Противоэпидемиологическое сокращение антител во время лечения оррелизумаба не связано с множественным склерозом.
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Esposito Antonio, Corsaro Luca, Delle Cave Ilaria, Nicolella Valerio, Palladino Raffaele, Affinito Giuseppina, Selvaggi Franco, Petracca Maria, Carotenuto Antonio, Lanzillo Roberta, Portella Giuseppe, Castaldo Giuseppe, Brescia Morra Vincenzo, Moccia Marcello
Аннотация
Оригинал публикации
Anti-EBV antibody reduction during ocrelizumab treatment is not associated with multiple sclerosis outcomes.
BACKGROUND: The pathogenesis of multiple sclerosis (MS) involves genetic, environmental and immunological aspects. Epstein-Barr virus (EBV) infection is recognized as a major risk factor for MS, potentially contributing through infection and transformation of CD20 B cells. Monoclonal antibodies targeting CD20, such as ocrelizumab, may exert therapeutic effects by depleting memory B cells harbouring latent EBV.
OBJECTIVE: We aim to evaluate changes in serum anti-EBV immunoglobulin G (IgG) titres and clinical correlates during ocrelizumab treatment.
METHODS: We analysed serum samples from 58 patients treated with ocrelizumab, with levels of total IgG, anti-CMV IgG, and anti-EBV IgG before treatment initiation and after mean follow-up of 4.8 ± 1.5 years. Statistical analyses included paired t-tests to evaluate longitudinal changes in antibody levels, and linear regression models to investigate associations between IgG changes and relapse occurrence, MRI activity, EDSS progression and their combination.
RESULTS: Over 4.8 ± 1.5 years, we observed significant reductions in anti-EBV IgG (percentage mean change -8.2%, p = 0.03), comparable to the decline in total IgG (-8.8%, p < 0.01) and anti-CMV IgG (-7.8%, p < 0.01). No significant associations were identified between changes in anti-EBV IgG and different outcomes.
CONCLUSIONS: Ocrelizumab treatment was associated with reductions in total, anti-EBV and anti-CMV IgGs. Antibody-mediated response to EBV was not associated with disease worsening.