Immunology of relapses

Burman J, Svensson E, Fransson M, Loskog AS, Zetterberg H, Raininko R, Svenningsson A, Fagius J, Mangsbo SM The cerebrospinal fluid cytokine signature of multiple sclerosis: A homogenous response that does not conform to the Th1/Th2/Th17 convention. J Neuroimmunol. 2014;277(1-2):153-159.

In this cross-sectional study, we wanted to identify key cytokines characteristic of different stages of multiple sclerosis (MS). To this end, cerebrospinal fluid from patients with MS was investigated with a multiplexed fluorescent bead-based immunoassay. In total 43 cytokines were assessed and related to clinical and imaging data. Increased levels of CCL22, CXCL10 and sCD40L characterized relapsing-remitting MS patients with the presence of gadolinium-enhancing lesions; decreased CCL2 and increased CXCL1 and CCL5 were typical of relapsing-remitting MS patients irrespectively of the presence of gadolinium-enhancing lesions. These homogenous patterns of cytokine activation do not conform to conventional Th1/Th2/Th17 responses

Immunologists, particularly animal immunologists have created biological concepts about how autoimmunity may develop. One concept was TH1 bad and TH2 good. TH1 cells produced a certain type of protein signature such as the production of gamma interferon, TH2 cells produce interleukin 4 and TH17 cells produce intereleukin 17. Probably one should think Th1 Bad and Th2 bad but what was clear that humans do not give the clear-cut differentiation of T cell subtypes. In this study they found that chemokines CCL...CXCL which are attractant cehmicals may give some indication of the disease course. However the disease course gives idea of the disease course more easily than looking at cytokines but may give us some ideas of what is going on