Multiple sclerosis (MS) is a chronic disease of the central nervous system (CNS).1 MS disease symptoms vary in severity and include but are not limited to
limb weakness or paralysis, speech disorders, vision
impairment, cognitive disorders, and pain.1,2 MS typically presents in early adulthood and is more frequent
in women. 3,4
A hallmark of MS is aberrant immune responses
resulting in the destruction of neuronal cell myelin sheathing, compromising conductivity.5 It also leads to axonal
damage, the loss of oligodendrocytes (myelin producing cells), and astrocytic gliosis.6 Underlying this pathology are the chronically activated immune cells, including
T and B cells that recognize host antigens as foreign (loss of
tolerance).7-10 Hence, inhibition of activated autoreactive
T and B cells is an important strategy with marked potential for the development of MS treatment.
IMMUNE SYSTEM HOMEOSTASIS
Normally, immune responses are tightly controlled and
result in acute, transient e;ects speci;c to a foreign pathogen.11,12 Invading viruses, bacteria, fungi, and parasites are
recognized as foreign by an array of pattern recognition
receptors expressed on the surface of dendritic cells and
macrophages, which initiates the non-speci;c, rapidly-acti-vated innate immune response.13 ;is recognition initiates
a series of signals that result in the activation of other components of the innate immune system, including granulocytes, macrophages, dendritic cells, and natural killer cells.12
Macrophages are phagocytic cells that clear cellular debris
from the body. Natural killer cells recognize and induce
lysis or apoptosis of target cells.12
Dendritic cells process protein antigens to produce
short peptides, which are presented on major histocom-
patibility complex (MHC) molecules (types I and II).
This supplement is sponsored by Sano; Genzyme.
Dr. Gudesblatt reports that he has received honorarium from or served as a consultant to: AbbVie Inc; Biogen; EMD Serono, Inc.; Sano;-Genzyme;
Lundbeck; Mallinckrodt Pharmaceuticals; Medtronic; Novartis Pharmaceuticals Corporation; Roche; and Teva Pharmaceuticals USA. He has served
on the science advisory board for Spastic Paraplegia Foundation and received research support from Biogen, Sano;-Genzyme, and Teva.
Dr. Markovic-Plese reports that she is on the advisory boards for Chugai Pharma USA, Inc., and Sano;-Genzyme. She has received research grant
support from Biogen; Chugai Pharma USA, Inc.; EMD Serono, Inc.; Sano;-Genzyme; and Novartis Pharmaceuticals Corporation.
Dr. Wiendl reports that he is a consultant for Biogen; Merck Serono; Novartis Pharmaceuticals Corporation; Roche Pharma; and Sano;-Genzyme. He
serves on scienti;c advisory boards/steering committees for Bayer Healthcare; Biogen; Sano;-Genzyme; Merck Serono; Novartis; Roche Pharma;
Sano;-Genzyme; and Teva Pharmaceuticals Industries, Ltd. Dr. Wiendl received speaker honoraria and travel support from Bayer Vital GmbH; Bayer
Schering AG; Biogen; CSL Behring; EMD Serono; Fresenius Medical Care; Merck Serono; Omnia-Med; Novartis; Sano; Aventis; Sano;-Genzyme; and
Teva. He has received research support from Bayer Healthcare; Bayer Vital; Biogen; Merck Serono; Novartis; Sano;-Genzyme; Sano; US; and Teva.
Targeting T and B Cells as a
Therapeutic Approach for
MARK GUDESBLATT, MD
South Shore Neurologic
Patchogue, New York
SILVA MARKOVIC-PLESE, MD, PHD
Department of Neurology, Microbiology
UNC School of Medicine
Chapel Hill, North Carolina
HEINZ WIENDL, MD, PhD
Department of Neurology
University of Münster