B cells in multiple sclerosis

Abstract

B cells are a crucial arm of the adaptive immune system best known for their ability to produce antibodies that mediate humoral immunity toward pathogens. From a therapeutic point of view, B cells, and their antibody products produced by terminally differentiated plasma cells, are important targets for treatment: Promoting antibody production is a cornerstone of vaccine development, whereas B cell depleting agents using antibody-based therapies have been employed in various autoimmune diseases, including Multiple Sclerosis (MS). It is now appreciated that B cells have important functions beyond antibody production. This is particularly true in MS where B cells have been shown to produce both pro- and anti-inflammatory cytokines and can also function as antigen presenting cells. A better appreciation for the heterogeneity of B cells in the context of homeostasis and disease will allow us to design superior therapies for the treatment of MS. This Chapter focuses on the role of B cells in MS, beginning with a review of B cell development, homeostasis, activation and effector functions, then detailing the role of B cells in MS and its animal model (Experimental Autoimmune Encephalomyelitis – EAE), followed by descriptions of antibody-independent B cell functions and a perspective on how these may be exploited for design of superior treatments for people living with MS.