Mononuclear subsets in the peripheral blood of multiple sclerosis patients in relation to results of brain gadolinium- enhancing imaging.

UNLABELLED: Very little is known about processes which are leading to the development of new multiple sclerosis (MS) plaques. Therefore, the problem of correlating immunological disequilibrium in MS patients with the onset of a relapse and with other markers of the disease seems to be of great importance. In our studies we have evaluated the mononuclear subsets in the peripheral blood of multiple sclerosis patients in relation to results of brain gadolinium-enhancing imaging. A positive magnetic resonance imaging (MRI) gadolinium enhancement indicates an ongoing inflammation and activity of the MS process, whereas gadolinium (Gd) negative imaging should be considered as a sign of stabilization of the MS process.
MATERIAL AND METHODS: Peripheral blood was taken from 70 MS patients, fulfilling the criteria of McDonald et al [8]. Brain MRI was performed using a Magneton Impact 1.0 T (Siemens) machine. Enhanced T1 images were obtained after administration of 0.1 mmol/kg gadolinium - DTPA. Lymphocyte subsets were analyzed by flow cytometry with the aid of specific monoclonal antibodies.
RESULTS: The relative percentage of the white blood cell count as well as the absolute number of mononuclears and of CD3+ lymphocyte were significantly lowered only in the group of gadolinium negative MS cases. The CD4+ relative percentage was significantly higher both in the total as well as in gadolinium positive and negative subgroups. The ratio of CD4/CD8 was significantly higher in MS patients. The absolute number of CD4 lymphocytes was the lowest in gadolinium negative MS cases.
CONCLUSION: An appropriate regulation of the Th /T helper/ cells seems to be critical in the control and prevention of diverse states of the disease. In the course of an acute process, gadolinium positive imaging as well as immunological events, represented by mononuclear subsets in the peripheral blood may proceed and change very quickly, whereas gadolinium negative findings reflecting a stabilization of processes, are changing more slowly and therefore may be detected more easily in peripheral blood cell counts.