We determined fluctuations in circulating lymphocyte subsets induced by methylprednisolone pulse therapy (MPT) and the continuous administration of prednisolone (PSL) in 17 patients with autoimmune or systemic rheumatic disease. Two-color flow cytometry, using monoclonal antibodies to various lymphocyte subsets, was perfomed to identify a possible association between the clinical efficacy of treatment and modulative effects on each subset Both MPT and continuous oral PSL showed suppressive effects on most of the lymphocyte subsets: CD4~+, CD45RA or CD45RA~+CD4~+, CD8~+, CD11b~-CD8~+, CD5~+ B, and CD57~+ or CD57~-CD16~+ cells. Modulation of lymphocyte subsets were more profound with MPT than with continuous oral PSL. The results are relevant to the different degrees of immuno-suppression effected by the two treatment modalities. We found that the number of CD45RA~-CD4~+ cells after MPT treatment correlated with the clinical efficacy of the treatment: the less CD45RA~-CD4~+ cell numbers decreased after MPT treatment, the greater was the clinical efficacy of the treatment. The results probably are associated with a rapid recovery of the subset after MPT treatment in the responders. Thus, the sequential monitoring of circulating lymphocyte subsets is useful in predicting the clinical effects of MPT treatment
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