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. 2011 Jan;227(1):19-23.
doi: 10.1016/j.expneurol.2010.10.009. Epub 2010 Oct 20.

Glatiramer acetate for treatment of MS: regulatory B cells join the cast of players

Luc Van Kaer  1
Affiliations

Glatiramer acetate for treatment of MS: regulatory B cells join the cast of players

Luc Van Kaer. Exp Neurol. 2011 Jan.

Abstract

Glatiramer acetate (GA, copolymer-1, Copaxone) is a Food and Drug Administration-approved drug for the treatment of relapsing-remitting multiple sclerosis (MS). However, its mechanism of action remains ill-defined. The available evidence indicates that GA induces antigen-presenting cells with anti-inflammatory properties and promotes the generation of immunoregulatory T cells that suppress pathogenic T cells. A new study by Kala et al. (2010) now shows that B lymphocytes, which are best known for their antibody-secreting properties, contribute to the beneficial effects of GA against experimental autoimmune encephalomyelitis (EAE), the animal model of MS. This commentary discusses these new findings in the context of the pathogenesis of MS and EAE, the emerging immunoregulatory role of B cells in autoimmunity, and the relevance of B cells as targets for immunotherapy in MS.

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Figures

Fig. 1
Fig. 1
Proposed role for B cells in the protective effects of GA in CNS autoimmunity. Based on the studies of Kala et al. (2010), a model is proposed for the role of IL-10-producing Bregs in the mechanism of action of GA in EAE and MS. GA induces a regulatory phenotype in B cells that is likely independent of their specificity for GA. These IL-10-producing Bregs might suppress autoimmunity in multiple ways, by (1) inhibiting the pathogenic activity of myelin antigen-specific Th1 and Th17 cells, (2) promoting the generation of Th2 cells (and possibly Foxp3-expressing Tregs), which, in turn, suppress pathogenic Th1 and Th17 cells through “bystander suppression,” and (3) suppressing the capacity of APCs to induce pathogenic T cells. It is unclear whether these proposed mechanisms are restricted to the periphery or occur in the CNS as well. Abbreviations: Ig, immunoglobulin; MHC II, MHC class II; TCR, T cell receptor.
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