ACTRIMS 2023 | CSF immune cell phenotyping & NfL to measure inflammatory activity and DMT response in MS

Traditionally, multiple sclerosis (MS) was thought to be a T-cell-mediated disorder, but the success of B-cell therapies has elucidated the role of B-cells in the pathogenesis of MS. Shane Arsenault, MD, Memorial University of Newfoundland, St. John’s, Canada, describes a study investigating how disease-modifying treatments (DMTs) affect B-cells and T-cells, and how those levels were related to neurofilament light chain (NfL), a frontrunner as a potential biomarker to measure DMT response in MS. CSF, peripheral blood mononuclear cells, and plasma were collected from individuals with diagnosed relapsing-remitting MS (RRMS) before starting immunomodulatory treatment. CSF was also collected from participants with RRMS on moderate to high-efficacy DMTs and from participants diagnosed with other non-inflammatory or inflammatory neurological conditions, as well as healthy controls. Findings showed that individuals with RRMS had significant increases in the numbers of CD3+CD8+ T-cells and CD19+ B-cells in CSF compared to controls. In the CSF of treated RRMS participants, numbers of CD45+ leukocytes, CD4+ helper T-cells, CD19+ B-cells, and CD16+CD56+ NK cells were significantly decreased. In RRMS, CSF NfL levels were positively correlated with CSF B-cells and NK cells. Levels of CD45+ leukocytes, CD19+ B-cells, and CSF NfL were negatively correlated with the number of months since the most recent relapse. This interview took place at the Americas Committee for Treatment and Research in Multiple Sclerosis (ACTRIMS) Forum 2023 in San Diego, CA.

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