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B-cell depletion therapy for multiple sclerosis.

Yusei Miyazaki1, Masaaki Niino2

  • 1Department of Neurology, National Hospital Organization Hokkaido Medical Center, Sapporo, Japan.

Immunological Medicine
|July 21, 2021
PubMed
Summary

B cells play a key role in multiple sclerosis (MS) pathology through antibody-dependent and independent mechanisms. B-cell depletion therapy targeting CD20+ B cells is effective in both relapsing and progressive MS.

Keywords:
Anti-CD20 antibodyB cellscoronavirus diseasemultiple sclerosisprogressive multifocal leukoencephalopathy

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Area of Science:

  • Neuroimmunology
  • Autoimmune diseases
  • Cellular immunology

Background:

  • B cells were historically implicated in multiple sclerosis (MS) via autoantibody production.
  • Emerging evidence shows B cells contribute to MS relapses through antigen presentation and cytokine release.
  • B cell-rich structures in the meninges suggest roles in progressive MS.

Purpose of the Study:

  • To review the evolving understanding of B cell roles in multiple sclerosis (MS) pathogenesis.
  • To highlight the efficacy of B-cell depletion therapy in different MS phases.

Main Methods:

  • Review of historical observations and recent findings on B cell functions in MS.
  • Analysis of clinical trial data for B-cell depletion therapies.

Main Results:

  • B cells contribute to MS through antibody-independent mechanisms.
  • B cell-rich meningeal structures are observed in progressive MS.
  • B-cell depletion therapy (anti-CD20) shows efficacy in relapsing and primary progressive MS.

Conclusions:

  • B cells are critical players in both relapsing and progressive MS.
  • B-cell depletion therapy represents a significant advancement in MS treatment.
  • Targeting B cells offers a unique therapeutic strategy for MS.