B-Cell Therapies in Multiple Sclerosis

Cold Spring Harb Perspect Med. 2019 Feb 1;9(2):a032037. doi: 10.1101/cshperspect.a032037.

Abstract

B cells play a vital function in multiple sclerosis (MS) pathogenesis through an array of effector functions. All currently approved MS disease-modifying therapies alter the frequency, phenotype, or homing of B cells in one way or another. The importance of this mechanism of action has been reinforced with the successful development and clinical testing of B-cell-depleting monoclonal antibodies that target the CD20 surface antigen. Ocrelizumab, a humanized anti-CD20 monoclonal antibody, was approved by the Food and Drug Administration (FDA) in March 2017 after pivotal trials showed dramatic reductions in inflammatory disease activity in relapsing MS as well as lessening of disability progression in primary progressive MS. These and other clinical studies place B cells at the center of the inflammatory cascade in MS and provide a launching point for development of therapies that target selective pathogenic B-cell populations.

Publication types

  • Review

MeSH terms

  • Antibodies, Monoclonal, Humanized / administration & dosage
  • Antibodies, Monoclonal, Humanized / adverse effects
  • Antibodies, Monoclonal, Humanized / pharmacology*
  • Antigens, CD20 / immunology
  • B-Lymphocytes / immunology*
  • Disease Progression
  • Humans
  • Immunologic Factors / administration & dosage
  • Immunologic Factors / adverse effects
  • Immunologic Factors / pharmacology*
  • Interferons / administration & dosage
  • Interferons / adverse effects
  • Interferons / pharmacokinetics*
  • Multiple Sclerosis / drug therapy*

Substances

  • Antibodies, Monoclonal, Humanized
  • Antigens, CD20
  • Immunologic Factors
  • Interferons