. Author manuscript; available in PMC: 2018 Aug 12.

Published in final edited form as: Semin Pediatr Neurol. 2017 Aug 12;24(3):229–239. doi: 10.1016/j.spen.2017.08.001

Table 3.

Use of CSF immunophenotyping to test the capacity of targeted immunotherapies to rectify the initial abnormalities

Agent	Indication	Post-treatment Immunophenotyping Results
Daclizumab	MS	Decreased CD4+CD25+ T cell counts; decreased CD4+ and CD8+ T cell/NK cell ratio; increased CD56(bright) NK cells; no change in CD4+/CD8+ T cell ratio.^45,95
Fingolimod	MS	Decreased proportion of CD+ T cells. It had no impact on CSF B cells. The percentage of CSF CD8+ T cells, NK cells, and monocytes increased compared to controls. The CSF CD4+/CD8+ T cell ratio reversed in majority of patients.⁹⁴
Natalizumab	MS	Lowered CSF B cells and CD4/CD8 ratio.⁹⁸ Also decreased numbers of CD4+ and CD8+ T cells, and CD138+ plasma cells (Stüve2008).⁹⁶
Rituximab	MS	CSF B cell counts decreased, as did CD3+ T cell counts.⁹⁹ In PP-MS (n = 4), CSF B cells were not as depleted as blood B cells, and B cell activation was only temporarily expressed.⁹⁷ Rituximab is detectable in CSF for up to 24 weeks.¹⁰⁰
Rituximab	pOMS	CSF B cell frequency dropped to undetectable levels;^12–18 months later, B cells in peripheral blood had repopulated, but the CSF B cell percentage did not exceed control percentages.⁸¹
Rituximab-IT	SP-MS	Intrathecal rituximab lacked efficacy on CSF biomarkers.⁴³ Insufficient saturation of CD20, absence of lytic complement, and dearth of cytotoxic NK cells (CD56-dim) may explain the insufficient disease response.⁴³

IT = intrathecal