title: Relapse of multiple sclerosis in a patient retaining CCR7-expressing T cells in CSF under fingolimod therapy.
abstract: Fingolimod acts as a functional antagonist of the sphingosine-1-phosphate receptor, and it traps lymphocytes in secondary lymphoid organs and precludes their migration into the central nervous system. We report the case of a patient who suffered a relatively severe relapse of multiple sclerosis (MS) during the initial 3 months of fingolimod therapy, with retention of CCR7 expression on CD4(+) T cells in the cerebrospinal fluid (CSF) despite decreased numbers of lymphocytes and decreased expression of CCR7 on CD4(+) T cells in the blood. These data suggest that fingolimod may cause differential effects on the CSF and blood lymphocytes of patients with MS during the initial months of therapy.
authors.affiliation: Department of Neurology, Brain Research Institute, Niigata University, Niigata, Japan.
authors.forename: Akiko
authors.initials: A
authors.lastname: Yokoseki
authors.forename: Etsuji
authors.initials: E
authors.lastname: Saji
authors.forename: Musashi
authors.initials: M
authors.lastname: Arakawa
authors.forename: Mariko
authors.initials: M
authors.lastname: Hokari
authors.forename: Takanobu
authors.initials: T
authors.lastname: Ishiguro
authors.forename: Fumihiro
authors.initials: F
authors.lastname: Yanagimura
authors.forename: Tomohiko
authors.initials: T
authors.lastname: Ishihara
authors.forename: Kouichirou
authors.initials: K
authors.lastname: Okamoto
authors.forename: Masatoyo
authors.initials: M
authors.lastname: Nishizawa
authors.forename: Izumi
authors.initials: I
authors.lastname: Kawachi
mesh_terms: D001921:Brain / Q000473:pathology; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology*; D000068876:Fingolimod Hydrochloride; D005434:Flow Cytometry; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D008279:Magnetic Resonance Imaging; D008297:Male; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000134:cerebrospinal fluid* / Q000188:drug therapy / Q000276:immunology; D011409:Propylene Glycols / Q000627:therapeutic use*; D054400:Receptors, CCR7 / Q000276:immunology; D013110:Sphingosine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D055815:Young Adult
chemical_list: C515370:CCR7 protein, human; D007166:Immunosuppressive Agents; D011409:Propylene Glycols; D054400:Receptors, CCR7; D000068876:Fingolimod Hydrochloride; D013110:Sphingosine
keywords: CCR7; CSF; Fingolimod; compartmentalized immune response; multiple sclerosis