A study by the Neuroimmunology Research Group at the Hospital del Mar Medical Research Institute (IMIM) has found a marker that could help personalise and improve the efficacy and safety of multiple sclerosis treatment.
Multiple sclerosis is an autoimmune disease in which the B-lymphocytes themselves attack the myelin covering the nerves. It is currently treated with anti-CD20 monoclonal antibodies that bind to the CD20 protein on B cells. The NK cells of the immune system then eliminate these lymphocytes, controlling the disease. This treatment is administered every 6 months to all patients, although this period may not be suitable for all of them. Therefore, as José Enrique Martínez, head of the study, says, “finding a marker that allows us to find out which patients need treatment at 6 months and which patients can wait, can be very useful for personalising treatments”.
This is precisely what they have done in this study, where they analysed data from 38 patients with multiple sclerosis. The results showed that patients whose NK cells expressed higher levels of the NKG2C receptor had a more intense function; that is, they kill more B lymphocytes and delay their repopulation. Therefore, “the NKG2C receptor may be a very interesting marker, as patients with a higher presence of the receptor may be able to delay the treatment dose,” says Martínez.
It is still too early to change treatment guidelines, but this study has opened the door to being able to treat multiple sclerosis in a more personalised way.
Moreira A, Munteis E, Vera A, Macías Gómez A, Bertrán Recasens B, Rubio Pérez MÁ, Llop M, Martínez-Rodríguez JE. Delayed B cell repopulation after rituximab treatment in multiple sclerosis patients with expanded adaptive NK cells. Eur J Neurol. 2022 Mar 5. doi: 10.1111/ene.15312. Epub ahead of print. PMID: 35247022.