Publication details

The impact of lymphocytosis and CD4/CD8 ratio on the anti-JCV antibody index and clinical data in patients treated with natalizumab

Authors

KOLČAVA Jan HULOVÁ Monika ŘÍHOVÁ Lucie BEDNAŘÍK Josef ŠTOURAČ Pavel

Year of publication 2021
Type Article in Periodical
Magazine / Source NEUROLOGICAL SCIENCES
MU Faculty or unit

Faculty of Medicine

Citation
web https://link.springer.com/article/10.1007/s10072-020-04897-2
Doi http://dx.doi.org/10.1007/s10072-020-04897-2
Keywords Natalizumab; Multiple sclerosis; T lymphocytes; Flow cytometry; JC virus
Description Background Natalizumab is an effective therapy in the treatment of relapsing-remitting multiple sclerosis; it induces lymphocytosis (NIL, natalizumab-induced lymphocytosis) and changes the peripheral lymphocyte pattern. Methods This study aims to evaluate NIL, peripheral blood lymphocyte subsets, CD4/CD8 ratio, and their impacts on JCV index and clinical data-No Evidence of Disease Activity (NEDA-3) and annualized relapse rate (ARR) in patients treated with natalizumab. Results Forty-one patients (33 women) were included in the study. The mean duration of follow-up on natalizumab treatment was 6.7 +/- 3.2 years. Significant increases in relative lymphocytosis after 1 month, with a median of 40.4% (- 34.1 to + 145.5%) (p < 0.001), and after 1 year (49.0% (- 9.3 to + 127.6%)) (p < 0.001) were found. Significant differences were found after 1 month when comparing NIL between patients JCV-seroconverting (20.6% (- 17.7 to 72.7%)) and stable JCV-seronegative ones (43.5% (- 6.3 to +96.3%)) (p = 0.04). No significant difference NIL level was found between the patients exhibiting NEDA-3 status and those without it. ARR on natalizumab treatment correlated with CD4/CD8 ratio (r = 0.356; p = 0.021); patients who maintained NEDA-3 status over the whole treatment period exhibited a lower CD4/CD8 ratio (1.89 +/- 1.08 vs. 2.5 +/- 0.73; p < 0.04). Conclusion This contribution reports the CD4/CD8 ratio as a possible biomarker for better clinical efficacy of natalizumab in patients exhibiting a lower CD4/CD8 ratio. NIL did not correlate with long-term therapeutic efficacy in patients treated with natalizumab, but was demonstrated as lower in patients JCV-seroconverting in the course of follow-up.
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