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The effects of natalizumab on the innate and adaptive immune system in the central nervous system

  • Olaf Stüve
    Correspondence
    Corresponding author. VA North Texas Health Care System, Medical Service, 4500 South Lancaster Rd. Dallas, TX 75216, USA. Tel.: +1 214 6488816; fax: +1 214 6489129.
    Affiliations
    Neurology Section, VA North Texas Health Care System, Medical Service, Dallas, TX, USA
    Department of Neurology, University of Texas Southwestern Medical Center at Dallas, TX, USA
    Department of Immunology, University of Texas Southwestern Medical Center at Dallas, TX, USA
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      Abstract

      Multiple sclerosis (MS) is an inflammatory demyelinating disorder of the central nervous system (CNS). Natalizumab (®Tysabri) is a humanized recombinant monoclonal antibody that binds to the alpha (α)4 chain of the α4 beta (β)1 integrin (very late activation antigen 4; VLA-4), and α4β7 integrin. Recently, two patients with MS and one patient with Crohn’s disease who were treated with natalizumab in the setting of clinical trials developed progressive multifocal leukoencephalopathy (PML), an opportunistic infection of the brain with the polyoma virus JC. We recently showed that natalizumab decreases the numbers of CD4+ and CD8+ T lymphocytes, CD19+ B cells, and CD138+ plasma cells in the cerebrospinal fluid (CSF) of patients with MS on natalizumab therapy. In addition, we demonstrated that the cell numbers in CSF remained unchanged even 6 months after cessation of natalizumab treatment.

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