Association between peripheral blood T cell subsets and clinical disability in multiple sclerosis patients.

BACKGROUND

Multiple sclerosis (MS) is a chronic immune-mediated disorder involving complex interactions among adaptive and innate immune pathways. The relationship between peripheral blood T cell subsets and clinical disability remains inadequately characterized. This study investigated associations between T cell subsets (CD4+, CD8+, CD4+/CD8 + ratio) and Expanded Disability Status Scale (EDSS) scores in MS patients.

METHODS

We conducted a cross-sectional study of 48 MS patients who underwent EDSS scoring and flow cytometric analysis of peripheral blood T cell subsets. Clinical and treatment-related characteristics were also collected. Correlations between T cell parameters and EDSS scores were analyzed using Spearman correlation and multivariable linear regression. Exploratory sensitivity analyses were performed to evaluate the potential influence of disease-modifying therapy (DMT) exposure on the association between CD4+/CD8 + ratio and EDSS.

RESULTS

Forty-eight MS patients (mean age 35.1 ± 5.8 years, 72.9% female) with mean EDSS score of 3.20 ± 1.50 were included. Mean CD4+/CD8 + ratio was 2.76 ± 1.08 and correlated negatively with EDSS scores (r = -0.345, p = 0.016). Stratified analysis showed progressive decline across disability groups: mild (EDSS 0-2.5): 3.19 ± 1.37; moderate (EDSS 3.0-4.5): 2.64 ± 0.81; severe (EDSS ≥ 5.0): 2.13 ± 0.56 (p = 0.050). In the selected covariate-adjusted multivariable model, the association between CD4+/CD8 + ratio and EDSS was attenuated (β = -0.350, p = 0.084). Exploratory treatment-related sensitivity analyses further suggested that this association may be influenced by DMT exposure.

CONCLUSION

CD4+/CD8 + ratio was negatively associated with clinical disability in this cross-sectional MS cohort, and stratified analysis showed a progressive decline across disability severity groups. These findings suggest that CD4+/CD8 + ratio may represent an exploratory peripheral immune indicator associated with disability status in MS.