Cell-mediated immunity in acute idiopathic optic neuritis and multiple sclerosis

T-lymphocyte subpopulations in acute unilateral optic neuritis

The authors prospectively analyzed T-lymphocyte subpopulations in the peripheral blood of nine patients with acute unilateral optic neuritis and compared them with 25 controls without neurologic disease. The presence or absence of alterations in circulating T-cell subsets has not been examined previously in patients with isolated optic neuritis. The authors found the mean ratio of inducer (CD4) to suppressor (CD8) T-lymphocytes was 2.07 +/- 0.51 for the group with optic neuritis, statistically indistinguishable from a value of 1.78 +/- 1.04 for the control group. Multiple sclerosis (MS) subsequently developed in one patient. Her inducer/suppressor T-cell ratio was initially 2.66, but progressively increased to 3.68 concomitant with the clinical manifestation of focal neurologic signs. Although optic neuritis may be the initial clinical sign of MS, the periodic alteration of circulating T-lymphocytes increasing the inducer/suppressor T-cell ratio in MS was not observed in those with isolated optic neuritis.

Lymphocytes subclasses and function in patients with optic neuritis in childhood with special reference to multiple sclerosis

Ten patients with childhood optic neuritis (5 with a single attack of ON and 5 with later MS) were studied at various stages of the disease. Lymphocyte count and function were analysed in the peripheral blood of all patients, 3 repeatedly, and in one they were also analysed in the CSF. T-lymphocytes counts were normal in all but 2 MS cases who had high counts. In acute stages the T4/T8 ratio were high in 1/3 determinations, in recovery low in 2/2 determinations, and in stable stages normal in 6/8 determinations. Lymphocyte function, measured by PHA, ConA and PWM stimulation, was normal in all but one. One patient showed significantly higher T-cell percentages and a high number of stimulated lymphocytes in CSF but a lower count of suppressor cells than in the blood. We found no abnormalities specific to MS nor to childhood MS or to disease activity stage. Rather than peripheral blood, it would seem more worthwhile to study CSF to clarify the pathogenesis of ON and MS.