{
  "abstract": "B cells have arisen as key in multiple sclerosis (MS) pathogenesis by the high efficacy of B cell depleting CD20 monoclonal antibodies and by the identification of Epstein-Barr virus (EBV) as a prerequisite factor. We previously demonstrated an expansion of memory and double negative (DN) B cells in the deep cervical lymph nodes (dcLNs) of newly diagnosed patients with MS (pwMS), with DN B cells showing a molecular signature consistent with lytic EBV infection. Effect of anti-CD20 therapies for pwMS require sustained administration, which led us to hypothesize that incomplete effects on the dcLNs, a natural site for lymphocyte priming towards the central nervous system (CNS), might be sustaining the pathology. Using single-cell transcriptomics and paired sampling, we characterized the effects of anti-CD20 therapies on dcLNs compared to circulation and to other therapies. We observed switched (SM) and unswitched (USM) memory B cells to be depleted uniquely by anti-CD20 in both dcLNs and circulation, whereas DN B cells of the dcLNs were not. Moreover, EBV lytic signature was retained in DN B cells during anti-CD20, and using clonal trajectory we saw that the DN B cells continued to contribute to the plasmablast differentiation within dcLNs. EBV targeting of expanded memory CD8 T cells, as well as CD8 T cell exhaustion, were retained during anti-CD20 therapy within the dcLNs. Our findings suggest a sustained, EBV-driven process in pwMS during anti-CD20 in the CNS-targeting priming dcLNs, with therapeutic implications to be investigated further.",
  "abstract_shown": true,
  "affiliations": [
    "Translational Immunology Research Program, University of Helsinki; Helsinki, Finland"
  ],
  "article_type": "PUBLISHAHEADOFPRINT",
  "arxiv": null,
  "author_total": 7,
  "authors": [
    {
      "name": "Y. K. Babal"
    },
    {
      "name": "J. Sarkkinen"
    },
    {
      "name": "E. Ahvenainen"
    },
    {
      "name": "A. Susi"
    },
    {
      "name": "M. Saarela"
    },
    {
      "name": "G. Kurdo"
    },
    {
      "affs": [
        0
      ],
      "name": "S. M. Laakso"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/9r2szq8hz21hj.bib",
  "cited_by": 0,
  "doi": "10.64898/2026.10.25.26366311",
  "fulltext_url": "https://www.medrxiv.org/content/10.64898/2026.10.25.26366311v1.full",
  "id": "9r2szq8hz21hj",
  "issns": [],
  "landing_url": "https://www.medrxiv.org/content/10.64898/2026.10.25.26366311v1",
  "language": null,
  "licence": "CC-BY-NC",
  "licence_label": "CC BY-NC",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "medrxiv",
      "neurology"
    ],
    [
      "openalex",
      "2734|Multiple Sclerosis Research Studies"
    ]
  ],
  "openalex": "W7224113278",
  "pdf_url": "https://www.medrxiv.org/content/10.64898/2026.10.25.26366311v1.full.pdf",
  "pmcid": null,
  "pmid": null,
  "published": "2026-10-25",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/9r2szq8hz21hj.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:21:54Z",
      "native_id": "10.64898/2026.10.25.26366311",
      "source": "medrxiv",
      "url": "https://www.medrxiv.org/content/10.64898/2026.10.25.26366311v1"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "medrxiv:neurology",
      "subfield": "neurology"
    }
  ],
  "title": "Cervical lymph node B cell subset resists depletion and sustains lytic Epstein Barr-virus signature in patients with multiple sclerosis",
  "title_text": "Cervical lymph node B cell subset resists depletion and sustains lytic Epstein Barr-virus signature in patients with multiple sclerosis",
  "type": "preprint",
  "updated_at": "2026-10-30T12:21:54Z",
  "url": "https://research.draconitic.com/paper/9r2szq8hz21hj",
  "venue": "medRxiv",
  "versions": []
}