4.3 Article

Relapse of multiple sclerosis in a patient retaining CCR7-expressing T cells in CSF under fingolimod therapy

Journal

MULTIPLE SCLEROSIS JOURNAL
Volume 19, Issue 9, Pages 1230-1233

Publisher

SAGE PUBLICATIONS LTD
DOI: 10.1177/1352458513481395

Keywords

Fingolimod; multiple sclerosis; CCR7; CSF; compartmentalized immune response

Funding

  1. JSPS KAKENHI [23591236]
  2. Grant for the Promotion of Niigata University Research Projects
  3. Ministry of Health, Labour and Welfare of Japan (MN)
  4. Grants-in-Aid for Scientific Research [25893076, 23591236] Funding Source: KAKEN

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Fingolimod acts as a functional antagonist of the sphingosine-1-phosphate receptor, and it traps lymphocytes in secondary lymphoid organs and precludes their migration into the central nervous system. We report the case of a patient who suffered a relatively severe relapse of multiple sclerosis (MS) during the initial 3 months of fingolimod therapy, with retention of CCR7 expression on CD4(+) T cells in the cerebrospinal fluid (CSF) despite decreased numbers of lymphocytes and decreased expression of CCR7 on CD4(+) T cells in the blood. These data suggest that fingolimod may cause differential effects on the CSF and blood lymphocytes of patients with MS during the initial months of therapy.

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