http://multiple-sclerosis-research.blogspot.com/2016/04/will-real-ms-stand-up-rebound-death.html
CONCLUSIONS:
Our results underline the differences in immune cell populations between the CSF and the CNS parenchyma, and suggest that aggressive immunosuppressive therapy targeting both T and B lymphocytes is warranted to control the overwhelming CNS
HIGHLIGHT
- The major T cell subset in MS and in EAE in animals is the Effector Memory Cell phenotype CD4/8, CD45RO, CCR7-
In this study the person was on for natalizumab for 2 years and switched to copaxone 1 month before discountinuation of natalizumab (NTZ), 4 months later the patient was hospitalised with a relapse.
In the brain autopsy was performed within 1 hour of death and histologically there was demyelinating lesions, plasma cells and more T cells. The final pathological interpretation was severe MS rebound inflammatory demyelinating activity after NTZ withdrawal, with presence of numerous active demyelinating lesions.
CD4+ and CD8+ T lymphocytes in peripheral blood were mostly effector memory T lymphocytes (CD45RA neg, CD45RO+, and CCR7neg. As expected, CD19+ and CD20+ B lymphocytes as well as CD14+ monocytes/macrophages were less abundant than T lymphocytes in the peripheral blood compartment
CD4+ and CD8+ T lymphocytes in CSF were mostly effector memory T lymphocytes (CD45RAneg, CD45RO+, and CCR7neg, data not shown)
In CNS. A ratio of 1:2 was observed for CD4:CD8, concordant with pathological findings, but inverse to the blood and the CSF ratio. Most CD4+ (86%) and CD8+ (70%) cells were CD45RO+ and CD45RAneg, and were also CCR7neg. There were B cells in the CNS and they were mainly plasma cells
Therefore the dominant T cell response was of the memory effector type