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Gomes L, Watson E, Smith MR, Morris E, Boggild M. Upper Gastrointestinal Tract Lymphoma With Natalizumab: Evidence of Impaired Immune Surveillance? Neurol Clin Pract 2021; 11:e546-e548. [PMID: 34484954 DOI: 10.1212/cpj.0000000000000985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Accepted: 08/21/2020] [Indexed: 11/15/2022]
Affiliation(s)
- Lauren Gomes
- Department of Neurology (LG, MB), Townsville University Hospital; Department of Neurology (EW), PA Hospital, Brisbane; Department of Gastroenterology (MRS), and Department of Haematology (EM), Townsville University Hospital, Queensland, Australia
| | - Emily Watson
- Department of Neurology (LG, MB), Townsville University Hospital; Department of Neurology (EW), PA Hospital, Brisbane; Department of Gastroenterology (MRS), and Department of Haematology (EM), Townsville University Hospital, Queensland, Australia
| | - Matthew Robert Smith
- Department of Neurology (LG, MB), Townsville University Hospital; Department of Neurology (EW), PA Hospital, Brisbane; Department of Gastroenterology (MRS), and Department of Haematology (EM), Townsville University Hospital, Queensland, Australia
| | - Edward Morris
- Department of Neurology (LG, MB), Townsville University Hospital; Department of Neurology (EW), PA Hospital, Brisbane; Department of Gastroenterology (MRS), and Department of Haematology (EM), Townsville University Hospital, Queensland, Australia
| | - Mike Boggild
- Department of Neurology (LG, MB), Townsville University Hospital; Department of Neurology (EW), PA Hospital, Brisbane; Department of Gastroenterology (MRS), and Department of Haematology (EM), Townsville University Hospital, Queensland, Australia
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Traub JW, Pellkofer HL, Grondey K, Seeger I, Rowold C, Brück W, Husseini L, Häusser-Kinzel S, Weber MS. Natalizumab promotes activation and pro-inflammatory differentiation of peripheral B cells in multiple sclerosis patients. J Neuroinflammation 2019; 16:228. [PMID: 31733652 PMCID: PMC6858649 DOI: 10.1186/s12974-019-1593-2] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Accepted: 09/23/2019] [Indexed: 12/29/2022] Open
Abstract
Background In the past, multiple sclerosis (MS) medications have been primarily designed to modulate T cell properties. Based on the emerging concept that B cells are equally important for the propagation of MS, we compared the effect of four commonly used, primarily T cell-targeting MS medications on B cells. Methods Using flow cytometry, we analyzed peripheral blood mononuclear cells (PBMC) of untreated (n = 19) and dimethyl fumarate (DMF; n = 21)-, fingolimod (FTY; n = 17)-, glatiramer acetate (GA; n = 18)-, and natalizumab (NAT; n = 20)-treated MS patients, focusing on B cell maturation, differentiation, and cytokine production. Results While GA exerted minor effects on the investigated B cell properties, DMF and FTY robustly inhibited pro-inflammatory B cell function. In contrast, NAT treatment enhanced B cell differentiation, activation, and pro-inflammatory cytokine production when compared to both intraindividual samples collected before NAT treatment initiation as well as untreated MS controls. Our mechanistic in vitro studies confirm this observation. Conclusion Our data indicate that common MS medications have differential, in part opposing effects on B cells. The observed activation of peripheral B cells upon NAT treatment may be instructive to interpret its unfavorable effect in certain B cell-mediated inflammatory conditions and to elucidate the immunological basis of MS relapses after NAT withdrawal. Trial registration Protocols were approved by the ethical review committee of the University Medical Center Göttingen (#3/4/14).
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Affiliation(s)
- Jan W Traub
- Institute of Neuropathology, University Medical Center, Robert-Koch-Straße 40, 37099 Göttingen, Germany.,Department of Neurology, University Medical Center, Robert-Koch-Straße 40, 37099 Göttingen, Germany
| | - Hannah L Pellkofer
- Department of Neurology, University Medical Center, Robert-Koch-Straße 40, 37099 Göttingen, Germany.,Institute of Clinical Neuroimmunology, Ludwig Maximilian University, Großhaderner Straße 9, 82152 Munich, Germany
| | - Katja Grondey
- Institute of Neuropathology, University Medical Center, Robert-Koch-Straße 40, 37099 Göttingen, Germany
| | - Ira Seeger
- Institute of Neuropathology, University Medical Center, Robert-Koch-Straße 40, 37099 Göttingen, Germany
| | - Christoph Rowold
- Institute of Neuropathology, University Medical Center, Robert-Koch-Straße 40, 37099 Göttingen, Germany.,Department of Neurology, University Medical Center, Robert-Koch-Straße 40, 37099 Göttingen, Germany
| | - Wolfgang Brück
- Institute of Neuropathology, University Medical Center, Robert-Koch-Straße 40, 37099 Göttingen, Germany
| | - Leila Husseini
- Department of Neurology, University Medical Center, Robert-Koch-Straße 40, 37099 Göttingen, Germany
| | - Silke Häusser-Kinzel
- Institute of Neuropathology, University Medical Center, Robert-Koch-Straße 40, 37099 Göttingen, Germany
| | - Martin S Weber
- Institute of Neuropathology, University Medical Center, Robert-Koch-Straße 40, 37099 Göttingen, Germany. .,Department of Neurology, University Medical Center, Robert-Koch-Straße 40, 37099 Göttingen, Germany.
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Sierra Morales F, Wright RB, Novo JE, Arvanitis LD, Stefoski D, Koralnik IJ. Glioblastoma in natalizumab-treated multiple sclerosis patients. Ann Clin Transl Neurol 2017; 4:512-516. [PMID: 28695151 PMCID: PMC5497532 DOI: 10.1002/acn3.428] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2017] [Revised: 04/18/2017] [Accepted: 05/08/2017] [Indexed: 12/20/2022] Open
Abstract
We present two natalizumab‐treated multiple sclerosis patients who developed glioblastoma multiforme (GBM) with variable outcomes. One patient had an isocitrate dehydrogenase (IDH)‐wildtype GBM with aggressive behavior, who declined treatment and died 13 weeks after symptoms onset. The other patient underwent resection of an IDH‐mutant secondary GBM that arose from a previously diagnosed grade II astrocytoma. He is still alive 5 years after the diagnosis of GBM. JC virus was not detected in either case. Whether natalizumab played a role in the development of GBM in those patients deserves further investigation.
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Affiliation(s)
- Fabian Sierra Morales
- Section of Neuroinfectious diseases Rush University Medical Center Chicago Illinois.,Department of Neurological Sciences Rush University Medical Center Chicago Illinois.,Multiple Sclerosis Center Rush University Medical Center Chicago Illinois
| | - Robert B Wright
- Department of Neurological Sciences Rush University Medical Center Chicago Illinois
| | - Jorge E Novo
- Department of Pathology Rush University Medical Center Chicago Illinois
| | | | - Dusan Stefoski
- Multiple Sclerosis Center Rush University Medical Center Chicago Illinois.,Department of Pathology Rush University Medical Center Chicago Illinois
| | - Igor J Koralnik
- Department of Neurological Sciences Rush University Medical Center Chicago Illinois
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