Lymphocyte Dynamics and Secondary Autoimmunity in Multiple Sclerosis

Strategic Insights -

Researchers from the University of Gothenburg investigated the immunologic changes induced by immune reconstitution therapies in patients with multiple sclerosis. They evaluated lymphocyte dynamics and their association with secondary autoimmune disease and its recurrence after treatment with different therapies. The study found that a lower CD8 T-cell count may suggest an increased risk of secondary autoimmune disease, and that certain lymphocyte subpopulations were associated with the emergence of secondary autoimmunity.

Key Takeaways:

  • 130 patients with multiple sclerosis were included in the study, with a mean age of 35.5 years and a median Expanded Disability Status Scale (EDSS) score of 1.5 at baseline.
  • 29.2% of patients received a diagnosis of secondary autoimmune disease during follow-up, and 43.1% showed no disease activity.
  • The secondary autoimmune disease cohort had lower median baseline ratios of CD4 T-cell recent thymic emigrant (Trte):CD4 and CD4 Trte:CD8+ terminally differentiated effector memory (Temra) compared to the non-secondary autoimmune disease cohort.
  • During follow-up, the secondary autoimmune disease cohort exhibited a greater relative increase in CD4 Trte:CD4, CD4 Trte:CD8+ Temra, and CD4 T regulatory cell (Treg):CD8+ Temra ratios at months 12 and 24 compared to baseline.
  • A lower CD8 T-cell count was associated with an increased risk of secondary autoimmune disease.

Statistics:

  • 130 patients were included in the study.
  • 51 patients received alemtuzumab (ALZ), 20 received autologous hematopoietic stem cell transplantation (AHSCT), and 59 received cladribine tablets (CladT).
  • The median follow-up duration was 4.7 years, with similar durations for each treatment group.
  • 29.2% of patients received a diagnosis of secondary autoimmune disease during follow-up.
  • 43.1% of patients showed no disease activity during follow-up.
  • The secondary autoimmune disease cohort had lower median baseline ratios of CD4 Trte:CD4 (0.26 vs 0.31) and CD4 Trte:CD8+ Temra (1.73 vs 3.61).

Sources:

  • Neurology-neuroimmunology & Neuroinflammation, 2025;12(6).
  • University of Gothenburg, Department of Clinical Neuroscience, Institute of Neuroscience and Physiology at Sahlgrenska Academy.
  • Lippincott Williams & Wilkins, Two Commerce Sq, 2001 Market St, Philadelphia, PA 19103, USA.