CTLA4 as Immunological Checkpoint in the Development of Multiple Sclerosis.
case_report · Level V
Where this comes from
- Record sourced from PubMed, PMID 27351142.
- Also identified by DOI 10.1002/ana.24715 and PMC identifier 5129566.
- Licence recorded as CC BY-NC-ND.
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Abstract
We investigated a patient who developed multiple sclerosis (MS) during treatment with the CTLA4-blocking antibody ipilimumab for metastatic melanoma. Initially he showed subclinical magnetic resonance imaging (MRI) changes (radiologically isolated syndrome). Two courses of ipilimumab were each followed by a clinical episode of MS, 1 of which was accompanied by a massive increase of MRI activity. Brain biopsy confirmed active, T-cell type MS. Quantitative next generation sequencing of T-cell receptor genes revealed distinct oligoclonal CD4(+) and CD8(+) T-cell repertoires in the primary melanoma and cerebrospinal fluid. Our results pinpoint the coinhibitory molecule CTLA4 as an immunological checkpoint and therapeutic target in MS. Ann Neurol 2016;80:294-300.
Medical subject headings
- Antibodies, Monoclonal
- CTLA-4 Antigen
- Multiple Sclerosis