Residual inflammation in the cerebrospinal fluid after short- and long-term natalizumab treatment in relapsing-remitting multiple sclerosis

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Natalizumab treatment significantly reduces cerebrospinal fluid inflammation biomarkers in relapsing-remitting multiple sclerosis patients.
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After more than five years of natalizumab treatment, certain biomarkers remain elevated in OCB-positive patients, indicating residual inflammation.
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Soluble CD27 levels were inversely associated with treatment duration, while OCB status correlated with higher levels of sCD27 and IgG index.
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The study involved 88 natalizumab-treated and 104 untreated RRMS patients, providing a comprehensive analysis of CSF biomarkers.
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Persistent intrathecal adaptive immune activation suggests that natalizumab incompletely suppresses compartmentalized inflammation in RRMS.

Frontiers In Immunology

by Sophie Buhelt, Malene Bredahl Hansen, Helle Bach Søndergaard, Sahla El Mahdaoui, Marie Mathilde Hansen, Mie Reith Mahler, Jeppe Romme Christensen, Finn Sellebjerg
June 5, 2026

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