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[B-cell Depletion Therapy in Multiple Sclerosis].

Yusei Miyazaki1, Masaaki Niino

  • 1Departments of Neurology, Hokkaido Medical Center.

Brain and Nerve = Shinkei Kenkyu No Shinpo
|November 13, 2018
PubMed
Summary

B cells play a key role in multiple sclerosis (MS) pathology through antibody-dependent and independent mechanisms. B-cell depletion therapy, like ocrelizumab, is effective for both relapsing and progressive MS.

Area of Science:

  • Neuroimmunology
  • Autoimmune Diseases
  • Cellular Immunology

Background:

  • B cells have long been implicated in multiple sclerosis (MS) pathogenesis via autoantibody production.
  • Emerging evidence highlights antibody-independent B cell functions, such as antigen presentation and cytokine release, contributing to MS.
  • B cell-rich structures in the meninges suggest roles in progressive MS.

Purpose of the Study:

  • To review the multifaceted roles of B cells in multiple sclerosis.
  • To discuss the clinical efficacy of B-cell depletion therapies in MS management.

Main Methods:

  • Review of historical observations and recent clinical trial data.
  • Analysis of B cell functions in MS pathogenesis.
  • Evaluation of B-cell depletion therapy outcomes.

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Main Results:

  • B cells contribute to MS through both antibody-dependent and antibody-independent mechanisms.
  • B-cell depletion therapy with ocrelizumab demonstrates significant efficacy in relapsing-remitting and primary progressive MS.
  • Ocrelizumab is approved for treating these MS forms, showing a favorable benefit-risk profile.

Conclusions:

  • B cells are critical players in MS, with diverse pathogenic roles.
  • B-cell depletion therapy represents a significant therapeutic advance for MS patients.
  • Targeting B cells offers a viable strategy for managing both relapsing and progressive forms of MS.