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A numerical reduction of total T cells has been evidenced in peripheral blood of patients with active multiple sclerosis. A contemporary raise in T helper/inducer cells was demonstrated in patients' cerebrospinal fluid. A significant reduction in T suppressor/cytotoxic cells could be detected only in patients' cerebrospinal fluid, while this subpopulation resulted to be less affected in patients' circulation. These data differed significantly from controls' values. We conclude that a redistribution of some T cell subpopulation between peripheral blood and central nervous system could account for the immunological derangements observed in active multiple sclerosis.

We are investigating peripheral blood and cerebrospinal fluid lymphocyte subpopulations in multiple sclerosis patients by monoclonal antibodies directed at T-helper, T-suppressor and total mature T-cell subsets. Patients affected by other neurological diseases are also being studied as a control population. Antibodies' selectivity together with careful cell handling, allowed us a detailed study even of small lymphocyte numbers usually recovered from multiple sclerosis cerebrospinal fluid. First results point to a marked increase in T-helper population, with a helper/suppressor imbalance in MS patients' cerebrospinal fluid, but not in peripheral blood. No difference could be detected between cerebrospinal fluid and peripheral blood lymphocyte subpopulations in control patients. Further work is now needed to achieve more complete and significative results.

We conducted a double-blind trial of high-dose parenteral 6-methylprednisolone (MP) and placebo on 23 patients with acute MS. After the double-blind trial, the patients were given corticosteroids in gradually decreasing doses. The frequency of improvement was significantly higher and the bout duration significantly lower in the MP group than in the placebo group. The first signs of improvement (3 to 6 days after starting MP) were associated with a marked decrease in the rate of CNS IgG synthesis, but IgG CSF oligoclonal bands did not change. CNS IgG production slowly returned toward baseline despite progressive clinical improvement.