Differential Effects of MS Therapeutics on B Cells-Implications for Their Use and Failure in AQP4-Positive NMOSD Patients.
Jan TraubSilke Häusser-KinzelMartin S WeberPublished in: International journal of molecular sciences (2020)
B cells are considered major contributors to multiple sclerosis (MS) pathophysiology. While lately approved disease-modifying drugs like ocrelizumab deplete B cells directly, most MS medications were not primarily designed to target B cells. Here, we review the current understanding how approved MS medications affect peripheral B lymphocytes in humans. These highly contrasting effects are of substantial importance when considering these drugs as therapy for neuromyelitis optica spectrum disorders (NMOSD), a frequent differential diagnosis to MS, which is considered being a primarily B cell- and antibody-driven diseases. Data indicates that MS medications, which deplete B cells or induce an anti-inflammatory phenotype of the remaining ones, were effective and safe in aquaporin-4 antibody positive NMOSD. In contrast, drugs such as natalizumab and interferon-β, which lead to activation and accumulation of B cells in the peripheral blood, lack efficacy or even induce catastrophic disease activity in NMOSD. Hence, we conclude that the differential effect of MS drugs on B cells is one potential parameter determining the therapeutic efficacy or failure in antibody-dependent diseases like seropositive NMOSD.
Keyphrases
- multiple sclerosis
- mass spectrometry
- ms ms
- peripheral blood
- disease activity
- white matter
- rheumatoid arthritis
- systemic lupus erythematosus
- end stage renal disease
- small molecule
- newly diagnosed
- chronic kidney disease
- prognostic factors
- ejection fraction
- magnetic resonance imaging
- dendritic cells
- climate change
- artificial intelligence
- human health
- data analysis