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Lack of CD4+ T cell percent decrease in alemtuzumab-treated multiple sclerosis patients with persistent relapses
Simona Rolla1, Stefania Federica De Mercanti1, Valentina Bardina1
1Clinical and Biological Sciences Department, University of Torino, San Luigi Gonzaga Hospital, Orbassano (TO), Italy.
Journal of Neuroimmunology
|November 21, 2017
Summary
Alemtuzumab treatment for relapsing remitting multiple sclerosis (RRMS) may not affect CD4+ T cell percentages in some patients. This atypical response warrants further investigation into CD4+ cell counts as a predictor of treatment efficacy.
Area of Science:
- Immunology
- Neurology
- Clinical Medicine
Background:
- Alemtuzumab is a monoclonal antibody used to treat relapsing remitting multiple sclerosis (RRMS).
- It functions by depleting lymphocytes, including CD4+ T cells, which are implicated in MS pathogenesis.
- Understanding treatment response variability is crucial for optimizing patient outcomes.
Observation:
- Two patients with persistent RRMS activity despite alemtuzumab treatment exhibited unusual CD4+ T cell dynamics.
- While overall lymphocyte counts decreased with treatment, their CD4+ T cell percentages remained largely unaffected.
- Pre-treatment CD4+ T cell percentages were already slightly below the normal range in these patients.
Findings:
- Atypical CD4+ T cell population behavior was observed in patients with persistent disease activity under alemtuzumab therapy.
- The CD4+ T cell percentage showed minimal impact from alemtuzumab, contrasting with expected lymphopenia.
- These findings suggest a potential dissociation between overall lymphocyte depletion and CD4+ T cell response.
Implications:
- CD4+ T cell percentage evaluation may serve as a biomarker for predicting individual clinical response to alemtuzumab.
- Further research is needed to elucidate the mechanisms behind this atypical CD4+ T cell behavior.
- This could lead to personalized treatment strategies for RRMS patients receiving alemtuzumab.