Immune Response Dynamics in Multiple Sclerosis and COVID-19

Multiple sclerosis (MS) is a chronic inflammatory disorder in which aberrant immune activity leads to demyelination and neurodegeneration. The emergence of COVID-19 has posed particular challenges for people with MS, many of whom receive disease-modifying therapies (DMTs) that alter lymphocyte function. Understanding how these therapies affect both natural and vaccine-induced immune responses to SARS-CoV-2 is critical for optimising patient care. Recent work has focused on dissecting the balance between protective antibody (humoral) responses and T cell (cellular) immunity, the role of immunosenescence in older or heavily treated patients, and the metabolic programmes underpinning antigen-specific cell function. These insights have global significance for vaccine scheduling, risk stratification and public-health guidance for immunosuppressed populations.

Research from Nature Portfolio

Recent studies have employed high-parameter cytometry and single-cell metabolic profiling to characterise SARS-CoV-2-specific T and B cells in MS patients receiving a range of DMTs. One investigation tracked functional and metabolic signatures up to eight months after a third mRNA vaccine dose, revealing that fingolimod and natalizumab therapy are associated with distinct metabolic phenotypes in antigen-specific lymphocytes, despite preserved overall functionality. Another seminal report defined the coordinated landscape of humoral and cellular immunity in patients on anti-CD20 monoclonal antibodies. While spike-specific antibody and memory B cell responses were substantially reduced, robust CD4+ and CD8+ T cell priming was universally observed. Notably, anti-CD20 treatment skewed follicular helper T cell responses and enhanced CD8+ induction, offering mechanistic insight into how B cell depletion reshapes vaccine-induced immunity.

Immune Response Dynamics in Multiple Sclerosis and COVID-19 publication trend

The graph below shows the total number of articles in immune response dynamics in multiple sclerosis and covid-19 across all publications each year (not limited to Nature Index journals).

Technical terms

Disease-modifying therapy (DMT): A medication that alters the course of multiple sclerosis by modulating or suppressing immune activity.

Humoral immunity: Immune protection mediated by antibodies produced by B cells.

Cellular immunity: Immune protection mediated by T cells, including CD4+ helper and CD8+ cytotoxic subsets.

Immunosenescence: Age-related decline in immune function, affecting the magnitude and quality of responses to infection or vaccination.

References

1. Immunosenescence and vaccine efficacy revealed by immunometabolic analysis of SARS-CoV-2-specific cells in multiple sclerosis patients. Nature Communications (2024).
2. Patient level dataset to study the effect of COVID-19 in people with Multiple Sclerosis. Scientific Data (2024).
3. Cellular and humoral immune responses following SARS-CoV-2 mRNA vaccination in patients with multiple sclerosis on anti-CD20 therapy. Nature Medicine (2021).
4. Multiple sclerosis therapies differentially impact SARS-CoV-2 vaccine-induced antibody and T cell immunity and function. JCI Insight (2022).
5. Immunity following SARS-CoV-2 vaccination in autoimmune neurological disorders treated with rituximab or ocrelizumab. Frontiers in Immunology (2023).