Meinl Edgar, Krumbholz Markus, Hohlfeld Reinhard
Department of Neuroimmunology, Max-Planck-Institute of Neurobiology, Martinsried, Munich, Germany.
Ann Neurol. 2006 Jun;59(6):880-92. doi: 10.1002/ana.20890.
B cells have long played an enigmatic role in the scenario of multiple sclerosis pathogenesis. This review summarizes recent progress in our understanding of B-cell trafficking, survival, and differentiation in the central nervous system (CNS). We propose four possible routes of intrathecal immunoglobulin-producing cells. The inflammatory CNS provides a unique, B-cell-friendly environment, in which B lineage cells, notably long-lived plasma cells, can survive for many years, perhaps even for a lifetime. These new findings offer a plausible explanation for the notorious persistence and stability of cerebrospinal fluid oligoclonal bands. Furthermore, we highlight similarities and differences of intrathecal immunoglobulin production in multiple sclerosis patients and patients with other CNS inflammatory conditions. Finally, we outline the possibly double-edged effects of B cells and immunoglobulin in the CNS and discuss various therapeutic strategies for targeting the B-cell response.
在多发性硬化症发病机制中，B细胞长期以来一直扮演着神秘的角色。本综述总结了我们对中枢神经系统（CNS）中B细胞迁移、存活和分化的最新认识进展。我们提出了鞘内产生免疫球蛋白细胞的四种可能途径。炎症性中枢神经系统提供了一个独特的、对B细胞友好的环境，在这个环境中，B淋巴细胞，尤其是长寿浆细胞，可以存活多年，甚至可能终身存活。这些新发现为脑脊液寡克隆带臭名昭著的持久性和稳定性提供了一个合理的解释。此外，我们强调了多发性硬化症患者和其他中枢神经系统炎症性疾病患者鞘内免疫球蛋白产生的异同。最后，我们概述了B细胞和免疫球蛋白在中枢神经系统中可能的双刃剑效应，并讨论了针对B细胞反应的各种治疗策略。
