Dubey Divyanshu, Forsthuber Thomas, Flanagan Eoin P, Pittock Sean J, Stüve Olaf
Department of Neurology (D.B., E.P.F., S.J.P.), and Department of Laboratory Medicine and Pathology (S.J.P.), Mayo Clinic, Rochester, MN; Department of Biology (T.F.), University of Texas at San Antonio; Department of Neurology and Neurotherapeutics (O.S.), University of Texas Southwestern Medical Center, Dallas; Neurology Section (O.S.), VA North Texas Health Care System, Dallas VA Medical Center, TX; and Department of Neurology (O.S.), Klinikum rechts der Isar, Technische Universität München, Germany.
Neurol Neuroimmunol Neuroinflamm. 2017 Oct 23;4(6):e405. doi: 10.1212/NXI.0000000000000405. eCollection 2017 Nov.
In recent years, there has been a significant increase in the therapeutic options available for the management of relapsing forms of MS. Therapies primarily targeting B cells, including therapeutic anti-CD20 monoclonal antibodies, have been evaluated in phase I, phase II, and phase III clinical trials. Results of these trials have shown their efficacy and relatively tolerable adverse effect profiles, suggesting a favorable benefit-to-risk ratio. In this review, we discuss the pathogenic role of B cells in MS and the rationale behind the utilization of B-cell depletion as a therapeutic cellular option. We also discuss the data of clinical trials for anti-CD20 antibodies in relapsing forms of MS and existing evidence for other B-cell-directed therapeutic strategies.
近年来,用于治疗复发型多发性硬化症(MS)的治疗选择显著增加。主要靶向B细胞的疗法,包括治疗性抗CD20单克隆抗体,已在I期、II期和III期临床试验中进行了评估。这些试验的结果显示了它们的疗效和相对可耐受的不良反应,表明其效益风险比良好。在本综述中,我们讨论了B细胞在MS中的致病作用以及将B细胞清除作为一种治疗性细胞选择的基本原理。我们还讨论了复发型MS抗CD20抗体的临床试验数据以及其他B细胞导向治疗策略的现有证据。