Soluble and cell surface ICAM-3 in blood and cerebrospinal fluid of patients with multiple sclerosis: influence of methylprednisolone treatment and relevance as markers for disease activity

Objective-The expression of intercellular adhesion molecule-3 (ICAM-3), a m ember of the Ig supergene family, is restricted to immune competent cells. Expression of soluble and cell surface ICAM-3 (s- and c-ICAM-3) is preferen tially seen in the state of low activation of the immune system. We studied the relevance of the expression levels of sand c-ICAM-3 in cerebrospinal f luid (CSF) and blood as markers for disease activity as well as the influen ce of high-dose methylprednisolone (MP) treatment upon the expression of s- and c-ICAM-3 in blood of patients with multiple sclerosis (MS). Materials and methods-A total of 33 patients (relapses n = 25, remission n = 8) with relapsing-remitting MS were included into the study. CSF and blood were acq uired from all of them. Of the patients 24 were treated with high-dose MP. In those, blood was additionally collected at the 10th day of the therapy a nd after 3 months. Expression of c-ICAM-3 was determined by two colour FAGS analysis, whereas the concentration levels of s-ICAM-3 were measured by EL ISA. Results-In CSF we detected a significant decrease of the expression le vels of c-ICAM-3 on CD3(+) T cells in 25 patients suffering from an acute r elapse in contrast to 8 patients with remission (P = 0.04). In comparison t o the levels before treatment and after 3 months, at the 10th day of MP tre atment we obtained highly significant changes of the expression values of c -ICAM-3 both on CD3(+) T cells (P=0.0004; P=0.005) and CD14(+) monocytes/ma crophages (P=0.0006; P=0.008) on the 10th day of high-dose MP treatment fro m 24 MS patients. Conclusion-The increase of ICAM-3 levels might indicate t he antiinflammatory effect of the MP treatment. It could be interesting to search for similar effects investigating the new immune modulatoring therap y forms of MS.