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. 2022 Dec 19;10(2):e200075. doi: 10.1212/NXI.0000000000200075

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Copyright © 2022 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Neurology.

This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License 4.0 (CC BY-NC-ND), which permits downloading and sharing the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.

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(A) The percentage of CD8⁺CD28⁻ Treg in the resting lymphocyte population trended 2-fold higher in healthy older than in younger subjects (p = 0.09). The percentage of Treg in unstimulated older therapy-naive MS was lower than in unstimulated older HCs (p = 0.001) and did not increase with aging. The percentage of Treg in unstimulated fingolimod-treated younger patients was 5.8-fold higher than in unstimulated younger therapy-naive MS (p = 0.005) and 5.6-fold higher in unstimulated fingolimod-treated older patients than in older unstimulated therapy-naive MS (p = 0.001). On activation with ConA, Treg percentages did not significantly change in young and old HCs or in therapy-naive patients and tended to lose some of the Treg increase because of fingolimod therapy, although levels were still greater than in therapy-naive MS (p = 0.0002 for young and p = 0.03 for old). Stable and active patients with MS had similar profiles and were combined for analysis. (B) The percentage of CD8⁺CD28⁺ CTL within total lymphocytes in older HCs and in older therapy-naive MS was lower than that of younger subjects and did not change with ConA activation. However, fingolimod therapy decreased the percentage of CTL in unstimulated young (p = 0.00004) and old MS (p = 0.01) and in ConA-activated young (p = 0.02) and old MS (p = 0.01). Hashing indicates ConA activation. * p ≤ 0.05, ** p ≤ 0.01, *** p ≤ 0.001. Abbreviations: ConA = concanavalin A mitogen; CTL = Cytolytic T lymphocyte; HC = healthy control; Treg = regulatory T cell.