PT  - JOURNAL ARTICLE
AU  - Amandine Mathias
AU  - Guillaume Perriard
AU  - Mathieu Canales
AU  - Fanny Vuilleumier
AU  - Gaetano Perrotta
AU  - Myriam Schluep
AU  - Renaud Du Pasquier
TI  - The VZV/IE63-specific T cell response prevents herpes zoster in fingolimod-treated patients
AID  - 10.1212/NXI.0000000000000209
DP  - 2016 Apr 01
TA  - Neurology - Neuroimmunology Neuroinflammation
PG  - e209
VI  - 3
IP  - 2
4099  - http://nn.neurology.org/content/3/2/e209.short
4100  - http://nn.neurology.org/content/3/2/e209.full
SO  - Neurol Neuroimmunol Neuroinflamm2016 Apr 01; 3
AB  - Objective: To assess longitudinally the antiviral immune response of T cells from patients with multiple sclerosis (MS) treated with fingolimod (FTY) vs other disease-modifying treatments (DMTs).Methods: We assessed cellular immune responses specific to influenza virus (FLU), JC virus (JCV), and varicella-zoster virus (VZV) using quantification of interferon-γ secretion by enzyme-linked immunospot in patients with MS on FTY (n = 31), including 2 with herpes zoster (HZ), natalizumab (n = 11), and other DMTs (n = 11). We used viral lysates for FLU and VZV and a pool of peptides for FLU, JCV (VP-1), and VZV (IE63).Results: Besides an expected drop of T cells, we found that, proportionally to the number of CD3+ T cells, only FTY-treated patients with MS exhibited an increased VZV/IE63-specific T cell response peaking 6 months into treatment, a response that returned to baseline after 12 and 24 months. Two FTY-treated patients developed an HZ 6 months into treatment, coinciding with an absent VZV/IE63-specific T cell response. However, cellular immune responses specific to VZV lysate, JCV, and FLU (lysate and pool of peptide epitopes) were similar between all 3 categories (FTY, natalizumab, and other DMTs) of study patients.Conclusions: FTY-treated patients with MS exhibit an increased VZV/IE63-specific cellular immune response after 6 months of treatment. FTY-treated patients who develop an HZ are not able to mount such a response, suggesting that a T cell response directed against this viral protein may be key in preventing the occurrence of HZ.DMT=disease-modifying treatment; ELISPOT=enzyme-linked immunospot; FLU=influenza virus; FTY=fingolimod; HZ=herpes zoster; IFN-γ=interferon-γ; JCV=JC virus; MS=multiple sclerosis; NTZ=natalizumab; PBMC=peripheral blood mononuclear cell; SFC=spot-forming cell; VZV=varicella-zoster virus