eligibility_summary
Adults ≥18 with active MS (≥1 enhancing lesion in past 6 mo), treatment‑naïve except relapse therapies, starting high‑efficacy DMT (e.g., ocrelizumab/natalizumab), able to consent, normal labs within 3 mo. Exclude: TSPO low‑binding genotype, tracer hypersensitivity, PET/CT/MRI contraindications, eGFR<60, severe claustrophobia, pregnancy/breastfeeding, radiation therapy, insulin‑dependent diabetes, LP contraindications/anticoagulation, serious comorbidity, >5 rem/yr research radiation.
trial_source
clinical_trials.gov from Dec 2, 2025
annotation_status
ai
ai_summary
Observational RRMS study using PET/MRI and CSF single-cell RNA-seq before/after high-efficacy DMT to characterize smoldering inflammation. Interventions/drugs: • [11C]-CS1P1 (PET radiotracer) targets sphingosine-1-phosphate receptor-1 (S1P1) to image S1P1 signaling linked to lymphocyte trafficking and endothelial/glial pathways. • [11C]-DPA-713 (PET radiotracer) is a TSPO ligand to quantify microglial/macrophage activation. • [18F]-FDG (PET radiotracer) measures glucose metabolism. • Anti-CD20 MS treatment (e.g., ocrelizumab, monoclonal antibody) depletes CD20+ B cells to suppress adaptive immunity, natalizumab (monoclonal antibody) blocks α4-integrin (VLA-4) to prevent leukocyte CNS entry. Targeted cells/pathways: B cells (CD20), leukocyte trafficking (α4-integrin, S1P1), microglia/macrophages (TSPO), and lesion/tissue metabolism.