Neurológia pre prax 6/2022

Biologics targeting CD20 molecule on B cells in the therapy of multiple sclerosis patients

B cells are substantially contributing into the adverse inflammatory reaction mediated by abnormally polarized Th1 and Th2 subsets of T cells in the immunopathogenesis of multiple sclerosis (MS). B cells are able to recognize (auto)antigens via specific receptors. Activation and clonal expansion of B cells is in addition supported by PRR receptors identifying damage associated molecular patterns (DAMP) and(or) patterns of microbial invasion (PAMP). Ectopic highly organized lymphatic tissue are found in CNS of MS patients. B cells are potent antigen presenting cells stimulating specific T cells thus contributing to their clonal expansion and abnormal functional polarisation. B cells are also producing the whole spectrum of cytokines. The substantial role of B cells in the immunopathogenesis of multiple sclerosis is evidenced using animal models. However, the ultimate evidence addressing the participation of B cells in the immunopathogenesis of MS is given by very positive response induced in MS patients who are treated with biologics targeting CD20 molecule on B cells. Currently, ocrelizumab and ofatumumab are monoclonal antibodies approved for treatment of MS patients.

Keywords: multiple sclerosis, adverse inflammation, B cells, biologics antiCD20