out of all lymphocytes compared with the control group. We have also found a significant increased expression of CD11a, CD18 and CD54 antigens on granulocytes, and higher percentage CD11b+CD18(+) granulocytes out of all granulocytes in MS patients compared with control. Higher levels of expression of the adhesion molecules may reflect the activation state of leukocytes in MS patients.

Presence of T-cell subset abnormalities in newly diagnosed cases of multiple sclerosis and relationship with short-term clinical activity

Abnormalities of T-cell subsets in patients with multiple sclerosis are well known; in order to assess whether immunological abnormalities are relevant in the pathogenesis of the disease after its clinical onset, peripheral blood lymphocyte subsets (CD3+, CD4+, CD4(+)-CD45RA+, CD4+CD45RA-, CD8+, CD8+CD57+, CD57+, CD25+) were analysed serially in 25 patients at the first clinical episode suggestive of inflammatory demyelinating disease and in an equal number of age- and sex-matched controls. During the follow-up period (12-18 months, mean 14) 6 of 25 patients presented new relapses: in this subgroup of patients, significant changes in CD4+ ratio (% CD4+CD45RA-/%CD4+CD45RA+) were detected in comparison both with healthy controls and with clinically stable patients. Patients clinically stable at follow-up did not display immunological abnormalities, regardless of the presence or absence of cerebrospinal fluid and/or magnetic resonance imaging alterations consistent with multiple sclerosis. These findings suggest a possible prognostic role of early T-cell subset imbalance in multiple sclerosis.

CD4+, CD8+, and CD4- CD8- T cells in CSF and blood of patients with multiple sclerosis and tension headache

Two-colour flow cytometric analysis was performed on paired samples of peripheral blood (PB) and cerebrospinal fluid (CSF) of patients with untreated multiple sclerosis (MS) and, for reference, subjects with muscular tension headache (TH) using anti-CD3, anti-CD4, anti-CD8, and anti-HLA-DR monoclonal antibodies in different combinations. CD4+/CD8+ T-cell ratio was increased in CSF compared to PB in both MS patients and TH subjects to a similar extent. This was mainly due to higher CD4+ T-cell levels in the CSF compartment. The proportion of HLA-DR+ T cells was higher in CSF than PB in both MS and TH; this increase of DR+ T cells in CSF was more prominent in MS. The level of CD4+ CD8+ T cells, which represent a subset of activated T cells, was not different between CSF and PB, either in MS or in TH. The proportion of CD4- CD8- T cells, which were found generally not to be blast cells, was lower in CSF compared to PB in both patient groups. However, their CSF level was higher and their PB level lower in MS compared to TH. Results point to an accumulation of activated T-helper cells in the CSF of both MS patients and healthy subjects. Fetal-type CD4- CD8- T cells bearing the unusual T-cell receptor gamma/delta seem to be selectively recruited to the CSF of MS patients.

T-lymphocyte subsets defined by double immunofluorescence in multiple sclerosis

T-lymphocyte subpopulations were studied in the blood of 25 multiple sclerosis patients and 25 healthy age and sex-matched controls. Monoclonal antibodies labelled with different fluorochromes were used to define the percentages of CD4 (helper/inducer) and CD8 (suppressor/cytotoxic) positive cells and to dissect them into phenotypic subgroups. The results confirm the decrease in CD8 positive cells in the blood associated with multiple sclerosis. The subset showing the most marked decrease was the CD11 marker negative population, which has been reported to be associated with cytotoxicity rather than suppression. There was no significant decrease in the percentage of cells positive for both CD4 and CD45R markers reported to contain suppressor-inducer or naive T-helper cells in the MS patients. The results suggest that further dissection of T-cell subpopulations may clarify our understanding of this disease process.

Monocyte defect causes decreased autoMLR in multiple sclerosis patients

We have recently demonstrated that peripheral blood monocytes from patients with multiple sclerosis (MS) have a defect in stimulating autologous and allogeneic T lymphocytes. This defect was found to correlate with disease activity. We report here that T4+ cells from MS patients proliferate weakly in the autologous mixed lymphocyte reaction (autoMLR). Furthermore, we provide direct proof that the depressed T4+ cell proliferation is due to the monocyte functional (stimulatory) defect.

Líquido cefalorraqueano e neurocisticercose: aspectos evolutivos da resposta inflamatória celular

