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B cells in multiple sclerosis therapy—A comprehensive review
Author(s) -
Rahmanzadeh R.,
Weber M. S.,
Brück W.,
Navardi S.,
Sahraian M. A.
Publication year - 2018
Publication title -
acta neurologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.967
H-Index - 95
eISSN - 1600-0404
pISSN - 0001-6314
DOI - 10.1111/ane.12915
Subject(s) - ofatumumab , ocrelizumab , rituximab , multiple sclerosis , cd20 , immunology , medicine , monoclonal antibody , b cell , cd19 , natalizumab , antibody , pathogenesis , monoclonal , monoclonal antibody therapy , antigen , b cell activating factor
For decades, B cells were ignored in multiple sclerosis ( MS ) pathogenesis, and the disease was always regarded as a T cell‐mediated disorder. Recent evidence shows that there is an antigen‐driven B‐cell response in the central nervous system of patients with MS , and memory B cells/plasma cells are detectable in MS lesions. The striking efficacy of B cell‐depleting therapies in reducing the inflammatory activity of the disease highlights that B cells may play more pathogenetic roles than expected. B cells express several unique characteristic markers on their surface, for example, CD 19, CD 20 molecules, that provide selective targets for monoclonal antibodies. In this respect, several B cell‐targeted therapies emerged, including anti‐ CD 20 antibodies (rituximab, ocrelizumab, and ofatumumab), anti‐ CD 19 antibody (inebilizumab), and agents targeting the BAFF / APRIL signaling pathway (atacicept, belimumab, and LY 2127399). In this review, we discuss, in detail, the immunobiology of B cells and their protective and destructive roles in MS pathogenesis. In the second part, we list the completed and ongoing clinical trials investigating the safety and efficacy of B cell‐related monoclonal antibodies in MS .