Work

Longitudinal analysis of the effects of cladribine tablets on B and T cell memory recall responses to vaccine antigens in people with multiple sclerosis

Year: 2026

Type: article

Abstract: Introduction: Cladribine tablets (CladT) are used as an immune reconstitution therapy for multiple sclerosis (MS). Patients are dosed in year 1 (time 0) and again after 12 months. The aim of therapy is to allow development of a reconstituted immune repertoire with reduced pathogenic autoreactivity. However, CladT could also affect the durability of memory T and antibody responses to bacterial and viral pathogens against which people with MS have previously been vaccinated. The objective of this study was to investigate changes in memory recall responses to vaccines over a 2-year period after the initial administration of CladT. Methods: Blood was collected prior to the initial administration of CladT and at 5 timepoints (3, 6, 12, 18 and 24 months) after administration from 18 people with MS. The effects of CladT on antigen-specific T cell and/or antibody responses to influenza, varicella zoster, tetanus toxoid, and SARS-CoV-2 were assessed. Results: While levels of antibodies remained relatively stable for most vaccine antigens, numbers of T cells specific for the vaccine antigens declined in most individuals, particularly after the second course of treatment. Observations from individuals revaccinated against influenza suggest that revaccination at 18-24 months after starting CladT treatment, after both courses have been given, can restore influenza-specific responses. Discussion: CladT treatment can cause a decline in numbers of vaccine-specific memory T cells. Numbers of influenza-specific memory T cells could be restored to pre-treatment levels by revaccination after the second course of treatment. Larger studies are needed to define antigen-specific revaccination schedules more broadly.

Source: Frontiers in Immunology

DOI: 10.3389/fimmu.2026.1881334

Authors: Peter A. Csurhes, Pamela A. McCombe, Judith M. Greer

Institution: The University of Queensland

Language: English

Topic: Multiple Sclerosis Research Studies

Subfield: Clinical Neurology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $3,801