在多发性硬化症中使用ocrelizumab治疗后,在保存IgA B细胞的同时,持久的B细胞损伤
Alexandra Garcia1, Stephane Rodriguez2,3, Emilie Dugast1
1INSERM, Center for Research in Transplantation and Translational Immunology CR2TI, UMR 1064, CHU Nantes, Nantes Université, Nantes, France.
Annals of clinical and translational neurology
|August 8, 2025
概括
在复发性复发性多发性硬化症 (RR-MS) 中使用ocrelizumab (OCR) 治疗会改变B细胞配置,增加调控性B细胞. 在停止OCR后,天真B细胞以炎症特征重新出现,由更具调节性的B细胞平衡.
科学领域:
- 免疫学 免疫学 免疫学
- 神经免疫学 神经免疫学
- 多发性硬化症的病理生理学
背景情况:
- 复发性复发性多发性硬化症 (RR-MS) 是一种自身免疫性疾病,其特征是B细胞参与.
- 奥克雷利祖马布 (OCR) 是一种人性化的抗CD20单克隆抗体,通过消耗B细胞有效治疗RR-MS.
- 在OCR治疗期间和之后了解B细胞动态对于阐明疾病机制至关重要.
研究的目的:
- 评估RR-MS患者在Ocrelizumab (OCR) 治疗前,期间和之后的早期细胞B细胞概况.
- 研究OCR对B细胞子集及其表型的影响.
- 了解OCR的作用机制和多发性硬化症 (MS) 病理生理学.
主要方法:
- 用光谱流细胞测量分析了18名未接受治疗的RR-MS患者和10名健康志愿者 (HVs) 的B细胞表型.
- 在基线,经过1年OCR治疗后,以及与HVs相比,B细胞概况被评估.
- 在OCR停药后的三名患者中,使用流细胞计和单细胞RNA测序分析了B细胞复制.
主要成果:
- 基线RR-MS患者与HVs相比,IgG分泌B细胞增加.
- OCR治疗显著改变了B细胞子集比例,部分节省了IgA B细胞的记忆力.
- 在OCR停止后,重新出现的B细胞主要是具有炎症/迁移型表型的天真细胞,以及调节性B细胞的增加.
结论:
- 在剩余的B细胞中,OCR治疗促进了调节性表型.
- 在OCR停止后B细胞的补充涉及具有炎症特征的天真细胞.
- 调节性B细胞的比例增加可能会抵消OCR治疗后的炎症性B细胞复制.
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