Hospital Universitari Germans Trias i Pujol
Immunology

Author Of 1 Presentation

Disease Modifying Therapies – Mechanism of Action Poster Presentation

P0313 - Dimethyl fumarate-induced changes in lymphocyte subpopulations could identify "NEDA" patients (ID 1433)

Presentation Number
P0313
Presentation Topic
Disease Modifying Therapies – Mechanism of Action

Abstract

Background

The optimal response to dimethyl fumarate (DMF) is mediated by a shift to antiinflammatory and immunoregulatory profile. In a preliminary study of 22 patients with multiple sclerosis (MS) followed for 12 months, we observed that, at 3 months of treatment, patients with "No evidence of disease activity (NEDA)" had a decrease in the Th1-like Th17 effector memory subpopulation.

Objectives

To analyze the long-term effect of DMF on the lymphocyte subpopulations of MS patients and its relationship with the activity of the disease.

Methods

Ongoing longitudinal prospective study in MS patients undergoing DMF treatment. A panel of T and B lymphocyte subpopulations in peripheral blood is analyzed by flow cytometry. Patients with a complete follow-up of more than 1 year are classified as: NEDA, MEDA (minimal clinical or radiological activity) or EDA.

Results

To date, 48 patients have been analyzed. After a 2.66 (1-5) years follow-up, we find 39.6% in NEDA, 25% in MEDA, and 16.7% in EDA.

The changes induced on the subpopulations (increase T [CD4 and CD8] and B naïve, and decrease T central memory (CM) and effector memory (EfM), and B memory) remain stable in the long term (> 2 years), being most prominent in NEDA patients. In these, lower percentages of Th1 CM and EfM pre-treatment (p = 0.009, p = 0.002), as well as of Th1, Th17 and Th1-like Th17 CM (p <0.001, p = 0.002, p = 0.012) and Th1 and Th17 EfM (p <0.001, p = 0.034) during the first 12 months of treatment are found. MEDA patients appear to behave like EDA patients in changes in Th1/Th17/Th1-like Th17.

Conclusions

The changes induced by DMF on the lymphocyte subpopulations remain stable over time. NEDA patients have an immunophenotype that seems to identify them. Immunomonitoring detects the true biological effect of the treatments.

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