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. 2024 Jul:264:110262.
doi: 10.1016/j.clim.2024.110262. Epub 2024 May 23.

Effects of anti-CD20 therapy on circulating and intrathecal follicular helper T cell subsets in multiple sclerosis

Sahla El Mahdaoui  1 , Marie Mathilde Hansen  2 , Malene Bredahl Hansen  2 , Victoria Hyslop Hvalkof  2 , Helle Bach Søndergaard  2 , Mie Reith Mahler  2 , Jeppe Romme Christensen  2 , Finn Sellebjerg  3 , Marina Rode von Essen  2
Affiliations
Free article

Effects of anti-CD20 therapy on circulating and intrathecal follicular helper T cell subsets in multiple sclerosis

Sahla El Mahdaoui et al. Clin Immunol. 2024 Jul.
Free article

Abstract

Follicular helper T (Tfh) cells and their interplay with B cells likely contribute to the pathogenesis of relapsing-remitting multiple sclerosis (RRMS). Tfh cells are enriched in cerebrospinal fluid (CSF) in RRMS, but effects of anti-CD20 therapy are unknown. We investigated Tfh cells in controls, untreated and anti-CD20-treated patients with RRMS using flow cytometry. CSF Tfh cells were increased in untreated patients. Compared to paired blood samples, CD25- Tfh cells were enriched in CSF in RRMS, but not in controls. Contrast-enhancing brain MRI lesions and IgG index correlated with CSF CD25- Tfh cell frequency in untreated patients with RRMS. Anti-CD20 therapy reduced the numbers of circulating PD1+ Tfh cells and CD25- Tfh cells, and the frequency of CSF CD25- Tfh cells. The study suggests that CD25- Tfh cells are recruited to the CSF in RRMS, associated with focal inflammation, and are reduced by anti-CD20 therapy.

Keywords: B-cell depletion; CD4; CXCL13; CXCR5; Ocrelizumab; Rituximab.

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Conflict of interest statement

Declaration of competing interest Outside the submitted work, SEM has received speaker honoraria and non-financial support for conference participation from Merck. MH has received non-financial support for conference participation from Merck and Sanofi. MBH, VHH and HBS report no conflicting interests. MRM has received non-financial support for conference participation from Merck. JRC has received speaker honoraria from Biogen. FS has served on scientific advisory boards for, served as consultant for, received support for congress participation or received speaker honoraria from Alexion, Biogen, Bristol Myers Squibb, Lundbeck, Merck, Novartis, Roche and Sanofi Genzyme. His laboratory has received research support from Biogen, Merck, Novartis, Roche and Sanofi Genzyme. MRvE has received speaker honoraria from Merck.

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