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From the School of Public Health (Drs. Detels and Visscher and Ms. Malmgren), the Department of Neurology, School of Medicine (Drs. Myers and Ellison), University of California, Los Angeles, CA, and the National Institute of Neurological and Communicative Disorders and Stroke (Drs. Madden and Sever), National Institutes of Health, Bethesda, MD.
Address correspondence and reprint requests to Dr. Detels, Division of Epidemiology, School of Public Health, University of California, 1–1s Angeles, CA 90024.
Changes in clinical status and in two measures of immune function were followed for 21 months (median) in 106 multiple sclerosis (MS) patients and cohabitant controls. Antibody titers to measles, cytomegalovirus, and herpesvirus l and 2, and leukocyte migration inhibition indexes (LMIs) to measles and streptokinase/streptodornase (SKSD) were measured at 3- to 6-month intervals and at time of exacerbation in the index case. There were 36 exacerbations in 25 patients. Mean baseline antibody titers and LMI to measles were higher in cases than in controls. No consistent changes occurred in antibody titers to any of the viruses, nor in LMI to SKSD. LMIs to measles were lower in most MS patients during exacerbations than before or after exacerbations. This apparent improvement in cell-mediated immune response to measles only during exacerbations may reflect aberrant immune regulation in MS patients, response to recrudescence of a latent agent, or some other phenomenon as yet undefined.
This work was supported by Grant No. 2R01 NS 10186 from the National Institute of Neurological and Communicative Disorders and Stroke, National Institutes of Health. Computing assistance was obtained from the Health Sciences Computing Facility and the Hospital Data Processing Facility, UCLA.
Acknowledgments We thank David Barsky, Gary Kinsley, and Thomas Cunningham for technical assistance; Morris Lucia for neurologic support; Mary Lange and Nora Valdiviezo for statistical support; Patty Tokuda for patient management; Virginia Hansen for editing; and Deborah Heifetz and Tamba McIntire-Morgan for manuscript preparation. We particularly express our deepest gratitude to the patients and their friends who made this study possible.
Accepted for publication June 16, 1980
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