Browsing by Author "Solana, Elisabeth"

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    mRNA COVID-19 Vaccination Does Not Exacerbate Symptoms or Trigger Neural Antibody Responses in Multiple Sclerosis
    (2023) Blanco, Yolanda; Escudero, Domingo; Lleixa, Cinta; Llufriu, Sara; Egri, Natalia; Garcia, Raquel Ruiz; Alba, Mercedes; Aguilar, Esther; Artola, Montse; Aldea Novo, Marta; Alvarez, Silvia; Caballero, Eva; Cabrera-Maqueda, Jose Maria; Fonseca, Elianet; Guasp, Mar; Hernando, Ana; Martinez-Hernandez, Eugenia; Olive-Cirera, Gemma; Lopez-Contreras, Joaquin; Martin-Aguilar, Lorena; Martinez-Martinez, Laura; Rombauts, Alexander; Rodes, Maria; Sabater, Lidia; Sepulveda, Maria; Solana, Elisabeth; Tejada-Illa, Clara; Vidal-Fernandez, Nuria; Vilella, Anna; Fortuny, Claudia; Armangue, Thais; Dalmau, Josep O.; Querol, Luis; Saiz, Albert
    Background and ObjectiveIn people with multiple sclerosis (pwMS), concern for potential disease exacerbation or triggering of other autoimmune disorders contributes to vaccine hesitancy. We assessed the humoral and T-cell responses to SARS-CoV-2 after mRNA vaccination, changes in disease activity, and development of antibodies against central or peripheral nervous system antigens.MethodsThis was a prospective 1-year longitudinal observational study of pwMS and a control group of patients with other inflammatory neurologic disorders (OIND) who received an mRNA vaccine. Blood samples were obtained before the first dose (T1), 1 month after the first dose (T2), 1 month after the second dose (T3), and 6 (T4), 9 (T5), and 12 (T6) months after the first dose. Patients were assessed for the immune-specific response, annualized relapse rate (ARR), and antibodies to onconeuronal, neural surface, glial, ganglioside, and nodo-paranodal antigens.ResultsAmong 454 patients studied, 390 had MS (22 adolescents) and 64 OIND; the mean (SD) age was 44 (14) years; 315 (69%) were female; and 392 (87%) were on disease-modifying therapies. Antibodies to the receptor-binding domain were detected in 367 (86%) patients at T3 and 276 (83%) at T4. After a third dose, only 13 (22%) of 60 seronegative patients seroconverted, and 255 (92%) remained seropositive at T6. Cellular responses were present in 381 (93%) patients at T3 and in 235 (91%) patients at T6 including all those receiving anti-CD20 therapies and in 79% of patients receiving fingolimod. At T3 (429 patients) or T6 (395 patients), none of the patients had developed CNS autoantibodies. Seven patients had neural antibodies that were already present before immunization (3 adult patients with MS had MOG-IgG, 2 with MG and 1 with MS had neuronal cell surface antibodies [unknown antigen], and 1 with MS had myelin antibody reactivity [unknown antigen]. Similarly, no antibodies against PNS antigens were identified at T3 (427 patients). ARR was lower in MS and not significantly different in patients with OIND. Although 182 (40%) patients developed SARS-CoV-2 infection, no cases of severe COVID-19 or serious adverse events occurred.DiscussionIn this study, mRNA COVID-19 vaccination was safe and did not exacerbate the autoimmune disease nor triggered neural autoantibodies or immune-mediated neurologic disorders. The outcome of patients who developed SARS-CoV-2 infection was favorable.
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    Predictive value of retinal atrophy for cognitive decline across disease duration in multiple sclerosis
    (2024) Alba-Arbalat, Salut; Solana, Elisabeth; Lopez-Soley, Elisabet; Camos-Carreras, Anna; Martinez-Heras, Eloy; Vivo, Francesc; Pulido-Valdeolivas, Irene; Andorra, Magi; Sepulveda, Maria; Cabrera, Jose Maria; Fonseca, Elianet; Calvi, Alberto; Alcubierre, Rafel; Dotti-Boada, Marina; Saiz, Albert; Martinez-Lapiscina, Elena H.; Villoslada, Pablo; Blanco, Yolanda; Sanchez-Dalmau, Bernardo; Llufriu, Sara
    Background We investigated the association between changes in retinal thickness and cognition in people with MS (PwMS), exploring the predictive value of optical coherence tomography (OCT) markers of neuroaxonal damage for global cognitive decline at different periods of disease.Method We quantified the peripapillary retinal nerve fibre (pRFNL) and ganglion cell-inner plexiform (GCIPL) layers thicknesses of 207 PwMS and performed neuropsychological evaluations. The cohort was divided based on disease duration (<= 5 years or >5 years). We studied associations between changes in OCT and cognition over time, and assessed the risk of cognitive decline of a pRFNL <= 88 mu m or GCIPL <= 77 mu m and its predictive value.Results Changes in pRFNL and GCIPL thickness over 3.2 years were associated with evolution of cognitive scores, in the entire cohort and in patients with more than 5 years of disease (p<0.01). Changes in cognition were related to less use of disease-modifying drugs, but not OCT metrics in PwMS within 5 years of onset. A pRFNL <= 88 mu m was associated with earlier cognitive disability (3.7 vs 9.9 years) and higher risk of cognitive deterioration (HR=1.64, p=0.022). A GCIPL <= 77 mu m was not associated with a higher risk of cognitive decline, but a trend was observed at <= 91.5 mu m in PwMS with longer disease (HR=1.81, p=0.061).Conclusions The progressive retinal thinning is related to cognitive decline, indicating that cognitive dysfunction is a late manifestation of accumulated neuroaxonal damage. Quantifying the pRFNL aids in identifying individuals at risk of cognitive dysfunction.