title: Do neutralising antibodies against exogenous interferon-beta inhibit endogenous signalling pathways?
abstract: BACKGROUND
  Interferon-beta (IFNβ) is currently the most used disease-modifying treatment for relapsing-remitting multiple sclerosis (RRMS), but it can lead to the production of neutralising antibodies (NABs) against IFNβ.
  
  
  METHODS
  A lady with a past history of genital herpes was diagnosed with RRMS, started IFNβ treatment with a good initial response. Three years later her treatment was interrupted to become pregnant. After delivery she restarted IFNβ; she had more reactivations of genital herpes and experienced intermittent sensory symptoms often coinciding with herpes reactivation. High NABs titres against IFNβ were found. Since the introduction of famciclovir as prophylactic antiviral therapy and a switch from IFNβ to glatiramer acetate, herpes reactivations ceased and she had no further MS relapses.
  
  
  CONCLUSIONS
  Exacerbations of genital herpes coinciding with MS relapses suggest a potential link between the development of NABs and inhibition of anti-viral action of endogenous IFNβ. This case highlights that NABs not only decreases exogenous IFNβ treatment efficacy, but may also interfere with anti-viral properties of endogenous IFNβ. Investigating patients who are treated with biological medication will allow us to better understand the biology and signalling pathways in humans.
authors: Queen Mary University of London, Barts and The London School of Medicine and Dentistry, Blizard Institute, 4 Newark Street, London E1 2AT, England.
authors: Debra
authors: D
authors: Fine
authors: Queen Mary University of London, Barts and The London School of Medicine and Dentistry, Blizard Institute, 4 Newark Street, London E1 2AT, England.
authors: Abhishek
authors: A
authors: Dattani
authors: Queen Mary University of London, Barts and The London School of Medicine and Dentistry, Blizard Institute, 4 Newark Street, London E1 2AT, England.
authors: Isabel
authors: I
authors: Moreira
authors: Queen Mary University of London, Barts and The London School of Medicine and Dentistry, Blizard Institute, 4 Newark Street, London E1 2AT, England.
authors: Gavin
authors: G
authors: Giovannoni
authors: Queen Mary University of London, Barts and The London School of Medicine and Dentistry, Blizard Institute, 4 Newark Street, London E1 2AT, England. Electronic address: m.calado-marta@qmul.ac.uk.
authors: Monica
authors: M
authors: Marta
mesh_terms: D000328:Adult; D000906:Antibodies / Q000627:therapeutic use*; D005260:Female; D006558:Herpes Genitalis / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D016899:Interferon-beta / Q000276:immunology*; D020528:Multiple Sclerosis, Chronic Progressive / Q000150:complications / Q000188:drug therapy*; D015398:Signal Transduction / Q000187:drug effects*
chemical_list: D000906:Antibodies; D016899:Interferon-beta
keywords: Interferon-beta; Multiple sclerosis; Neutralising antibodies