To study whether Tumor Necrosis Factor alpha (TNF-) or Interferon-gamma (IFN-) production precedes or accompanies clinical and Magnetic Resonance Imaging signs of disease activity in patients with Multiple Sclerosis, by stimulated White Blood Cells (Leukocytes).
Design & Setting
Prospective study with a follow-up of 9 months, in patients visiting an outpatient Univclinic.
The 30 Amsterdam-based patients (28 completing all evaluations) participating in a multicenter, randomized, placebo-controlled, double-blind trial of a chimeric Anti-CD4 AntiBody in the treatment of active Relapsing/Remitting and Secondary/Progressive Multiple Sclerosis.
Patients in both treatment arms were included, because for these patients Anti-CD4 treatment in this study did not affect TNF- and IFN- production and did not reduce signs of disease activity on Magnetic Resonance Imaging.
Main Outcome Measure
Distribution of classes of TNF- and IFN- production (expressed as z scores) in patients with or without clinical or Magnetic Resonance Imaging signs of disease activity.
One month preceding exacerbations of Multiple Sclerosis, there was a shift toward higher z scores of TNF- production (P<.05), but not of IFN- production.
There was no statistically significant relationship between IFN- and TNF- production and Magnetic Resonance Imaging markers of Multiple Sclerosis activity.
The production of TNF-, and not of IFN-, is significantly higher in patients with Multiple Sclerosis before exacerbations than in patients with stable disease.
Although present, this relationship is too weak to use TNF- production as a surrogate marker of disease activity in Multiple Sclerosis.