Multiple sclerosis (MS) was previously thought to be a T-cell-mediated, demyelinating disease of the central nervous system. Disease-modifying therapies targeting T cells have, indeed, shown remarkable efficacy in patients with relapsing-remitting MS. However, these therapies do also target B cells, and a B-cell-depleting monoclonal antibody (ocrelizumab) has recently been approved for MS therapy and is efficacious not only in relapsing forms of MS but also in some patients with primary progressive MS. This suggests that B cells may play a more important role in the pathogenesis of MS than previously appreciated. We review the potential roles of B cells, which are the precursors of antibody-secreting plasma cells in the pathogenesis of MS. Furthermore, we provide an overview of the characteristics and clinical data for the four monoclonal antibodies (ocrelizumab, ofatumumab, rituximab, and ublituximab) that have been approved, are currently been used off-label or are being investigated as treatments for MS. These antibodies all target the cluster of differentiation (CD)-20 molecule and bind to distinct or overlapping epitopes on B cells and a subset of T cells that express CD20. This leads to B-cell depletion and, possibly, to depletion of CD20-positive T cells. The net result is strong suppression of clinical and radiological disease activity as well as slowing of the development of persisting neurological impairment.

中文翻译：

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用于复发性和进行性多发性硬化的抗CD20单克隆抗体。

多发性硬化症（MS）以前被认为是T细胞介导的中枢神经系统脱髓鞘疾病。实际上，针对T细胞的疾病改良疗法在复发缓解型MS患者中已显示出显着的疗效。然而，这些疗法也确实针对B细胞，并且最近已批准消耗B细胞的单克隆抗体（ocrelizumab）用于MS治疗，不仅对复发型MS有效，而且对某些原发性进行性MS患者有效。这表明B细胞在MS的发病机理中可能比以前认识的更重要。我们回顾了B细胞的潜在作用，B细胞是MS发病机理中分泌抗体的浆细胞的前体。此外，我们提供了已获批准，目前已在标签外使用或正在作为MS治疗方法的四种单克隆抗体（ocrelizumab，ofatumumab，rituximab和ublituximab）的特征和临床数据的概述。这些抗体均靶向分化（CD）-20分子簇，并与表达CD20的B细胞和一部分T细胞上不同或重叠的表位结合。这导致B细胞耗竭，并可能导致CD20阳性T细胞耗竭。最终结果是强烈抑制了临床和放射疾病的活动，并减缓了持续性神经功能缺损的发展。这些抗体均靶向分化（CD）-20分子簇，并与表达CD20的B细胞和一部分T细胞上不同或重叠的表位结合。这导致B细胞耗竭，并可能导致CD20阳性T细胞耗竭。最终结果是强烈抑制了临床和放射疾病的活动，并减缓了持续性神经功能缺损的发展。这些抗体均靶向分化（CD）-20分子簇，并与表达CD20的B细胞和一部分T细胞上不同或重叠的表位结合。这导致B细胞耗竭，并可能导致CD20阳性T细胞耗竭。最终结果是强烈抑制了临床和放射疾病的活动，并减缓了持续性神经功能缺损的发展。