{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T01:06:34Z","timestamp":1792803994806,"version":"4.5.0"},"reference-count":60,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2025,11,28]],"date-time":"2025-11-28T00:00:00Z","timestamp":1764288000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Carlos III Health Institute Health Care Research Fund","award":["CM22\/00065"],"award-info":[{"award-number":["CM22\/00065"]}],"id":[{"id":"https:\/\/ror.org\/00ca2c886","id-type":"ROR","asserted-by":"crossref"}]},{"name":"Miguel Servet","award":["CP20\/00024"],"award-info":[{"award-number":["CP20\/00024"]}]},{"DOI":"10.13039\/501100000780","name":"European Union","doi-asserted-by":"crossref","award":["FI22\/00009"],"award-info":[{"award-number":["FI22\/00009"]}],"id":[{"id":"10.13039\/501100000780","id-type":"DOI","asserted-by":"crossref"}]},{"name":"La Paz University Hospital biomedical foundation","id":[{"id":"https:\/\/ror.org\/034ebdq29","id-type":"ROR","asserted-by":"crossref"}]},{"DOI":"10.13039\/100008061","name":"Fundacion Mutua Madrile\u00f1a","doi-asserted-by":"crossref","award":["AP180562022"],"award-info":[{"award-number":["AP180562022"]}],"id":[{"id":"10.13039\/100008061","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100004587","name":"Carlos III Health Institute","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100004587","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diseases"],"abstract":"<jats:p>Background: Immunological monitoring in multiple sclerosis (MS) patients treated with disease-modifying drugs may help predict infectious complications and guide treatment. The main objective of this study was to evaluate whether anti-CD20 treatments in MS patients induce immunodeficiency and whether certain immunological parameters can predict the risk of infection and response to treatment. Methods: This retrospective, observational, single-centre study included MS patients who started treatment with ocrelizumab or rituximab and received follow-up in the Neuroimmunology Unit of our centre between January 2017 and January 2023. The study was conducted in collaboration with the Immunology Department of this hospital. Results: Fifty-five patients were included, with a mean age of 47 years and a follow-up period of 24 months. Analyses of lymphocyte subpopulations (T, B, NK) and immunoglobulin levels (IgG, IgA, IgM) were performed before treatment and at 6-, 12- and 24-month follow-ups. In addition, we carried out an exhaustive study of B cells in the baseline analysis. Sixty-four percent of patients presented infections, mostly due to COVID-19. Three patients developed cryptogenic organising pneumonia. IgG hypogammaglobulinemia was the main risk factor for developing infections. Patients with infections had fewer mature memory B cells and a lower percentage of NK cells. Furthermore, a lower proportion of na\u00efve and mature memory B cells was associated with inflammatory activity and disease progression, respectively. The absence of CD20 depletion during follow-up was associated with clinical worsening. Conclusions: Baseline immunophenotype and immunological monitoring can help predict the risk of infections and the efficacy of anti-CD20 therapy in MS patients.<\/jats:p>","DOI":"10.3390\/diseases13120387","type":"journal-article","created":{"date-parts":[[2025,12,3]],"date-time":"2025-12-03T11:29:30Z","timestamp":1764761370000},"page":"387","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Immunological Monitoring During Anti-CD20 Therapies to Predict Infection Risk and Treatment Response in Multiple Sclerosis Patients"],"prefix":"10.3390","volume":"13","author":[{"given":"Gabriel","family":"Torres Iglesias","sequence":"first","affiliation":[{"name":"Neurological Sciences and Cerebrovascular Research Laboratory, Department of Neurology, Neurology and Cerebrovascular Disease Group, Neuroscience Area of Hospital La Paz Institute for Health Research IdiPAZ, La Paz University Hospital, Universidad Aut\u00f3noma de Madrid, 28046 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5580-8387","authenticated-orcid":false,"given":"Ana","family":"Mart\u00ednez-Feito","sequence":"additional","affiliation":[{"name":"Clinical Immunology Department, La Paz University Hospital, 28046 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8765-6341","authenticated-orcid":false,"given":"Laura","family":"Otero-Ortega","sequence":"additional","affiliation":[{"name":"Neurological