The evidence for a role of B cells in multiple sclerosis

    loading  Checking for direct PDF access through Ovid

Abstract

Understanding the pathogenesis of complex immunologic disorders such as multiple sclerosis (MS) is challenging. Abnormalities in many different cell types are observed in the immune system and CNS of patients with MS and the identification of the primary and secondary events is difficult. Recent studies suggest that the model of MS as a disorder mediated only by T cells is overly simplistic and propose an important role for B cells in the propagation of the disease. B-cell activation in the form of oligoclonal bands (OCB) production is the most consistent immunologic finding in patients with MS. Notably, markers of B-cell activation within the CSF of patients with MS predict conversion from clinically isolated syndrome to clinically definite MS and correlate with MRI activity, onset of relapses, and disability progression. In addition, the main genetic risk factor in MS is associated with OCB production, and environmental agents associated with MS susceptibility (vitamin D and the Epstein-Barr virus) influence B-cell proliferation and function. Finally, the only cell-specific treatments that are effective in patients with MS are monoclonal antibodies targeting the B-cell antigen CD20, suggesting a potentially causative role for B cells. Based on current evidence there is no longer doubt that B cells are relevant to the etiology and pathogenesis of MS. Elucidating the role of B cells in MS will be a fruitful strategy for disease prevention and treatment.

GLOSSARY

CDMS: clinically definite multiple sclerosis

GLOSSARY

ChIP-seq: chromatin immunoprecipitation followed by massively parallel DNA sequencing

GLOSSARY

CIS: clinically isolated syndrome

GLOSSARY

EAE: experimental autoimmune encephalomyelitis

GLOSSARY

EBNA: Epstein-Barr nuclear antigen

GLOSSARY

EBV: Epstein-Barr virus

GLOSSARY

GC: germinal center

GLOSSARY

IL: interleukin

GLOSSARY

IM: infectious mononucleosis

GLOSSARY

LCL: lymphoblastoid cell line

GLOSSARY

LMP: latent membrane protein

GLOSSARY

MBP: myelin basic protein

GLOSSARY

MHC: major histocompatibility complex

GLOSSARY

MOG: myelin oligodendrocyte glycoprotein

GLOSSARY

MS: multiple sclerosis

GLOSSARY

OCB: oligoclonal bands

GLOSSARY

PLP: proteolipid protein

GLOSSARY

PPMS: primary progressive multiple sclerosis

GLOSSARY

RRMS: relapsing-remitting multiple sclerosis

GLOSSARY

SPMS: secondary progressive multiple sclerosis

GLOSSARY

Th: T helper cells

GLOSSARY

VDR: vitamin D receptor

GLOSSARY

VDRE: vitamin D responsive element

Related Topics

    loading  Loading Related Articles