Evidence map›Paper›PMID 39949773›Full record

ArticleFrontiers in immunology2025

Apheresis for the treatment of relapses in MS and NMOSD: reduced antibody reactivities, gene expression changes and potential clinical response indicators.

Michael Hecker, Brit Fitzner, Isis Ludwig-Portugall, Friederike Bohne, Edmar Heyland, Juliane Klehmet, Matthias Grothe, Matthias Schwab, Alexander Winkelmann, Stefanie Meister and 10 more

Abstract read
In one paragraph

Article in Frontiers in immunology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 synthesis or guideline pooled it.

  1. Guideline
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

20 authors.

Michael HeckerDivision of Neuroimmunology, Department of Neurology, Rostock University Medical Center, Rostock, Germany.
Brit Fitzner *Division of Neuroimmunology, Department of Neurology, Rostock University Medical Center, Rostock, Germany.
Isis Ludwig-Portugall *R&D Apheresis, Miltenyi Biotec B.V. & Co. KG, Teterow, Germany.
Friederike BohneR&D Apheresis, Miltenyi Biotec B.V. & Co. KG, Teterow, Germany.
Edmar HeylandR&D Apheresis, Miltenyi Biotec B.V. & Co. KG, Teterow, Germany.
Juliane KlehmetCenter for Multiple Sclerosis, Department of Neurology, Jüdisches Krankenhaus Berlin, Berlin, Germany.
Matthias GrotheDepartment of Neurology, University Medicine Greifswald, Greifswald, Germany.
Matthias SchwabDepartment of Neurology, Jena University Hospital, Jena, Germany.
Alexander WinkelmannDivision of Neuroimmunology, Department of Neurology, Rostock University Medical Center, Rostock, Germany.
Stefanie MeisterDivision of Neuroimmunology, Department of Neurology, Rostock University Medical Center, Rostock, Germany.
Ales DudesekDivision of Neuroimmunology, Department of Neurology, Rostock University Medical Center, Rostock, Germany.
Hannah WurmDepartment of Neurology, St. Josef-Hospital, Ruhr University Bochum, Bochum, Germany.
Ilya AyzenbergDepartment of Neurology, St. Josef-Hospital, Ruhr University Bochum, Bochum, Germany.
Ingo KleiterDepartment of Neurology, St. Josef-Hospital, Ruhr University Bochum, Bochum, Germany.
Corinna TrebstDepartment of Neurology, Hannover Medical School, Hannover, Germany.
Martin W HümmertDepartment of Neurology, Hannover Medical School, Hannover, Germany.
Bernhard NeumannDepartment of Neurology, University of Regensburg, Bezirksklinikum, Regensburg, Germany.
Klaus EulitzR&D Apheresis, Miltenyi Biotec B.V. & Co. KG, Teterow, Germany.
Dirk KoczanInstitute of Immunology, Rostock University Medical Center, Rostock, Germany.
Uwe K ZettlDivision of Neuroimmunology, Department of Neurology, Rostock University Medical Center, Rostock, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: High-dose glucocorticoids are the standard treatment for acute relapses in patients with multiple sclerosis (MS) or neuromyelitis optica spectrum disorder (NMOSD). Therapeutic apheresis can be considered for the escalation of relapse therapy, but some patients still do not recover sufficiently. We aimed to explore the effects of apheresis on humoral and cellular immune parameters and to identify features that correlate with beneficial clinical outcomes. Methods: We studied two cohorts comprising a total of 63 patients with MS or NMOSD who were undergoing relapse therapy with either methylprednisolone or apheresis. Blood samples were collected immediately before and after therapy to isolate plasma or serum as well as immune cells. We then measured (1) concentrations of the immunoglobulin isotypes IgG, IgM and IgA, (2) antibody reactivities against 12 peptides derived from potential autoantigens and Epstein-Barr virus proteins, (3) frequencies of CD19 Results: The initial therapy with methylprednisolone had no significant effect on immunoglobulin levels and (auto)antibody reactivities ( Conclusion: Our data reveal that therapeutic apheresis in MS rapidly leads to a significant decrease in IgG reactivities against EBNA1 (391-410) and cross-reactive targets such as GlialCAM (370-389) and also has an impact on the gene expression of B cells and T cells. Further studies are required to verify whether anti-EBNA1 (391-410) antibody reactivities and the expression of CD4-CTL-related genes may be indicative of the individual clinical response to this therapy.

Indexed as

Blood Component RemovalMultiple SclerosisNeuromyelitis OpticaAdultAutoantibodiesB-LymphocytesFemaleHumansMaleMethylprednisoloneMiddle AgedRecurrenceTranscriptomeTreatment OutcomeYoung AdultAutoantibodiesMethylprednisoloneacute relapseantibodiesapheresisgene expressionglucocorticoidslymphocytesmultiple sclerosisneuromyelitis optica spectrum disorder

Identifiers

PMID39949773
PMCPMC11821495

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.