Foram estudadas 357 amostras de LCR de 40 pacientes com neurocisticercose, submetidos a tratamento medicamentoso com praziquantel associado a dexametasona. No sentido de avaliar aspectos evolutivos do componente celular da resposta inflamatória, foram programadas, para cada paciente, avaliações do exame de LCR em 13 oportunidades: por ocasião do dagnóstico; durante o tratamento; e posteriormente, a intervalos prefixados até completar dois anos de evolução. Foi utilizada metodologia adequada ao estudo citológico e citomorfológico, bem como à quantificação de linfócitos B e T. Para determinação de subpopulações T-ativa, T-sensibilizada e T-ávidas foram utilizados, como marcadores de superfície, receptores para hemácias de carneiro. O grupo controle é constituído de 50 pacientes com cefaléia crônica e que não apresentavam alterações ao exame físico e ao exame neurológico. Em todos, o exame de LCR estava dentro dos limites normais. Linfócitos B e T não apresentavam alterações no exame inicial de LCR; não houve modificações no seu comportamento durante toda a evolução. Os elementos da resposta inflamatória celular capazes de fornecer informações significativas acerca do perfil evolutivo em estudo foram: o número de células, a presença e o número de polimorfonucleares neutrófilos e de células eosinófilas e a quantificação de subpopulações T-ativa e T-sensibilizada. A presença de polimorfonucleares neutrófilos embora influenciada pela ação dos corticosteróides e pela presença de sistema de derivação do trânsito do LCR, pode constituir-se em elemento qualitativo sugestivo de atividade inflamatória. Os valores percentuais para linfócitos T-ativos, diminuídos na primeira amostra, e T-sensibilizados, aumentados na primeira amostra, podem ser indicadores quantitativos e qualitativos adequados a reconhecer a vigência de atividade inflamatória local no sistema LCR; estas subpopulações linfocitárias, com alterações significativas em 63,2% dos pacientes no exame inicial, não são influenciadas significativamente pelo uso de corticosteróides. Os valores de eosinófilos e de linfócitos T-sensibilizados estão significativamente aumentados em pacientes que apresentaram complicações clínicas durante o período de acompanhamento após o tratamento; subpopulação de linfócitos T-ativos estava significativamente diminuída nestes casos. O número de células e a presença de eosinófilos são os elementos da resposta inflamatória celular relacionáveis a tipos de alterações detectadas pela tomografia computadorizada do crânio. Os elementos da resposta inflamatória celular estudados não apresentam correlação significativa entre si, podendo traduzir cada um deles aspectos particulares da reação inflamatória celular no SNC em pacientes com neurocisticercose.

T-lymphocyte subpopulation levels and immunoglobulin changes in the cerebrospinal fluid of patients with neurologic disorders

Immunologic mechanisms are thought to play an important role in the pathogenesis of multiple sclerosis (MS). In this study we examined cerebrospinal fluid (CSF) samples of 29 patients with MS and of 24 patients with other neurological disorders. An elevated T-helper (Th)/T-suppressor (Ts) ratio was typical for the CSF of patients with MS. There was a clear positive correlation between the percentage of Th cells and the existence of oligoclonal bands in the CSF. On the other hand, the percentage of Ts cells correlated negatively with the existence of oligoclonal bands in the CSF. The imbalance of CSF T-lymphocyte subpopulations may be one of the fundamental defects in MS, and the observed alterations in CSF immunoglobulin synthesis pattern might only reflect these changes.

Molecular analysis of the CD8 gene in multiple sclerosis

Analysis of DNA fragments of the CD8 gene following digestion with three restriction enzymes showed no differences between patients with chronic progressive multiple sclerosis (MS), familial MS and controls. These abnormalities suggest that any abnormalities in the expression of CD8 protein in MS are not likely to be due to a gross deletion or rearrangement of the CD8 gene.

Acute multiple sclerosis exacerbations are characterized by low cerebrospinal fluid suppressor/cytotoxic T-cells

The present study describes peripheral blood (PB) and CSF T-lymphocyte subpopulations in 55 MS patients with and without acute exacerbation and compares the results with those obtained from 8 with CNS infections and 45 with other neurological disorders or symptoms (OND). The MS patients were most strongly characterized by a decline of their CSF suppressor/cytotoxic T-cells, which was most profound during acute exacerbations. The proportional amount of CSF helper/inducer T-cells (Th) was higher in both MS group than in the OND group, but not different from that of the CNS infection group. No statistically significant change in the CSF Th-cells during exacerbations was seen. MS patients without an exacerbation had somewhat higher levels of their PB Th-cells than the patients with OND, but otherwise no differences in the PB T-cell subsets were seen.

The effects of long-term administration of recombinant alpha-2 interferon on lymphocyte subsets, proliferation, and suppressor cell function in multiple sclerosis

The immunological effects of long-term treatment with recombinant alpha-2 interferon (rIFN-alpha 2) were investigated in multiple sclerosis (MS) patients treated with 2 X 10(6) units of IFN or a placebo three times per week for one year. A mild lymphopenia was observed in IFN patients who also showed a decrease in the absolute number of total T cells in the blood (OKT3 binding cells); however, the percentage of cells reacting with OKT3, OKT4, and OKT8 antibodies did not change significantly during the study. The percentage of cells reacting with the Leu-7 antibody, which recognizes NK cells, was unchanged. During MS exacerbations, placebo patients showed a tendency for decreased levels of OKT3 and OKT8 cells. In contrast, IFN patients did not demonstrate a decrease in either OKT3 or OKT8 cells during disease attacks. Concanavalin A (ConA)-induced suppressor cell activity was depressed in both IFN and placebo-treated patients during attacks. Lymphoproliferative responses to phytohemagglutinin, pokeweed mitogen, and ConA were unchanged. These studies demonstrate that long-term treatment with rIFN-alpha 2 induces a generalized T-cell lymphopenia, but at this dose does not significantly affect the profiles of T-cell subsets and suppressor cell function in MS patients.