THE EFFECTS OF INTRAVENOUS PULSE METHYLPREDNISOLONE ON IMMUNOLOGICAL AND INFLAMMATORY PROCESSES IN ANKYLOSING-SPONDYLITIS

Abstract

Acute phase reactants, serum Ig and immune complexes and T cell function were measured in 8 patients with active ankylosing spondylitis (AS) before and up to 3 mo. after 3 pulses of 1 g methylpregnisolone. There was a 2-stage effect. The 1st stage was an early anti-inflammatory event with a fall in clinical disease activity mirrored by changes in acute phase reactants particularly prealbumin. The 2nd stage occurred later and was an immunological event with a fall in serum IgA and IgG and a rise in mitogenic response, mixed lymphocyte response and delayed cutaneous hypersensitivity. Most of these changes returned towards pre-treatment levels by 3 mo. Pulse methylprednisolone has an immediate anti-inflammatory and a prolonged immunological effect in AS.