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

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

Stefan Bittner  1 , Tobias Ruck  2 , Heinz Wiendl  2 , Oliver M Grauer  2 , Sven G Meuth  2
Affiliations
Review

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

Stefan Bittner et al. Ther Adv Neurol Disord. 2017 Jan.

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.

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Conflict of interest statement

Conflict of interest statement: The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: SB has received honoraria for lecturing, travel expenses for attending meetings and financial research support from Bayer Schering AG, Biogen Idec, Merck Serono, Novartis and TEVA. TR has received travel expenses and financial research support from Genzyme and has received honoraria for lecturing from Genzyme, Biogen and Teva. OG has received honoraria for lecturing and travel expenses for attending meetings from Roche and Bristol-Myers-Squibb. HW has received honoraria for lecturing, travel expenses for attending meetings from Bayer Health Care, Biogen Idec/Elan Corporation, Lilly, Lundbeck Merck Serono, Novartis, Sanofi Aventis, and TEVA Neuroscience; has served/serves as a consultant for Biogen Idec, Merck Serono, Novartis Pharma Sanofi-Aventis; and receives research support from Bayer Schering Pharma, Biogen Idec/Elan Corporation, Merck Serono, Novartis, Novo Nordisk and Sanofi-Aventis. SGM has received honoraria for lecturing and travel expenses for attending meetings and has received financial research support from Bayer, Bayer Schering, Biogen Idec, Genzyme, Merck Serono, MSD, Novartis, Novo Nordisk, Sanofi-Aventis and Teva.

Figures

Figure 1.
Figure 1.
Pathways of B-cell differentiation and characteristic cell surface markers. Targeting of B-cell subtypes by MEDI-551, rituximab, ofatumumab, ocrelizumab and atacicept are shown. See the text for details on the therapeutics.
See this image and copyright information in PMC

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