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       #Post#: 982--------------------------------------------------
       B cells can drive inflammation in MS
       By: agate Date: October 23, 2015, 3:20 pm
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       Indexed but not abstracted in PubMed, October 23, 2015. The
       article below is from The Scientist (October 21):
       [quote]B Cells Can Drive Inflammation in MS
       Researchers identify a subset of proinflammatory
       cytokine-producing B cells that may spark multiple
       sclerosis-related inflammation.
       By Anna Azvolinsky | October 21, 2015
       A type of B cell that produces the inflammation-inducing
       cytokine granulocyte macrophage–colony stimulating factor
       (GM-CSF) may be key to driving disease-causing inflammation and
       relapses in multiple sclerosis (MS), according to research
       published today (October 21) in Science Translational Medicine.
       The results of the study, in which researchers examined blood
       samples from MS patients, suggest a possible mechanism as to why
       B cell-targeted therapies have been found to be efficacious for
       the disease.
       “This is an important paper and among the first to study the
       role of B cells in MS, which has predominantly been studied from
       a T cell perspective,” said Claudia Mauri, a professor of
       immunology at the University College London who was not involved
       in the work.
       In MS, immune cells attack the protective myelin coating that
       surrounds nerve fibers that branch out from neurons, leading to
       difficulties in walking and balance, muscle spasms, numbness,
       and other symptoms resulting from faulty communication between
       the central nervous system (CNS) and the rest of the body. Among
       the cells of the adaptive immune system implicated in the
       disease, T cells have been most studied because they outnumber B
       cells in MS lesions and because of their dominant role in
       experimental autoimmune encephalomyelitis, the most commonly
       used mouse model of the human disease.
       Previously, antibody-mediated depletion of B cells was shown to
       reduce new inflammation in patients with relapsing MS. Recent
       clinical trial results showed that the anti-CD20 antibody,
       ocrelizumab, significantly reduced new CNS inflammation and
       relapse in MS patients and progression in those with gradually
       worsening disease. “The [positive results] of this antibody
       treatment are surprising and this paper may show why this
       treatment works so well in people,” said Ari Waisman, a
       professor at the Medical University of Mainz in Germany, who
       penned an accompanying perspective.
       While B cells are best known for making antibodies, the benefit
       of B cell depletion in limiting MS relapse is likely unrelated
       to this function since the abnormal antibodies present in the
       spinal fluid of MS patients do not change following the
       effective B cell depletion therapy, according to study coauthor
       Amit Bar-Or, a neurologist and neuroimmunologist at the Montreal
       Neurological Institute and Hospital in Canada. To study the role
       of B cells in MS beyond antibody generation, Bar-Or and his
       colleagues analyzed B cells extracted from blood draws of 35 MS
       patients and 35 healthy volunteers. The researchers identified a
       population of memory B cells that expressed GM-CSF and were more
       frequent and active in the blood MS patients compared to that of
       controls. These B cells derived from MS patients could also
       stimulate a switch in macrophages to become proinflammatory,
       which is thought in turn to activate MS-promoting T cells.
       In the blood of MS patients, depleting B cells with another
       anti-CD20 antibody, rituximab, resulted in detection of more
       macrophages that were anti- rather than proinflammatory.
       Sampling blood in these patients after their B cell pool had
       been repopulated revealed both a persistent reduction in the
       number of detected GM-CSF producing B cells and an
       anti-inflammatory effect on macrophages suggesting a shift in
       the balance between anti- and proinflammatory immune cells that
       might provide a benefit for MS patients. “It appears that in
       addition to removing pro-inflammatory B cells, both the B cells
       generated after therapy and the macrophages are less
       inflammatory,” Bar-Or told The Scientist.
       The team also uncovered the signaling mechanism that underlies
       the generation of the GM-CSF expressing B cells, which could be
       useful for identifying targeted approaches to selectively
       inhibit these cells, according to Bar-Or.
       While these cells appear to play a potentially important role in
       the disease, these results do not show that these B cells are
       pathogenic or causative in MS, Anne Cross, a professor of
       neurology at the Washington University School of Medicine in St.
       Louis who studies the pathology of MS using mouse models but was
       not involved in the work, noted in an email.
       The study raises many questions on the pathogenesis of MS and
       immune function in general. Cross said she would like to see
       whether the disproportionate presence of this GM-CSF-producing B
       cell subset may be a general characteristic of other autoimmune
       or inflammatory diseases. Bar-Or and his colleagues plan to
       investigate this question, as well as whether these cells may be
       a useful biomarker for MS relapse.
       Another question, according to Mauri, is whether these newly
       identified cells produce other cytokines and signaling
       molecules. How these B cells potentially influence the activity
       of MS-promoting T cells is also not clear. “The immune system is
       very complex. All cells communicate and influence each other in
       a tissue-dependent way,” said Mauri. “This study should raise
       more interest for other researchers to study the role of B cells
       in immune diseases.”
       _______________________
       R. Li et al., “Pro-inflammatory GM-CSF–producing B cells in
       multiple sclerosis and B cell depletion therapy,” Science
       Translational Medicine, doi:10.1126/scitranslmed.aab4176,
       2015.[/quote]
       The article can be seen here
  HTML http://www.the-scientist.com/?articles.view/articleNo/44289/title/B-Cells-Can-Drive-Inflammation-in-MS/.
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