Die Relevanz einer B-Zell-abhängigen Immunpathologie für die Multiple Sklerose

Zusammenfassung

Die Immunpathologie der Multiplen Sklerose (MS) ist bis heute nicht vollständig verstanden. Im Mittelpunkt der vorliegenden Arbeit stehen die B-Lymphozyten, die als Produzenten von Autoantikörpern und durch die Fähigkeit zur Präsentation von Antigenen eine Schlüsselstellung einnehmen können, jedoch bislang in ihrer Bedeutung für die MS unterschätzt wurden. Auch wird die Bildung von ektopen B-Zell-Follikeln im ZNS und deren mögliche Korrelation mit dem Krankheitsverlauf und Schweregrad diskutiert. Nicht zuletzt sollen regulatorische Aspekte einer B-Zell-abhängigen Pathologie erwähnt werden. Ein umfassendes Verständnis der komplexen Immunprozesse der MS kann Therapien hervorbringen, die spezifisch in die Pathogenese eingreifen. Ansatzpunkte einer B-Zell-orientierten Therapie werden im Folgenden erörtert. Insgesamt soll dieser Übersichtsartikel dazu anstoßen, bestehende Paradigmen der Erkrankung zu überdenken und die Rolle der B-Lymphozyten bei der MS zu würdigen.

Abstract

In spite of keen clinical and neuroscientific interest, the aetiology and immunopathology of multiple sclerosis (MS) remain to be elucidated. The present work seeks to give insight into the important, but thus far underestimated contribution of B cells to the disease. Emphasis will be placed on the role of B cells as producers of autoantibodies and as antigen presenting cells. In addition, the development of ectopic B cell follicles in the CNS and their potential correlation with the course of the disease and MS severity will be discussed. Finally, regulatory functions of a B cell-dependent immunopathology should be mentioned. A better understanding of the complex pathomechanisms of MS will allow for therapeutic options that are causative. Potential targets of a B cell-oriented therapy will be delineated in the following review. We hereby aim at triggering a critical re-evaluation of traditional paradigms assigned to MS, appreciating the importance of B cells in the disease.

Schlüsselwörter

Antikörper - Autoimmunität - B-Lymphozyten - EAE - MS

Keywords

antibodies - autoimmunity - B cells - EAE - MS

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