Immunological Predictors of Dimethyl Fumarate-Induced Lymphopenia

Ann Neurol. 2022 May;91(5):676-681. doi: 10.1002/ana.26328. Epub 2022 Mar 4.


Treatment with dimethyl fumarate (DMF) leads to lymphopenia and infectious complications in a subset of patients with multiple sclerosis (MS). Here, we aimed to reveal immune markers of DMF-associated lymphopenia. This prospective observational study longitudinally assessed 31 individuals with MS by single-cell mass cytometry before and after 12 and 48 weeks of DMF therapy. Employing a neural network-based representation learning approach, we identified a CCR4-expressing T helper cell population negatively associated with relevant lymphopenia. CCR4-expressing T helper cells represent a candidate prognostic biomarker for the development of relevant lymphopenia in patients undergoing DMF treatment. ANN NEUROL 2022;91:676-681.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Dimethyl Fumarate / adverse effects
  • Humans
  • Immunosuppressive Agents / adverse effects
  • Lymphopenia* / chemically induced
  • Multiple Sclerosis* / chemically induced
  • Multiple Sclerosis* / drug therapy
  • Multiple Sclerosis, Relapsing-Remitting* / drug therapy
  • Prospective Studies


  • Immunosuppressive Agents
  • Dimethyl Fumarate