2013.03.26

Relapse of multiple sclerosis in a patient retaining CCR7-expressing T cells in CSF under fingolimod therapy

（Mult Scler. 2013 Aug;19(9):1230-3. doi: 10.1177/1352458513481395. Epub 2013 Mar 21.）

Yokoseki A^1,*, Saji E^1,*, Arakawa M¹, Hokari M¹, Ishiguro T¹, Yanagimura F¹, Ishihara T¹, Okamoto K², Nishizawa M¹, Kawachi I¹.
* These authors contributed equally to this work.

¹Department of Neurology, Brain Research Institute, Niigata University
²Department of Neurosurgery, Brain Research Institute, Niigata University

Abstract

Fingolimod acts as a functional antagonist of the sphingosine-1-phosphate receptor, and it traps lymphocytes in secondary lymphoid organs and precludes their migration into the central nervous system. We report the case of a patient who suffered a relatively severe relapse of multiple sclerosis (MS) during the initial 3 months of fingolimod therapy, with retention of CCR7 expression on CD4+ T cells in the cerebrospinal fluid (CSF) despite decreased numbers of lymphocytes and decreased expression of CCR7 on CD4+ T cells in the blood. These data suggest that fingolimod may cause differential effects on the CSF and blood lymphocytes of patients with MS during the initial months of therapy.

*Reprinted with permission from the copyright owner.

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