Do neutralising antibodies against exogenous interferon-beta inhibit endogenous signalling pathways?

Area of Science:

• Immunology
• Neurology
• Virology

Background:

• Interferon-beta (IFNβ) is a primary disease-modifying therapy for relapsing-remitting multiple sclerosis (RRMS).
• A significant challenge with IFNβ treatment is the potential development of neutralising antibodies (NABs).
• NABs can diminish the therapeutic effectiveness of exogenous IFNβ.

Observation:

• A patient with RRMS and a history of genital herpes experienced increased herpes reactivations and sensory symptoms after restarting IFNβ therapy.
• These reactivations coincided with elevated NABs titres against IFNβ.
• Following a switch to glatiramer acetate and initiation of prophylactic famciclovir, herpes reactivations ceased, and MS relapses were prevented.

Findings:

• The co-occurrence of herpes exacerbations and MS relapses suggests a link between NABs development and impaired antiviral responses.
• High NABs titres against IFNβ were detected in the patient.
• The patient's symptoms improved after discontinuing IFNβ and starting antiviral prophylaxis.

Implications:

• This case highlights that NABs against IFNβ may not only reduce treatment efficacy but also compromise the antiviral functions of endogenous IFNβ.
• Investigating patients on biological therapies can provide insights into human biology and signaling pathways.
• Understanding the interplay between NABs, viral infections, and autoimmune diseases is crucial for optimizing patient care.