Fig. 6: Patients with MS treated with aCD20 with no detectable anti-RBD IgG demonstrate the highest level of immune discoordination after SARS-CoV-2 mRNA vaccination.

a, Correlations of antigen-specific features at T2, T4 and T5 in healthy controls (left, n = 10) and patients with MS treated with aCD20 (right, n = 20). Associations were calculated using Spearman rank correlation; *P < 0.05. b,c, Correlations between the frequency of T4 AIM⁺ circulating T_FH cells and T4 anti-spike IgG (left) or spike-specific memory B cells (right) (b) and between the frequency of T5 AIM⁺CD8 T cells and T5 anti-spike IgG (left) or spike-specific memory B cells (right) (c). Only patients receiving aCD20 therapy were considered for these correlations (n = 20). Associations were calculated using Spearman rank correlation and are shown with Pearson trend lines for visualization. d,e, Opt-SNE projections of concatenated cytometry data for activated Ki67⁺CD38⁺ CD4 (d) and activated Ki67⁺CD38⁺ CD8 (e) T cells for each time point and group combination are shown. Groups: healthy controls (n = 10); MS-aCD20 with anti-RBD IgG⁺ at any time point (MS-aCD20 RBD antibody⁺, n = 10); and MS-aCD20 with anti-RBD IgG⁻ at all time points examined (MS-aCD20 RBD antibody⁻, n = 10). f, AIM⁺ frequencies of the indicated T cell populations after mRNA vaccination at T4 and T5. The values represent the background-subtracted frequency of AIM⁺ non-naive T cells above paired baseline frequencies for healthy controls (gray, n = 10), MS RBD antibody⁺ (orange, n = 10) and MS RBD antibody⁻ (purple, n = 10) groups. Statistics were calculated using an unpaired, two-tailed Wilcoxon test. *P < 0.05, **P < 0.01.