Monocytic myeloid-derived suppressor cells, but not regulatory T cells, track immunoregulatory dynamics and relapse recovery in early RRMS
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Introduction
Incomplete recovery from relapses contributes to long-term disability accumulation in relapsing–remitting multiple sclerosis (RRMS), yet the relationship between immune regulation and relapse recovery remains poorly defined.
Objective
To longitudinally characterize regulatory/effector immune cell dynamics in untreated RRMS patients and assess their association with immune balance and relapse recovery.
Methods
Monocytic myeloid-derived suppressor cells (M-MDSCs), regulatory T cells (Treg), and effector CD4⁺ T cell subsets were measured in blood from 69 untreated RRMS patients sampled during relapse or remission and re-evaluated after 12 months. Associations with clinical recovery after relapse were examined.
Results
During relapse, patients exhibited higher M-MDSC and Treg frequencies than in remission, while effector T cell subsets remained unchanged. Over one year, M-MDSCs increased consistently regardless of baseline clinical status, whereas Treg frequencies remained stable. Effector-to-M-MDSC ratios were markedly elevated during relapse and declined over time, while effector-to-Treg ratios showed minimal variation. M-MDSC levels during relapse were associated with sustained regulatory features at 12-month follow-up. Importantly, higher baseline M-MDSC levels, but not Treg frequencies, were associated with complete relapse recovery at one year.
Conclusion
These findings suggest that circulating M-MDSCs, but not Treg, reflect interindividual differences in immune regulation and clinical recovery after relapse in early RRMS.
