Research: Effect of Natalizumab on T cells



Epub: Börnsen et al. Effect of Natalizumab on Circulating CD4(+) T-Cells in Multiple Sclerosis. PLoS One. 2012;7(11):e47578. doi: 10.1371/journal.pone.0047578. Epub 2012 Nov 30.In multiple sclerosis (MS), treatment with the monoclonal antibody natalizumab effectively reduces the formation of acute lesions in the central nervous system (CNS). Natalizumab binds the integrin very late antigen (VLA)-4, expressed on the surface of immune cells, and inhibits VLA-4 dependent transmigration of circulating immune-cells across the vascular endothelium into the CNS. Recent studies suggested that natalizumab treated MS patients have an increased T-cell pool in the blood compartment which may be selectively enriched in activated T-cells. Proposed causes are sequestration of activated T-cells due to reduced extravasation of activated and pro-inflammatory T-cells or due to induction of VLA-4 mediated co-stimulatory signals by natalizumab. In this study we examined how natalizumab treatment altered the distribution of effector and memory T-cell subsets in the blood compartment and if T-cells in general or myelin-reactive T-cells in particular showed signs of increased immune activation. Furthermore we examined the effects of natalizumab on CD4(+) T-cell responses to myelin in vitro. Natalizumab-treated MS patients had significantly increased numbers of effector-memory T-cells in the blood. In T-cells from natalizumab-treated MS patients, the expression of TNF-α mRNA was increased whereas the expression of fourteen other effector cytokines or transcription factors was unchanged. Natalizumab-treated MS patients had significantly decreased expression of the co-stimulatory molecule CD134 on CD4(+)CD26(HIGH) T-cells, in blood, and natalizumab decreased the expression of CD134 on MBP-reactive CD26(HIGH)CD4(+) T-cells in vitro. Otherwise CD4(+) T-cells from natalizumab-treated and untreated MS patients showed similar responses to MBP. Research: Predicting MS from CIS.

This study essentially shows that Natalizumab blocked white blood cells from leaving the blood we know this already.

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  • This study insinuates that Tysabri "infuriates" T-cells by restricting their actions, and thus provides an explanation for the origin of the rebound effect after drug discontinuation.

  • If they cat leave the blood cells accumulate their and are ready to kick off disease as soon as treatment is stopped.I would not say the treatment is onfuriating t cells but can we insinuate that you are saying you think t cells are causing disease. ….A new year resolution?

  • MD, you forget. T-cells enter the brain to clear debris. This creates swelling and pressure to axons. More debris + more T-cells = BIG swelling = GREAT pressure to axons and nearby tissue (vessels, oligos, astros) = rebound effect

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