Neurológia pre prax 3/2025
The impact of immunosupressive therapy on the immune system of a patient with multiple sclerosis
Highly effective innovative immunotherapies for multiple sclerosis (MS) significantly improve the long-term prognosis of patients with MS. This immunointerventional treatment
- DMT (Disease modifying therapy) affects various levels of immune processes and can induce secondary immunodeficiency, mainly lymphopenia, by changing lymphocyte transport, their depletion and disruption of their replication. Immunosuppressive treatment of the disease can also lead to hypogammaglobulinemia and an increased risk of occurrence and worsening of the course of infections, to reactivation of latent pathogens and to worsening of asymptomatic chronic infections. In the article, we present an overview of the most common changes in immune responses during immunosuppressive treatment of multiple sclerosis, preventive strategies to minimize the risks of infections, especially by vaccination, which is a standard part of the managing patients with MS. In clinical practice, it is necessary to consider when and which vaccines to administer to the patient concerning his treatment of the underlying disease with preparations of the DMT group, which can affect vaccine reactions.
Keywords: multiple sclerosis, immune system, immunosuppressive therapy, lymphopenia, immunodeficiency, vaccination
