Please use this identifier to cite or link to this item: http://hdl.handle.net/1942/24950
Title: Cytotoxic CD4+T Cells Drive Multiple Sclerosis Progression
Authors: PEETERS, Liesbet 
VANHEUSDEN, Marjan 
SOMERS, Veerle 
VAN WIJMEERSCH, Bart 
STINISSEN, Piet 
BROUX, Bieke 
HELLINGS, Niels 
Issue Date: 2017
Publisher: FRONTIERS MEDIA SA
Source: FRONTIERS IN IMMUNOLOGY, 8, p. 1-7 (Art N° 1160)
Abstract: Multiple sclerosis (MS) is the leading cause of chronic neurological disability in young adults. The clinical disease course of MS varies greatly between individuals, with some patients progressing much more rapidly than others, making prognosis almost impossible. We previously discovered that cytotoxic CD4+ Tcells (CD4+ CTL), identified by the loss of CD28, are able to migrate to sites of inflammation and that they contribute to tissue damage. Furthermore, in an animal model for MS, we showed that these cells are correlated with inflammation, demyelination, and disability. Therefore, we hypothesize that CD4+ CTL drive progression of MS and have prognostic value. To support this hypothesis, we investigated whether CD4+ CTL are correlated with worse clinical outcome and evaluated the prognostic value of these cells in MS. To this end, the percentage of CD4+ CD28null T cells was measured in the blood of 176 patients with relapsing-remitting MS (=baseline). Multimodal evoked potentials (EP) combining information on motoric, visual, and somatosensoric EP, as well as Kurtzke expanded disability status scale (EDSS) were used as outcome measurements at baseline and after 3 and 5 years. The baseline CD4+ CD28null T cell percentage is associated with EP (P = 0.003, R-2 = 0.28), indicating a link between these cells and disease severity. In addition, the baseline CD4+ CD28null T cell percentage has a prognostic value since it is associated with EP after 3 years (P = 0.005, R-2 = 0.29) and with EP and EDSS after 5 years (P = 0.008, R-2 = 0.42 and P = 0.003, R-2 = 0.27). To the best of our knowledge, this study provides the first direct link between the presence of CD4+ CTL and MS disease severity, as well as its prognostic value. Therefore, we further elaborate on two important research perspectives: 1 degrees investigating strategies to block or reverse pathways in the formation of these cells resulting in new treatments that slow down MS disease progression, 2 degrees including immunophenotyping in prediction modeling studies to aim for personalized medicine.
Notes: [Peeters, Liesbet M.; Vanheusden, Marjan; Somers, Veerle; Van Wijmeersch, Bart; Stinissen, Piet; Broux, Bieke; Hellings, Niels] Hasselt Univ, Transnat Univ Limburg, Sch Life Sci, Biomed Res Inst, Diepenbeek, Belgium.
Keywords: multiple sclerosis; prognosis; multimodal evoked potentials; CD4+CD28null T  cells; personalized medicine; prognostic risk factor;multiple sclerosis; prognosis; multimodal evoked potentials; CD4+CD28null T cells; personalized medicine; prognostic risk factor
Document URI: http://hdl.handle.net/1942/24950
ISSN: 1664-3224
e-ISSN: 1664-3224
DOI: 10.3389/fimmu.2017.01160
ISI #: 000411178200001
Rights: Copyright: © 2017 Peeters, Vanheusden, Somers, Van Wijmeersch, Stinissen, Broux and Hellings. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
Category: A1
Type: Journal Contribution
Validations: ecoom 2018
Appears in Collections:Research publications

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