Residual inflammation in the cerebrospinal fluid after short- and long-term natalizumab treatment in relapsing-remitting multiple sclerosis - Summary - MDSpire
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Residual inflammation in the cerebrospinal fluid after short- and long-term natalizumab treatment in relapsing-remitting multiple sclerosis
To examine the associations between Natalizumab (NTZ) treatment duration, oligoclonal band (OCB) status, and cerebrospinal fluid (CSF) inflammatory and tissue biomarkers, highlighting the significance of understanding residual intrathecal inflammation after more than five years of NTZ treatment.
Key Findings:
Most CSF biomarkers were significantly lower in NTZ-treated patients compared to untreated patients and controls (Bonferroni-adjusted p < 0.05).
sBCMA, sCD27, CHIT1, IgG index, and IL-10 were higher in NTZ-treated patients compared to controls (adj-p < 0.05).
OCB-positive patients had higher sCD27 and IgG index levels compared to age-matched controls after more than five years of NTZ treatment (adj-p < 0.05).
Interpretation:
Natalizumab treatment reduces CSF inflammation biomarkers. However, residual intrathecal adaptive immune activation persists in OCB-positive patients after long-term treatment.
Limitations:
The study is observational and cross-sectional, limiting causal inferences.
Sample size for some comparisons may be limited, potentially affecting the robustness of the findings.
Conclusion:
The presence of residual intrathecal inflammation in OCB-positive NTZ-treated RRMS patients suggests that NTZ incompletely suppresses compartmentalized adaptive inflammation.
by Sophie Buhelt, Malene Bredahl Hansen, Helle Bach Søndergaard, Sahla El Mahdaoui, Marie Mathilde Hansen, Mie Reith Mahler, Jeppe Romme Christensen, Finn Sellebjerg
