Arecent article describing the findings by Khoury et al1 correlating T cell markers with clinical status and MRI findings in patients with MS is interesting but the results cannot be translated into long-term follow-up criteria since T-cell changes were transitory. It would be important to know if the authors encountered patients with confounding results, eg, those who had no MRI changes but had an increased percentage of cells expressing interleukin-2 receptor (CD25), class II major histocompatability complex, or surface dipeptidyl peptidase (CD26). This could be important since another study2 found that the levels of sICAM-1, a molecule of the immunoglobulin superfamily, were elevated without gadolinium enhancement on MRI. That Khoury et al1 found that MRI results and T-cell markers were not congruent in some patients implies that routine MRI with gadolinium enhancement may have to be supplemented with other laboratory tests and that, in some subtypes of MS, no radiological changes may follow the elevation of specific markers. Additionally, it would be helpful to know how the authors specifically eliminated the likely bias in their results of intercurrent infection/medications.
Avasarala JR. Surrogate Markers in Multiple Sclerosis. Arch Neurol. 2001;58(5):834. doi: