Highlights
- •Immunoglobulins in oligoclonal bands secreted by plasma cells in the CNS can contribute to worsening pathology in MS.
- •Secreted immunoglobulin can interact with microglial Fc receptors in an antigen non-specific manner.
- •Microglia and astrocytes may create a survival niche for long-term plasma cell survival.
- •Plasma cells, microglia and astrocytes may interact to establish a locally neurotoxic or dystrophic environment.
- •Bruton's tyrosine kinase inhibitors may be therapeutic agents for the potential elimination of plasma cells and OCB from the CNS in MS.
Abstract
Since their discovery, the existence of secreted oligoclonal immunoglobulin in the
central nervous system in people with multiple sclerosis has been the subject of scientific
investigation and debate over several decades. Although autoantibodies can be detected
in some individuals, probably secondary to release of neo-antigens after damage, evidence
for a major, primary involvement of damaging antibodies is still relatively lacking.
However, it is possible to construct a working hypothesis that establishes the interaction
of plasma cells, which are the source of oligoclonal bands, microglia and astrocytes
to create a self-perpetuating activated phenotype. This may generate an environment
conducive to long-term plasma cell survival and the initiation and perpetuation of
neurotoxicity that may contribute to disease worsening in multiple sclerosis. Therapeutic
strategies to re-establish a homeostatic environment conducive to repair/recovery
are indicated to control progressive multiple sclerosis.
Keywords
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Article info
Publication history
Published online: July 19, 2018
Accepted:
July 16,
2018
Received in revised form:
July 13,
2018
Received:
May 1,
2018
Identification
Copyright
Crown Copyright © 2018 Published by Elsevier B.V. All rights reserved.
