Specific Considerations for Monoclonal Antibody Treatment in NMOSD: Shuhei Nishiyama, MD, PhD


The research fellow at the Neuroimmunology Clinic and Research Laboratory, Massachusetts General Hospital and Harvard Medical School, talked about having safer and more specific treatments for NMOSD that are antigen-specific. [WATCH TIME: 4 minutes]

WATCH TIME: 4 minutes

“For some monoclonal antibodies, there are some specific things we must think about, like we have to give the vaccine before treating the monoclonal antibodies. But if we abide by monoclonal antibody regulation, it's going to be a safer way than previous treatment seen 20 years ago. It's going to be more targeted treatment as technology and sciences are getting better and better these days.”

In December 2022, a study was published in the Journal of Neuroinflammation that demonstrated the expression of CD16 and activation markers in natural killer (NK) and natural killer-T (NKT) cells significantly changed in patients with neuromyelitis optica spectrum disorder (NMOSD) compared with the controls.1 The research is to be presented by lead author Shuhei Nishiyama, MD, PhD, research fellow at the Neuroimmunology Clinic and Research Laboratory, Massachusetts General Hospital and Harvard Medical School, at the 2023 American Academy of Neurology (AAN) Annual Meeting, April 22-27, in Boston, Massachusetts.

The number of NKT cells increased in NMOSD (P <.001) from baseline, although the proportion of those who were CD16 positive was lower compared with normal controls (NCs) and disease controls (DCs)(P = .0012). The NK cell count was normal, even though the ratio of CD16 positive individuals was also significantly lower (P <.001). In both NK cells and NKT cells from the disease, C5 complement receptor expression was much higher than normal rates and disease controls (both P <.001).

Recently, Nishiyama sat down with NeurologyLive® in an interview to compare the types of treatment used in NMOSD 20 years ago and the currently available therapies based on his research that he will present at the 2023 AAN meeting. Additionally, he talked about ongoing research projects in his clinical practice and the possibility of alternative treatments. Nishiyama also shared what he thinks is important for clinicians who care for patients with NMOSD to be aware of in their own practice.

1. Nishiyama S, Wright AE, Lotan I, et al. Upregulated complement receptors correlate with Fc gamma receptor 3A-positive natural killer and natural killer-T cells in neuromyelitis optica spectrum disorder. J Neuroinflammation. 2022;19(1):296. Published 2022 Dec 12. doi:10.1186/s12974-022-02661-1

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