CD20+ T Cells in Multiple Sclerosis: From Pathogenesis to Treatment-Induced Depletion.

Area of Science:

• Neuroimmunology
• Cellular Immunology
• Autoimmune Diseases

Background:

• Multiple sclerosis (MS) is traditionally viewed as T cell-mediated.
• Effectiveness of anti-CD20 monoclonal antibodies (mAbs) challenges this, as CD20 is also on T cells.
• CD20+ T cells exhibit pro-inflammatory and CNS-invasive characteristics.

Purpose of the Study:

• To review current knowledge on CD20+ T cells in MS.
• To discuss their identification, characterization, and depletion by disease-modifying treatments (DMTs).
• To explore their pathogenetic role and therapeutic implications in MS.

Main Methods:

• Literature review of clinical and preclinical studies.
• Analysis of data on CD20 expression on T cells in MS patients.
• Examination of the impact of anti-CD20 therapies on CD20+ T cells.

Main Results:

• CD20+ T cells are present in MS brain lesions and experimental models.
• These cells show increased pro-inflammatory and migratory potential.
• Depletion of CD20+ T cells by DMTs is observed in MS patients.

Conclusions:

• CD20+ T cells are implicated in MS pathogenesis.
• Their depletion likely contributes to the efficacy of anti-CD20 therapies.
• Further research is needed to clarify their origin and precise role.