{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T12:40:06Z","timestamp":1773319206381,"version":"3.50.1"},"reference-count":10,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,2,18]],"date-time":"2026-02-18T00:00:00Z","timestamp":1771372800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,2,18]],"date-time":"2026-02-18T00:00:00Z","timestamp":1771372800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Ther Adv Neurol Disord"],"published-print":{"date-parts":[[2026,3]]},"abstract":"\n Background:<\/jats:title>\n The role of gut-mediated T cell licensing in multiple sclerosis (MS) remains incompletely understood.<\/jats:p>\n <\/jats:sec>\n \n Objective:<\/jats:title>\n We hypothesized that T cell licensing in the gut contributes to MS pathogenesis and evaluated whether vedolizumab\u2014an anti-\u03b14\u03b27 integrin, gut-selective monoclonal antibody approved for inflammatory bowel disease (IBD)\u2014is associated with MS prevalence.<\/jats:p>\n <\/jats:sec>\n \n Design:<\/jats:title>\n Retrospective observational study.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n Using Epic Cosmos, a large deidentified U.S. electronic health record platform, we identified individuals with Crohn\u2019s disease (CD) or ulcerative colitis (UC) and a concomitant MS diagnosis between August 2010 and August 2025.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n Among 1,027,704 CD and 1,294,362 UC patients, 8,098 (0.79%; 95%CI:0.77%\u20130.81%) and 9,564 (0.74%; 95%CI:0.73%\u20130.76%) had MS, respectively. In contrast, among vedolizumab-treated patients, only 125 with CD (0.22%; 95%CI:0.18%\u20130.26%) and 109 with UC (0.17%; 95%CI:0.14%\u20130.20%) developed MS within five years of treatment.<\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n While causality cannot be inferred, our findings highlight an opportunity to further explore whether vedolizumab-associated differences in MS prevalence may relate to gut-associated immune processes.<\/jats:p>\n <\/jats:sec>","DOI":"10.1177\/17562864261423751","type":"journal-article","created":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T07:11:42Z","timestamp":1771485102000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Vedolizumab and the gut\u2013CNS axis in multiple sclerosis: considering T cell licensing pathways"],"prefix":"10.1177","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8866-6426","authenticated-orcid":false,"given":"Afsaneh","family":"Shirani","sequence":"first","affiliation":[{"name":"Department of Neurology, Saint Luke\u2019s Marion Bloch Neuroscience Institute, Kansas City, MO, USA"},{"name":"Department of Neurology, University of Missouri-Kansas City, Kansas City, MO, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0469-6872","authenticated-orcid":false,"given":"Olaf","family":"Stuve","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of Texas Southwestern Medical Center, 6000 Harry Hines Boulevard, Dallas, TX 75390-8813, USANeurology Section, VA North Texas Health Care System, Dallas, TX, USAPeter O\u2019Donnell Jr. Brain Institute, University of Texas Southwestern Medical Center, Dallas, TX, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2026,2,18]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.2302697120"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.neurot.2024.e00442"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41586-025-09120-w"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.celrep.2019.09.002"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2019.00903"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1101\/cshperspect.a029066"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1907607"},{"key":"e_1_3_4_9_2","unstructured":"Epic Systems Corporation. Epic Cosmos. Available at: https:\/\/cosmos.epic.com\/ (accessed 4 September 2025)."},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.1093\/ecco-jcc\/jjw092"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.12998\/wjcc.v10.i8.2569"}],"container-title":["Therapeutic Advances in Neurological Disorders"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/17562864261423751","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/17562864261423751","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/17562864261423751","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T18:58:56Z","timestamp":1773255536000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/17562864261423751"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,18]]},"references-count":10,"alternative-id":["10.1177\/17562864261423751"],"URL":"https:\/\/doi.org\/10.1177\/17562864261423751","relation":{},"ISSN":["1756-2864","1756-2864"],"issn-type":[{"value":"1756-2864","type":"print"},{"value":"1756-2864","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,18]]},"article-number":"17562864261423751"}}