Neurol. praxi. 2016;17(5):310-314 | DOI: 10.36290/neu.2016.064

Immunological outlook on modern therapy of multiple sclerosis

doc. MUDr. Vojtěch Thon, Ph.D.

Ústav klinické imunologie a alergologie LF MU a FN u sv. Anny,

Centrum pro výzkum toxických látek v prostředí (RECETOX) Přírodovědecké fakulty Masarykovy univerzity v Brně

Multiple sclerosis (MS) is a chronic autoimmune disorder affecting the central nervous system through demyelination and neurodegeneration. Autoreactive lymphocytes penetrate the blood-brain barrier to attack the nervous system. Fingolimod was approved as the first oral treatment for relapsing forms of MS. Its active metabolite, formed by in vivo phosphorylation, modulates sphingosine 1-phosphate receptors (S1PRs) and retains autoreactive lymphocytes in lymph nodes. It means unique mechanism of action which is different from the other immunomodulatory or immunosuppressive drugs. By the laboratory monitoring of immunotherapy in patients with MS it is necessary to recognize depletion versus lymphocyte compartmentalization. Assessment of differential blood count (WBC) is a sensitive laboratory test for monitoring of patients treated with modern forms of multiple sclerosis therapy. WBC is substantive marker not only for fingolimod monitoring but also determined by the therapy of patients with alemtuzumab, dimethyl fumarate and teriflunomide.

Keywords: multiple sclerosis, immunomodulation therapy, autoimmunity, vaccination, depletion

Published: November 7, 2016  Show citation