Prognostic value of natural killer cell/T cell ratios for disease activity in multiple sclerosis

Background and purpose: Natural killer (NK) cells may play a role in multiple sclerosis (MS). Ratios of NK cells to CD4+ T cells have been proposed as a biomarker for the therapeutic effect of stem cell transplantation in MS. The objectives here were to explore the relevance of this ratio in MS patients by analysing NK and T cell subsets, as well as their prognostic value for disease activity. Methods: Baseline peripheral blo

NK/T cell ratios associate with interleukin-2 receptor alpha chain expression and shedding in multiple sclerosis

NK/T-cell ratios predict disease activity in relapsing remitting multiple sclerosis (RRMS). We investigated in 50 RRMS patients whether interleukin-2 receptor alpha-chain (IL-2Rα) expression and shedding associates with NK/T-cell balance, as suggested by daclizumab-trials in RRMS. A subsample (N = 31) was genotyped for IL2RA-associated MS risk SNPs. CD56bright NK-cell/IL-17A+CD4+ T-cell ratios correlated negatively with plasma and PBMC-culture supernatant sIL-2Rα-levels [R = -0.209; p = 0.038 and R = -0.254; p = 0.012, resp.], and with CD4+ T-cell CD25 MFI [R = -0.341; p = 0.001]. Carriers of the rs3118470 risk-allele showed higher sIL-2Rα-levels (P = 0.031) and a lower

Hype or hope? Vitamin D in multiple sclerosis: A clinical and immunological perspective

Vitamin D and its role in health and in diseases like multiple sclerosis (MS) has generated growing interest in recent years. But the question remains: does vitamin D make a demonstrable difference for MS patients or have high expectations and an enthusiastic response created a hype that science has yet to substantiate? This dissertation examines the role of vitamin D in MS disease regression, as vitamin D levels tend to play a particularly significant role in disease activity and disease regression early on in the illness. Prescribing high doses of vitamin D does not change the patient's immune system, but does prevent further deregulation

Illuminating vitamin D effects on B cells - the multiple sclerosis perspective

Vitamin D is associated with many immune‐mediated disorders. In multiple sclerosis (MS) a poor vitamin D status is a major environmental factor associated with disease incidence and severity. The inflammation in MS is primarily T‐cell‐mediated, but increasing evidence points to an important role for B cells. This has paved the way for investigating vitamin D effects on B cells. In this review we elaborate on vitamin D interactions with antibody production, T‐cell‐stimulating capacity and regulatory B cells. Although in vitro plasma cell generation and expression of co‐stimulatory molecules are inhibited and the function of regulatory B cells is promoted, this is not supported by in vivo data. We speculate that differences might be explained by the B‐cell–Epstein–Barr virus interaction in MS, the exquisite role of germinal centres in B‐cell biology, and/or in vivo interactions with other hormones and vitamins that interfere with the vitamin D pathways. Further research is warranted to illuminate this tube‐versus‐body paradox

Fingolimod in active multiple sclerosis: an impressive decrease in Gd-enhancing lesions

BACKGROUND: Fingolimod is a disease modifying therapy (DMT) in highly active relapsing remitting multiple sclerosis (RRMS), as is natalizumab. Fingolimod decreases annual relapse rates and gadolinium enhancing lesions on MRI as compared to either interferon beta (IFNβ) or placebo. The effect of fingolimod on MRI outcomes compared to natalizumab treatment has not been investigated in (head to head) clinical trials. Clinical experience with natalizumab is much more extended and in general practice often preferred. CASE PRESENTATION: This case describes a 31-year old woman with RRMS, who experienced severe side effects on natalizumab. After a voluntary four months treatment free period, a severe relapse appeared which was treated with prednisone and plasmapheresis; thereafter fingolimod was initiated. In the following months MRI signs improved spectacularly. CONCLUSION: This case suggests that fingolimod might be a good alternative for natalizumab, especially for use in RRMS patients, with highly active, advanced disease, when natalizumab treatment is stopped due to side effects or even after a severe relapse