BartsMS, Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, 4 Newark Street, London E1 2AT, United Kingdom.
BartsMS, Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, 4 Newark Street, London E1 2AT, United Kingdom.
Mult Scler Relat Disord. 2019 Oct;35:19-25. doi: 10.1016/j.msard.2019.06.030. Epub 2019 Jun 26.
There is increasing evidence that agents that target peripheral B cells and in some instances plasma cells can exhibit marked effects on relapsing multiple sclerosis. In addition, B cells, including plasma cells, within the central nervous system compartment are likely to play an important role in disease progression in both relapsing and progressive MS. However, current B cell-targeting antibodies may not inhibit these, because of poor penetration into the central nervous system and often oligoclonal bands of immunoglobulin persist within the cerebrospinal fluid despite immunotherapy. Through targeting B cells and plasma cells in the CNS, it may be possible to obtain additional benefit above simple peripheral depletion of B cells. As such there are a number of inhibitors of B cell function and B cell depleting agents that have been developed for myeloma and B cell leukaemia and lymphoma, which could potentially be used off-label or as an experimental treatment for advanced (progressive) MS.
越来越多的证据表明，靶向外周 B 细胞的药物在某些情况下对浆细胞有明显的效果，可用于治疗复发性多发性硬化症。此外，中枢神经系统内的 B 细胞（包括浆细胞）可能在复发和进展性多发性硬化症的疾病进展中发挥重要作用。然而，由于目前的 B 细胞靶向抗体难以穿透中枢神经系统，而且尽管进行了免疫治疗，脑脊液中仍经常存在免疫球蛋白的寡克隆带，因此这些抗体可能无法抑制这些 B 细胞和浆细胞。通过靶向中枢神经系统中的 B 细胞和浆细胞，有可能在单纯外周 B 细胞耗竭的基础上获得额外的益处。因此，有许多针对骨髓瘤和 B 细胞白血病和淋巴瘤的 B 细胞功能抑制剂和 B 细胞耗竭剂已被开发出来，这些药物可能可以在标签外使用，或作为晚期（进展性）多发性硬化症的实验性治疗方法。
