Combined therapy with methylprednisolone and ulinastatin in experimental autoimmune encephalomyelitis

Background Our previous study had demonstrated that ulinastatin(UTI)had a neuroprotective effect in experimental autoimmune encephalomyelitis(EAE).Methylprednisolone has been recommended to be a standard drug in multiple sclerosis(MS)therapies.The present study was to investigate the protective effects of UTI combined methylprednisolone in EAE.Methods Mice were divided into a UTI treatment group,a methylprednisolone treatment group,a combined treatment group with UTI and methylprednisolone,a normal saline treatment group,and a.normal control group.EAE mice were induced in groups receiving different combined treatments,or respective monotherapies.Demyelination was evaluated by Solochrome cyanin staining.2’,3’-cyclic nucleotide 3’-phosphodiesterase(CNP)/myelin basic protein(MBP)/the precursor form of nerve growth factor(proNGF)/p75/inducible nitric oxide synthase(iNOS)proteins in cerebral cortex of EAE were detected by Western blotting.Results The combined treatment group had a lower clinical score(0.61±0.06)and demyelinating score(1.33±0.33)than the groups with normal saline(clinical score:1.39±0.08,P<0.001;demyelinating score:2.75±0.49,P<0.05)or monotheraphies.Compared with the saline treated EAE group,UTI combined methylprednisolone significantly increased expressions of CNP(1.14±0.06 vs.0.65±0.04,P<0.001),MBP(1.28±0.14 vs.0.44±0.17,P<0.001),and decreased expressions of proNGF(1.08±0.10 vs.2.32±0.12,P<0.001),p75(1.13±0.13 vs.2.33±0.17,P<0.001),and iNOS(1.05+0.31 vs.2.17+0.13,P<0.001)proteins in EAE.Furthermore,UTI combined methylprednisolone could significantly upregulate MBP(1.28+0.14 vs.1.01±0.15,P<0.05)expression and downregulate iNOS(1.05±0.31 vs.1.35±0.14,P<0.05)expression compared to methylprednisolone treatment EAE group.And proNGF expression was significantly lower in combined treatment(1.08±0.10)than that in UTI(1.51±0.24,P<0.05)or methylprednisolone(1.31±0.04,P<0.05)treatment group.Conclusion Combination treatment of UTI with methylprednisolone was shown to protect EAE,suggesting that combination therapy is a potential novel treatment in MS.