Effect of ACTH treatment on CSF and blood lymphocyte subpopulations in patients with multiple sclerosis

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Abstract
Patients with active multiple sclerosis (MS) were examined for T lymphocytes (E‐rosette‐forming cells, E‐RFC) and IgG concentrations in cerebrospinal fluid (CSF) and in blood, and for other lymphocyte subpopulations in blood, before and after treatment with adrenocorticotropical hormone (ACTH). Patients who responded to treatment had higher initial percentages of CSF T lymphocytes (93.1 ± 3.0 %) compared to patients who showed no clinical improvement (88.2 ± 3.2 %). After treatment, the responders had decreased CSF T lymphocyte levels (83.1 ± 6.6 %) while those of the nonresponders were unchanged (90.2 ± 2.2 %). In blood, T cell counts were unchanged, but “active” T cell levels showed a tendency to increase in responders and decreased significantly in nonresponders. The percentage of Fc receptor‐positive cells increased after treatment in both responders and nonresponders, and that of complement receptor‐positive cells increased slightly in responders, but these changes were not statistically significant. Serum IgG concentrations decreased in eight of nine patients after treatment. CSF IgG concentrations were found to be increased, unchanged or decreased, after treatment with no significant differences between responders and nonresponders. The results suggests an involvement of the T lymphocyte in active MS.