Wootla Bharath, Denic Aleksandar, Keegan B Mark, Winters Jeffrey L, Astapenko David, Warrington Arthur E, Bieber Allan J, Rodriguez Moses
Department of Neurology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
Neurol Res Int. 2011;2011:780712. doi: 10.1155/2011/780712. Epub 2011 Sep 22.
The pathogenesis of multiple sclerosis (MS) remains elusive. Recent reports advocate greater involvement of B cells and immunoglobulins in the initiation and propagation of MS lesions at different stages of their ontogeny. The key role of B cells and immunoglobulins in pathogenesis was initially identified by studies in which patients whose fulminant attacks of demyelination did not respond to steroids experienced remarkable functional improvement following plasma exchange. The positive response to Rituximab in Phase II clinical trials of relapsing-remitting MS confirms the role of B cells. The critical question is how B cells contribute to MS. In this paper, we discuss both the deleterious and the beneficial roles of B cells and immunoglobulins in MS lesions. We provide alternative hypotheses to explain both damaging and protective antibody responses.
多发性硬化症（MS）的发病机制仍不清楚。最近的报告主张，在MS病变发生发展的不同阶段，B细胞和免疫球蛋白发挥着更大的作用。B细胞和免疫球蛋白在发病机制中的关键作用最初是通过研究确定的，在这些研究中，暴发性脱髓鞘发作对类固醇无反应的患者在进行血浆置换后功能有显著改善。复发缓解型MS的II期临床试验中对利妥昔单抗的阳性反应证实了B细胞的作用。关键问题是B细胞如何导致MS。在本文中，我们讨论了B细胞和免疫球蛋白在MS病变中的有害和有益作用。我们提供了替代假说，以解释破坏性和保护性抗体反应。
