MOA of B cell Therapy in MS

[@ashkandehqani2454]

The video was good! But there's a question, CD20 isn't expressed on plasma cells so how the mAb against CD20 is effective in the therapy of MS? Because IgGs which are found in CSF, are secreted by plasma cells.

[@dragonflymoonrunner872]

No mention of EBV B cell takeover. So this is not helpful.

[@jamesbowman7963]

Thank you... There is a very recent study that hypothesizes that the reason for the efficacy of CD20 targeting B cell therapy is that it eliminates the last place that Epstein Barr Virus in the body in its latent/semi-latent state and that is our B cells. The correlation between EBV and MS is exceedingly strong, not because everyone who contracts EBV gets MS but rather because those that don't do not get MS. So clearly EBV is a critical component and yet is working in conjunction with other genetic or environmental factors like HHV6 for instance. So T cells actually are the destroyer of Myelin not B cells, but the T cells are targeting a defective protein from EBV that is in B cells. It is more complicated but essentially that is the process. Now there are also OTC medicines that activate Myelin producing genes. If the EBV is either eradicated or greatly impaired and we can ramp up myelin production via clemastine fumerate, metronidazole, ketones etc... then perhaps we go from reducing progression to repair and healing and function.