Decrease in the numbers of dendritic cells and CD4 + T cells in cerebral perivascular spaces due to natalizumab

Maria Del Pilar Martin, Petra D. Cravens, Ryan Winger, Elliot Frohman, Michael K. Racke, Todd N. Eagar, Scott S. Zamvil, Martin S. Weber, Bernhard Hemmer, Nitin J. Karandikar, B. K. Kleinschmidt-DeMasters, Olaf Stuve

Research output: Contribution to journalArticlepeer-review

130 Scopus citations


Objective: To extend our studies on the prolonged and differential effect of natalizumab on T lymphocyte numbers in the cerebrospinal fluid, we investigated the number and phenotypes of leukocytes and the expression of major histocompatibility complex (MHC) classes I and II in cerebral perivascular spaces (CPVS). We hypothesized that natalizumab reduces the number of antigen presenting cells in CPVS. Design: A case-control study in which inflammatory cell numbers in the CPVS of cerebral tissue were assessed by immunohistochemical staining. Subjects: A patient with multiple sclerosis (MS) who developed progressive multifocal leukoencephalopathy (PML) during natalizumab therapy. Controls included location-matched cerebral autopsy material of patients without disease of the central nervous system, patients with MS not treated with natalizumab, and patients with PML not associated with natalizumab therapy. Results: The absolute number of CPVS in the patient with MS treated with natalizumab was significantly lower than in the control groups owing to extensive destruction of the tissue architecture. The expression of MHC class II molecules and the number of CD209 + dendritic cells were significantly decreased in the CPVS of the patient with MS treated with natalizumab. No CD4 + T cells were detectable. Conclusions: Our observations may explain the differential and prolonged effects of natalizumab therapy on leukocyte numbers in the cerebrospinal fluid.

Original languageEnglish (US)
Pages (from-to)1596-1603
Number of pages8
JournalArchives of neurology
Issue number12
StatePublished - Dec 2008

ASJC Scopus subject areas

  • Arts and Humanities (miscellaneous)
  • Clinical Neurology


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