Teriflunomide treatment reduces B cells in patients with MS

Ilaria Gandoglia; Federico Ivaldi; Alice Laroni; Federica Benvenuto; Claudio Solaro; Gianluigi Mancardi; Nicole Kerlero de Rosbo; Antonio Uccelli

doi:10.1212/NXI.0000000000000403

Teriflunomide treatment reduces B cells in patients with MS

Neurol Neuroimmunol Neuroinflamm. 2017 Oct 23;4(6):e403. doi: 10.1212/NXI.0000000000000403. eCollection 2017 Nov.

Authors

Ilaria Gandoglia¹, Federico Ivaldi¹, Alice Laroni¹, Federica Benvenuto¹, Claudio Solaro¹, Gianluigi Mancardi¹, Nicole Kerlero de Rosbo¹, Antonio Uccelli¹

Affiliation

¹ Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health Unit (I.G., A.L., F.B., G.M., N.K.d.R., A.U.), and Center of Excellence for Biomedical Research (CEBR) (F.I., A.L., G.M., A.U.), University of Genoa, Italy; Ospedale Policlinico San Martino-IRCCS (A.L., G.M., A.U.), Genoa, Italy; and Rehabilitation Unit (C.S.), Centro di Recupero e Rieducazione Funzionale, M.L. Novarese, Moncrivello, Italy.

Abstract

Objective: To study the immunomodulatory effect of teriflunomide on innate and adaptive immune cell populations through a pilot, open-label, observational study in a cohort of patients with relapsing-remitting MS.

Methods: Blood lymphocytes were isolated from 10 patients with MS before and after 3 or 12 months of treatment. Adaptive and innate immune cell subsets were analyzed by flow cytometry as follows: B cells (memory, regulatory, and mature subsets), T cells (effector and regulatory subsets), and natural killer (NK) cells (CD56^dim and CD56^bright subsets).

Results: Our results show that teriflunomide significantly reduces absolute counts of total CD19⁺ B cells and mature and regulatory B-cell subsets. T cells were affected to a lesser extent, with a trend in reduction of absolute counts for both T effector CD4⁺ cells (Th1, Th17 and Th1/17) and T regulatory CD8⁺ and CD4⁺ cells. Teriflunomide had no detectable effect on NK-cell numbers.

Conclusions: In our small cohort, teriflunomide treatment affects mainly and significantly on B-cell numbers, while having a milder effect on T-cell numbers. Larger cohorts are necessary to confirm these findings and understand the effect of teriflunomide on the functionality of these cells.