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Increased NK Cell Count in Multiple Sclerosis Patients Treated With Dimethyl Fumarate: A 2-Year Longitudinal Study

Damiano Marastoni1, Alessandro Buriani2, Anna Isabella Pisani1

  • 1Neurology B, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy.

Frontiers in Immunology
|August 6, 2019
PubMed

Insights

Dimethyl fumarate (DMF) treatment for multiple sclerosis causes a decrease in B and T cells but a significant increase in Natural Killer (NK) cells over two years, potentially impacting drug efficacy.

Area of Science:

  • Immunology
  • Neurology
  • Pharmacology

Background:

  • Dimethyl fumarate (DMF) is a key disease-modifying therapy for relapsing-remitting multiple sclerosis.
  • DMF modulates immune responses by altering immune cell populations and inducing lymphopenia.
  • The long-term effects of DMF on specific lymphocyte subsets remain incompletely understood.

Purpose of the Study:

  • To investigate the long-term impact of dimethyl fumarate (DMF) on lymphocyte subsets in multiple sclerosis (MS) patients.
  • To analyze changes in total lymphocyte count and specific subsets over a 24-month treatment period.

Main Methods:

  • A 2-year observational study involving 38 multiple sclerosis patients treated with DMF.
  • Flow cytometry was used to analyze peripheral blood lymphocyte counts and subsets at baseline and at 3, 6, 12, and 24 months.
  • Statistical analysis was performed to assess changes over time.

Main Results:

  • Total lymphocyte counts decreased with DMF exposure.
  • Significant reductions were observed in B cells (34.1%) and T cells (CD3+, CD4+, CD8+) within 12 months.
  • Natural Killer (NK) cell counts showed a significant increase (85.9%) after 2 years, with a notable rise in the CD4+/CD8+ ratio during the first year.

Conclusions:

  • Dimethyl fumarate (DMF) treatment leads to a sustained decrease in B and T lymphocytes but a significant increase in Natural Killer (NK) cells over two years.
  • The observed increase in NK cells may contribute to the immunomodulatory effects and therapeutic benefits of DMF in multiple sclerosis.
  • Understanding these long-term lymphocyte dynamics is crucial for evaluating DMF's efficacy and safety profile.
Keywords:
cell countdimethyl fumaratelymphocyte subsetslymphopeniamultiple sclerosisnatural killer cells

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