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[Change of interleukin-4 and interleukin-12 levels after therapy of multiple sclerosis relapse with methylprednisolone].

BACKGROUND AND PURPOSE
In the pathomechanism of multiple sclerosis (MS), a vital role is attributed to autoimmune responses. Higher activity of the disease is connected with an increased activity of proinflammatory cytokines while in remissions anti-inflammatory cytokines dominate. The aim of the study was to evaluate the effects of methylprednisolone treatment on the level of IL-4 and IL-12 and to determine whether their levels are related to the degree of disability and may be prognostic factors in the assessment of relapse sequelae.


MATERIAL AND METHODS
The study included 32 patients with MS (according to McDonald's criteria) with relapses and remissions (17 patients with relapse who received methylprednisolone in the dose of 1.0 g i. v. on 5 consecutive days and 15 patients in remission). The control group consisted of 15 patients with non-inflammatory diseases of the nervous system. The levels of cytokines were determined by ELISA method using the Pharmingen kits. The examinations of patients in relapse were conducted before and after steroid therapy; the remaining patients were examined only once.


RESULTS
In the relapse a visible increase in serum IL-12 level (p<0.05) was observed; its level after methylprednisolone treatment was found to be significantly decreased (p<0.001). The level of IL-4 was not significantly affected by steroid therapy. There was no relation between the severity of disability and cytokine levels.


CONCLUSIONS
The level of IL-12 increases in MS relapses and decreases after methylprednisolone therapy. The changes in IL-4 and IL-12 levels are the manifestations of inflammatory reactions connected with the relapse; however, they do not directly indicate the extent of damage to CNS. They cannot be treated as a prognostic factor allowing to anticipate the consequences of the relapse.