Th1 dominance in HAM/TSP and the optico-spinal form of multiple sclerosis versus Th2 dominance in mite antigen-specific IgE myelitis

To clarify the Th1/Th2 balance in spinal cord inflammation, we used ELISA t o measure the total and allergen-specific IgE in 69 patients with clinicall y definite multiple sclerosis (MS), including 24 patients with the optico-s pinal form of MS, 45 with HAM/TSP, 30 HTLV-I carriers without HAM/TSP, 40 p atients with acute myelitis, 43 with neurodegenerative disorders, and 42 he althy subjects, and flow cytometry to study the intracellular IFN gamma-pos itive versus IL-4-positive cell ratio (intracellular IFN gamma/IL-4 ratio) in peripheral blood CD4(+) T cells in 40 patients with MS, including 17 pat ients with the optico-spinal form of MS, 23 with HAM/TSP, 22 with acute mye litis, 23 with neurodegenerative disorders, and 36 healthy subjects. Patien ts with HAM/TSP showed a significantly higher intracellular IFN gamma/IL-4 ratio, lower IL-4(+)/LFN-gamma(-) cell percentages, lower total IgE level, and lower frequency of cedar pollen-specific IgE than did the controls. The patients with optico-spinal MS showed a significantly higher intracellular IFN gamma/IL-4 ratio and higher IL-4(-)/IFN-gamma(+) cell percentages than the controls even at remission or in the convalescence phase. In contrast, in the patients with acute myelitis, the total serum IgE level and the fre quency of mite antigen-specific IgE were significantly elevated in comparis on to the controls, while those having mite antigen-specific IgE myelitis s howed a significantly lower IFN gamma/IL-4 ratio in the CD4(+) T cells in c omparison to the controls. These findings suggest that the Th1 cell respons e is predominant in HAM/TSP and optico-spinal MS, whereas the Th2 cell resp onse is predominant in mite antigen-specific IgE myelitis. (C) 2000 Elsevie r Science BN. All rights reserved.