Objective:

To investigate associations between T cell subsets (CD4+, CD8+, CD4+/CD8+ ratio) and Expanded Disability Status Scale (EDSS) scores in MS patients.

Approach:

• Study Design: Cross-sectional study of 48 MS patients with EDSS scoring and flow cytometric analysis of peripheral blood T cell subsets.
• Data Analysis: Correlations between T cell parameters and EDSS scores were analyzed using Spearman correlation and multivariable linear regression.
• Sensitivity Analyses: Exploratory analyses evaluated the influence of disease-modifying therapy (DMT) exposure on the association between CD4+/CD8+ ratio and EDSS.

Key Findings:

• Forty-eight MS patients (mean age 35.1 ± 5.8 years, 72.9% female) with mean EDSS score of 3.20 ± 1.50 were included.
• Mean CD4+/CD8+ ratio was 2.76 ± 1.08 and correlated negatively with EDSS scores (r = −0.345, p = 0.016).
• Stratified analysis showed progressive decline across disability groups: mild (EDSS 0–2.5): 3.19 ± 1.37; moderate (EDSS 3.0–4.5): 2.64 ± 0.81; severe (EDSS ≥ 5.0): 2.13 ± 0.56 (p = 0.050).
• In the selected covariate-adjusted multivariable model, the association between CD4+/CD8+ ratio and EDSS was attenuated (β = −0.350, p = 0.084).

Interpretation:

The study presents findings on the CD4+/CD8+ ratio in relation to disability status in MS.

Limitations:

• Cross-sectional design limits causal inferences.
• Small sample size may affect generalizability.
• Potential confounding factors not fully accounted for.

Conclusion:

The study suggests a negative association between CD4+/CD8+ ratio and clinical disability in MS patients.