Bhise Vikram, Dhib-Jalbut Suhayl
Departments of Pediatrics, Rutgers Robert Wood Johnson Medical School, 89 French Street, Suite 2200, New Brunswick, NJ, 08901, USA.
Department of Neurology, Rutgers Robert Wood Johnson Medical School, 125 Paterson Street, Suite 65000, New Brunswick, NJ, 08901, USA.
Neurotherapeutics. 2021 Jan;18(1):244-251. doi: 10.1007/s13311-021-01008-7. Epub 2021 Feb 2.
Coronavirus SARS-CoV2 has emerged as one of the greatest infectious disease health challenges in a century. Patients with multiple sclerosis (MS) have a particular vulnerability to infections through their use of immunosuppressive disease-modifying therapies (DMTs). Specific DMTs pose particular risk based on their mechanisms of action (MOA). As a result, patients require individualized approaches to starting new treatments and continuation of therapy. Additionally, vaccinations must be considered carefully, and individuals on long-term B cell-depleting therapies may have diminished immune responses to vaccination, based on preserved T cells and diminished but present antibody titers to influenza vaccines. We review the immunology behind these treatments and their impact on COVID-19, as well as the current recommendations for best practices for use of DMTs in patients with MS.
新型冠状病毒SARS-CoV-2已成为一个世纪以来最严峻的传染病健康挑战之一。多发性硬化症（MS）患者由于使用免疫抑制性疾病修正疗法（DMTs），特别容易受到感染。特定的DMTs因其作用机制（MOA）而具有特殊风险。因此，患者在开始新治疗和继续治疗时需要个性化方法。此外，必须仔细考虑疫苗接种，长期接受B细胞耗竭疗法的个体对疫苗接种的免疫反应可能会减弱，这是基于其保留的T细胞以及对流感疫苗的抗体滴度降低但仍存在。我们回顾了这些治疗背后的免疫学及其对COVID-19的影响，以及目前关于MS患者使用DMTs的最佳实践建议。
