Studies of the immune profile in RAMBLE participants

This study will explore the mechanisms by which alemtuzumab works in the treatment of multiple sclerosis (MS), and how it leads to the development of other autoimmune diseases in approximately 36% of people treated.  

Data obtained from previous studies has shown the potential benefit of rituximab administration after alemtuzumab therapy in reducing the incidence of other autoimmune diseases. This study will explore the effect of low-dose rituximab administration in decreasing alemtuzumab-induced autoimmune disease. 

The development of other autoimmune diseases following alemtuzumab treatment is linked with B and T cells (types of immune cells) not growing back at the same rate after treatment. It has been suggested that the faster re-population of B cells in the absence of T cells might trigger the development of other autoimmune diseases. Additionally, higher baseline levels of the cytokine IL-21, a protein that helps control the immune system, have been observed in people who developed other autoimmune diseases compared to those who didn’t. Moreover, a genetic predisposition has been identified in people who developed secondary autoimmunity.  

This project will study how often certain genes are active in people who develop secondary autoimmunity compared to those who don’t. 

Ms Sofia Jimenez Sanchez’s focus is to better understand the mechanisms by which alemtuzumab works in the treatment of MS, and how this leads to the development of secondary autoimmunity. Moreover, the aim is to gather valuable data of the effects of this alemtuzumab-rituximab co-therapy regimen to decrease the incidence of autoimmunity secondary to alemtuzumab therapy.