RESUMEN
Background: Lack of sufficient information on the mechanism of plasma exchange[PE] therapy in multiple sclerosis [MS], has limited this treatment to individual patientswith severe relapses who have been refractory to other treatments. This is while PE isused very successfully as a first-line standard treatment in many other neuro-immunedisorders. Recent data suggest that Treg/Th17 counterbalance may indicate theboundaries between promotion and regulation of inflammatory responses in MS andTreg/Th17 ratio may be useful as a marker for monitoring the efficiency of MStherapies
Objective: To evaluate the effect of PE on the frequency and ratio ofTreg/Th17 cells through concomitant measurement of the expression levels of Treg andTh17 lineage specific transcription factors, FOXP3 and RORC2, respectively
Methods: Peripheral blood mononuclear cells of 8 relapsed MS patients were obtainedbefore and after a complete course of PE therapy and the FOXP3 and RORC2 mRNAlevels were assayed using real-time PCR approach
Results: No significant change inthe expression levels of individual transcription factors existed, but a significantincrease in FOXP3/RORC2 ratio [p=0.036] was observed
Conclusions: Our resultssuggest that PE therapy influences Treg/Th17 ratio and this maybe a mechanism bywhich this procedure exerts its improving effects in MS disease