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Dendritic cell, monocyte and T cell activation and response to glatiramer acetate in multiple sclerosis
Multiple Sclerosis Journal, 06/08/2012  Clinical Article

Sellebjerg F et al. – Multiple sclerosis (MS) patients treated with glatiramer acetate (GA) show prominent changes in circulating antigen–presenting cells and CD4+ T cells. Expression of CD40 on DCs is significantly lower and associated with relapse risk in MS patients treated with GA.

Methods
  • Flow cytometry was used to study the activation of CD4+ T cells and T cell subsets (CD25high and CD26high cells), monocytes and DCs in a cross–sectional study of 39 untreated and 29 GA–treated MS patients, the latter followed prospectively for one year.
  • Gd–enhanced magnetic resonance imaging (MRI) studies were conducted in all patients.
  • Disease activity was assessed as relapses.

Results
  • The median percentage of DCs expressing CD40 was 10% in untreated MS patients and 5.9% in GA–treated patients (Bonferroni–corrected p=0.0005).
  • The hazard ratio of relapse was 1.32 (95% confidence interval 1.05–1.64) per 1% increase in CD40+ DCs.
  • Patients treated with GA had fewer CD4+ T cells expressing surface markers associated with T helper type 1 effector responses and more CD4+ T cells expressing surface markers associated with regulatory, naive or central memory T cell populations, but CD4+ T cell activation was not related with relapse risk.

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