The results suggest these patient-specific factors can modulate the response of immune cells, and should be taken into account in clinical decision-making, the researchers said.
The study, “Patient-specific factors modulate leukocyte response in dimethyl fumarate treated MS patients,” was published in the journal PLOS ONE.
One of the adverse effects of Tecfidera (marketed by Biogen) is a condition known as lymphopenia, which is characterized by low levels of a type of immune cell known as lymphocytes. Low levels of immune cells, including white blood cells such as lymphocytes and neutrophils, are associated with increased risk of infections.
In clinical trials, up to 6% of MS patients developed severe lymphopenia (grade 3), defined as an absolute lymphocyte count (ALC) of less than 500. Lymphopenia seems to increase the risk for progressive multifocal leukoencephalopathy, a brain disorder that’s caused by a virus.
While there are several studies investigating this adverse effect, few have focused on a type of immune cells known as neutrophils — one of the first immune cells to migrate to a site of infection.
Animal models have suggested that neutrophils contribute to the demyelination process (loss of myelin, the protective coating of neurons), the hallmark of MS. In addition, Tecfidera treatment was shown to block neutrophil migration into the central nervous system.
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