Intravenous methylprednisolone (MP) is the standard method in the treatment of acute relapses in multiple sclerosis (MS) and is believed to affect various immunological processes involved in the pathology of MS, including apoptosis and phagocytosis. Peripheral blood was obtained from 50 patients, with clinically definite MS, fulfilling the revised criteria of McDonald, a day before, after 5 days of MP treatment, and two weeks after conclusion of the treatment. Intravenous administration of 1.0 gamma daily of MP was used to treat the new relapses of the disease. The control group comprised 20 healthy blood donors. The subset of lymphocytes CD3, CD4, CD8, CD16, CD19, CD95 /CD3 and CD95/ CD19 was studied using monoclonal antibodies by flow cytometry. Using the flow cytometric test the phagocytosis of granulocytes and caspase activity of granulocytes and lymphocytes were studied. In MS and in the course of MP treatment, both the absolute and relative count of lymphocytes were decreased, as well as the percentage of lymphocytes with CD3, CD4 and CD8 antigen. The relative amount of lymphocytes CD16 and CD19 was increased. The lymphocytes CD95/CD3 and CD95/CD19, representing markers of apoptotic activity, were not significantly changed. The phagocytosis of peripheral granulocytes before and after intravenous MP was increased. The quantitative shift in the lymphocyte immunomarkers have an impact on the effect of methylprednisolone in the course of MS relapses. The increase in phagocytic activity in MS is a generalized one and is reflected in the peripheral blood granulocytes, but without marked changes after MP therapy.
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