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Author Spotlight: Novel Assay for Studying B-Cell Responses in Multiple Sclerosis Research

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Published on: December 1, 2023

Cladribine tablets in relapsing-remitting multiple sclerosis preferentially target B-cells.

Francesca Ammoscato¹, Mohammad Wafa², Justyna Skonieczna¹

¹Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.

Clinical Immunology (Orlando, Fla.)

|October 20, 2024

Summary

Cladribine tablets (CladT) effectively manage relapsing-remitting multiple sclerosis (RRMS) by depleting memory B cells. This treatment leads to sustained reductions in intrathecal antibody production and key inflammatory markers in the cerebrospinal fluid.

Keywords:

Biomarkers Cerebrospinal fluid Cladribine Multiple sclerosis Peripheral immune cells

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Published on: May 15, 2019

Area of Science:

Neuroimmunology
Pharmacology

Background:

B cells play a critical role in multiple sclerosis (MS) pathogenesis.
B cell-targeting therapies have shown efficacy in managing MS activity.

Purpose of the Study:

To quantify temporal changes in peripheral immune cells and their activity during 96 weeks of Cladribine tablets (CladT) treatment in relapsing-remitting MS (RRMS).
To compare the immune cell profile changes with a historical alemtuzumab-treated cohort.

Main Methods:

Ten RRMS participants received CladT, with blood samples collected at multiple intervals up to 96 weeks.
Immune cell analysis, cerebrospinal fluid (CSF) analysis, clinical, and brain imaging assessments were performed.
Comparison with a historical cohort treated with alemtuzumab.

Main Results:

CladT primarily depleted memory B cells and antibody-secreting cell precursors.
Significant reductions were observed in the kappa free light chain (κFLC) index, IgG index, and CSF CXCL-13 levels.
CSF NfL levels were also reduced at 48 weeks, indicating a decrease in neuroinflammation.

Conclusions:

CladT treatment leads to sustained effects on intrathecal antibody production and total IgG in RRMS patients.
The observed reductions in CSF CXCL-13 and NfL suggest a significant impact on central nervous system inflammation.
CladT demonstrates a favorable immunomodulatory profile in managing RRMS activity.