Potential effects of different treatment in multiple sclerosis on CD20 positive T cells

Multiple sclerosis (MS) is a chronic inflammatory disease of the central nervous system (CNS), characterized by inflammatory lesions in brain tissue. This study examined disease-modifying therapies (DMTs) with immunomodulatory potential, such as dimethyl fumarate (DMF), fingolimod (FTY), natalizumab (NAT), glatiramer acetate (GA), and anti-CD20 antibodies, including rituximab (RTX) and ocrelizumab (OCR). Previous research has identified a population of T cells that express the B cell antigen CD20 on their surface. These cells are thought to play a role in MS pathogenesis. This study focused on this CD20+ T cell population, demonstrating its increased presence and proinflammatory phenotype in MS patients. Blood samples from MS patients were stained with fluorescent extracellular and cytokine markers. The immune cells, particularly the CD20+ T cells, were classified before and during treatment with one of the DMTs using flow cytometry (FACS) analysis. The stage of maturation and immunological properties were examined in particular. The results showed that anti-CD20 antibodies most effectively reduced the number of CD20+ T cells in the peripheral blood but did not affect the pathogenic properties of CD20+T cells. DMF was significantly more effective in altering phenotype and function of CD20+ T cells because it reduced their inflammatory properties. FTY prevented immune cells from being flushed out of the lymph nodes. This was accompanied with a reduction in T cells in the peripheral blood, including a reduction in CD20+ T cells. Regarding the phenotype of the CD20+ T cells in the peripheral blood, a reduction in proinflammatory properties was observed; however, it was less pronounced than with DMF. Interestingly, this study showed a tendency for NAT to activate CD20+ T cells and enhance their proinflammatory properties. Due to small sample size, the results of the samples treated with GA must be interpreted with caution. However, the study showed that GA therapy significantly reduced the activation of CD20+ T cells, highlighting the immunomodulatory properties of GA. In summary, the study demonstrated that CD20+ T cells play a pivotal role MS pathogenesis and that established MS therapies affect the function and phenotype of this proinflammatory cell population differently.