B-Cell Therapies in Relapsing Remitting and Primary Progressive Multiple Sclerosis: A Short Clinical Review

The history of multiple sclerosis (MS) has been focused primarily on T cells. Nevertheless, T lymphocytes directed approaches miss to understand the complexity underlying the progressive disease. Novel evidences triggered both laboratory and clinical research in an attempt to pursue this possible mechanism of action and improve therapeutic options for patients with MS. For several years, there have been hints that B cells play an important role in MS pathophysiology, but only recently has interest increased in the role of B cell-directed therapies in MS. With anti-B-cell treatment, part of the immune repertoire is targeted, but not completely in the lymph nodes or tissues. This does not seem to compromise the physiologic activity of our immune system. Surprisingly, it seems possible to deplete B cells without compromising normal immune reactivity. In this short review, these novel approaches are illustrated, and the new intriguing opportunities offered by B-cell directed therapy are summarized.