Targeting B cells in relapsing-remitting multiple sclerosis: from pathophysiology to optimal clinical management

Ther Adv Neurol Disord. 2017 Jan;10(1):51-66. doi: 10.1177/1756285616666741. Epub 2016 Sep 2.

Abstract

Multiple sclerosis (MS) is a chronic inflammatory demyelinating disease that is caused by an autoimmune response against central nervous system (CNS) structures. Traditionally considered a T-cell-mediated disorder, the contribution of B cells to the pathogenesis of MS has long been debated. Based on recent promising clinical results from CD20-depleting strategies by three therapeutic monoclonal antibodies in clinical phase II and III trials (rituximab, ocrelizumab and ofatumumab), targeting B cells in MS is currently attracting growing interest among basic researchers and clinicians. Many questions about the role of B and plasma cells in MS remain still unanswered, ranging from the role of specific B-cell subsets and functions to the optimal treatment regimen of B-cell depletion and monitoring thereafter. Here, we will assess our current knowledge of the mechanisms implicating B cells in multiple steps of disease pathology and examine current and future therapeutic approaches for the treatment of MS.

Keywords: B lymphocytes; dosage regime; monitoring; multiple sclerosis; ocrelizumab; ofatumumab; rituximab.

Publication types

  • Review