Longitudinal analysis of the effects of cladribine tablets on B and T cell memory recall responses to vaccine antigens in people with multiple sclerosis
- 1Frazer Institute, The University of Queensland
Abstract
Introduction: Cladribine tablets (CladT) are used as an immune reconstitution therapy for multiple sclerosis (MS). Patients are dosed in year 1 (time 0) and again after 12 months. The aim of therapy is to allow development of a reconstituted immune repertoire with reduced pathogenic autoreactivity. However, CladT could also affect the durability of memory T and antibody responses to bacterial and viral pathogens against which people with MS have previously been vaccinated. The objective of this study was to investigate changes in memory recall responses to vaccines over a 2-year period after the initial administration of CladT.
Methods: Blood was collected prior to the initial administration of CladT and at 5 timepoints (3, 6, 12, 18 and 24 months) after administration from 18 people with MS. The effects of CladT on antigen-specific T cell and/or antibody responses to influenza, varicella zoster, tetanus toxoid, and SARS-CoV-2 were assessed.
Results: While levels of antibodies remained relatively stable for most vaccine antigens, numbers of T cells specific for the vaccine antigens declined in most individuals, particularly after the second course of treatment. Observations from individuals revaccinated against influenza suggest that revaccination at 18–24 months after starting CladT treatment, after both courses have been given, can restore influenza-specific responses.
Discussion: CladT treatment can cause a decline in numbers of vaccine-specific memory T cells. Numbers of influenza-specific memory T cells could be restored to pre-treatment levels by revaccination after the second course of treatment. Larger studies are needed to define antigen-specific revaccination schedules more broadly.
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BibTeX
@article{csurhes2026longitudinal,
title = {{Longitudinal analysis of the effects of cladribine tablets on B and T cell memory recall responses to vaccine antigens in people with multiple sclerosis}},
author = {Peter A. Csurhes and Pamela A. McCombe and Judith M. Greer},
journal = {Frontiers in Immunology},
year = {2026},
month = oct,
doi = {10.3389/fimmu.2026.1881334},
url = {https://www.frontiersin.org/articles/10.3389/fimmu.2026.1881334/full},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Longitudinal analysis of the effects of cladribine tablets on B and T cell memory recall responses to vaccine antigens in people with multiple sclerosis
AU - Peter A. Csurhes
AU - Pamela A. McCombe
AU - Judith M. Greer
PY - 2026
DA - 2026/10/22
JO - Frontiers in Immunology
DO - 10.3389/fimmu.2026.1881334
UR - https://www.frontiersin.org/articles/10.3389/fimmu.2026.1881334/full
AB - Introduction: Cladribine tablets (CladT) are used as an immune reconstitution therapy for multiple sclerosis (MS). Patients are dosed in year 1 (time 0) and again after 12 months. The aim of therapy is to allow development of a reconstituted immune repertoire with reduced pathogenic autoreactivity. However, CladT could also affect the durability of memory T and antibody responses to bacterial and viral pathogens against which people with MS have previously been vaccinated. The objective of this study was to investigate changes in memory recall responses to vaccines over a 2-year period after the initial administration of CladT. Methods: Blood was collected prior to the initial administration of CladT and at 5 timepoints (3, 6, 12, 18 and 24 months) after administration from 18 people with MS. The effects of CladT on antigen-specific T cell and/or antibody responses to influenza, varicella zoster, tetanus toxoid, and SARS-CoV-2 were assessed. Results: While levels of antibodies remained relatively stable for most vaccine antigens, numbers of T cells specific for the vaccine antigens declined in most individuals, particularly after the second course of treatment. Observations from individuals revaccinated against influenza suggest that revaccination at 18–24 months after starting CladT treatment, after both courses have been given, can restore influenza-specific responses. Discussion: CladT treatment can cause a decline in numbers of vaccine-specific memory T cells. Numbers of influenza-specific memory T cells could be restored to pre-treatment levels by revaccination after the second course of treatment. Larger studies are needed to define antigen-specific revaccination schedules more broadly.
SN - 1664-3224
ER -