Sciences and Cerebrovascular Research Laboratory, Department of Neurology, Neurology and Cerebrovascular Disease Group, Neuroscience Area of Hospital La Paz Institute for Health Research IdiPAZ, La Paz University Hospital, Universidad Aut\u00f3noma de Madrid, 28046 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9171-2606","authenticated-orcid":false,"given":"MariPaz","family":"L\u00f3pez-Molina","sequence":"additional","affiliation":[{"name":"Neurological Sciences and Cerebrovascular Research Laboratory, Department of Neurology, Neurology and Cerebrovascular Disease Group, Neuroscience Area of Hospital La Paz Institute for Health Research IdiPAZ, La Paz University Hospital, Universidad Aut\u00f3noma de Madrid, 28046 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9567-1274","authenticated-orcid":false,"given":"Inmaculada","family":"Puertas","sequence":"additional","affiliation":[{"name":"Neurological Sciences and Cerebrovascular Research Laboratory, Department of Neurology, Neurology and Cerebrovascular Disease Group, Neuroscience Area of Hospital La Paz Institute for Health Research IdiPAZ, La Paz University Hospital, Universidad Aut\u00f3noma de Madrid, 28046 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1481-0018","authenticated-orcid":false,"given":"Andrea","family":"Gonzalez-Torbay","sequence":"additional","affiliation":[{"name":"Clinical Immunology Department, La Paz University Hospital, 28046 Madrid, Spain"},{"name":"Centre for Biomedical Network Research on Rare Diseases (CIBERE U767), 28029 Madrid, Spain"},{"name":"Lymphocyte Pathophysiology in Immunodeficiencies Group, La Paz Institute for Health Research (IdiPAZ), 28046 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2103-0973","authenticated-orcid":false,"given":"Claudia Geraldine","family":"Rita","sequence":"additional","affiliation":[{"name":"Clinical Immunology Department, La Paz University Hospital, 28046 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4885-0181","authenticated-orcid":false,"given":"Mireya","family":"Fern\u00e1ndez-Fournier","sequence":"additional","affiliation":[{"name":"Neurological Sciences and Cerebrovascular Research Laboratory, Department of Neurology, Neurology and Cerebrovascular Disease Group, Neuroscience Area of Hospital La Paz Institute for Health Research IdiPAZ, La Paz University Hospital, Universidad Aut\u00f3noma de Madrid, 28046 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"S\u00e1nchez Velasco","sequence":"additional","affiliation":[{"name":"Neurological Sciences and Cerebrovascular Research Laboratory, Department of Neurology, Neurology and Cerebrovascular Disease Group, Neuroscience Area of Hospital La Paz Institute for Health Research IdiPAZ, La Paz University Hospital, Universidad Aut\u00f3noma de Madrid, 28046 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beatriz","family":"Chamorro","sequence":"additional","affiliation":[{"name":"Neurological Sciences and Cerebrovascular Research Laboratory, Department of Neurology, Neurology and Cerebrovascular Disease Group, Neuroscience Area of Hospital La Paz Institute for Health Research IdiPAZ, La Paz University Hospital, Universidad Aut\u00f3noma de Madrid, 28046 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Exuperio","family":"D\u00edez-Tejedor","sequence":"additional","affiliation":[{"name":"Neurological Sciences and Cerebrovascular Research Laboratory, Department of Neurology, Neurology and Cerebrovascular Disease Group, Neuroscience Area of Hospital La Paz Institute for Health Research IdiPAZ, La Paz University Hospital, Universidad Aut\u00f3noma de Madrid, 28046 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eduardo","family":"L\u00f3pez-Granados","sequence":"additional","affiliation":[{"name":"Clinical Immunology Department, La Paz University Hospital, 28046 Madrid, Spain"},{"name":"Centre for Biomedical Network Research on Rare Diseases (CIBERE U767), 28029 Madrid, Spain"},{"name":"Lymphocyte Pathophysiology in Immunodeficiencies Group, La Paz Institute for Health Research (IdiPAZ), 28046 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,11,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1056\/NEJMra1401483","article-title":"Multiple Sclerosis","volume":"378","author":"Reich","year":"2018","journal-title":"N. 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