[HTML][HTML] Memory B cells are major targets for effective immunotherapy in relapsing multiple sclerosis

D Baker, M Marta, G Pryce, G Giovannoni… - …, 2017 - thelancet.com
EBioMedicine, 2017thelancet.com
Although multiple sclerosis (MS) is considered to be a CD4, Th17-mediated autoimmune
disease, supportive evidence is perhaps circumstantial, often based on animal studies, and
is questioned by the perceived failure of CD4-depleting antibodies to control relapsing MS.
Therefore, it was interestingly to find that current MS-treatments, believed to act via T cell
inhibition, including: beta-interferons, glatiramer acetate, cytostatic agents, dimethyl
fumarate, fingolimod, cladribine, daclizumab, rituximab/ocrelizumab physically, or …
Abstract
Although multiple sclerosis (MS) is considered to be a CD4, Th17-mediated autoimmune disease, supportive evidence is perhaps circumstantial, often based on animal studies, and is questioned by the perceived failure of CD4-depleting antibodies to control relapsing MS. Therefore, it was interestingly to find that current MS-treatments, believed to act via T cell inhibition, including: beta-interferons, glatiramer acetate, cytostatic agents, dimethyl fumarate, fingolimod, cladribine, daclizumab, rituximab/ocrelizumab physically, or functionally in the case of natalizumab, also depleted CD19+, CD27+ memory B cells. This depletion was substantial and long-term following CD52 and CD20-depletion, and both also induced long-term inhibition of MS with few treatment cycles, indicating induction-therapy activity. Importantly, memory B cells were augmented by B cell activating factor (atacicept) and tumor necrosis factor (infliximab) blockade that are known to worsen MS. This creates a unifying concept centered on memory B cells that is consistent with therapeutic, histopathological and etiological aspects of MS.
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