ArticleTherapeutic advances in neurological disorders2026
Vedolizumab and the gut-CNS axis in multiple sclerosis: considering T cell licensing pathways.
Article in Therapeutic advances in neurological disorders, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: The role of gut-mediated T cell licensing in multiple sclerosis (MS) remains incompletely understood. Objective: We hypothesized that T cell licensing in the gut contributes to MS pathogenesis and evaluated whether vedolizumab-an anti-α4β7 integrin, gut-selective monoclonal antibody approved for inflammatory bowel disease (IBD)-is associated with MS prevalence. Design: Retrospective observational study. Methods: Using Epic Cosmos, a large deidentified U.S. electronic health record platform, we identified individuals with Crohn's disease (CD) or ulcerative colitis (UC) and a concomitant MS diagnosis between August 2010 and August 2025. Results: Among 1,027,704 CD and 1,294,362 UC patients, 8,098 (0.79%; 95%CI:0.77%-0.81%) and 9,564 (0.74%; 95%CI:0.73%-0.76%) had MS, respectively. In contrast, among vedolizumab-treated patients, only 125 with CD (0.22%; 95%CI:0.18%-0.26%) and 109 with UC (0.17%; 95%CI:0.14%-0.20%) developed MS within five years of treatment. Conclusion: While causality cannot be inferred, our findings highlight an opportunity to further explore whether vedolizumab-associated differences in MS prevalence may relate to gut-associated immune processes.
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