B-cell antigen presentation in central nervous system autoimmunity

The role of B cells in central nervous system (CNS) autoimmunity was initially highlighted by successful clinical trials of anti-CD20 monoclonal antibodies in multiple sclerosis (MS). Research in MS as well as in aquaporin 4 (AQP4)-IgG+ neuromyelitis optica (NMO) and myelin oligodendrocyte glycoprotein (MOG) antibody-associated disorder (MOGAD) has expanded our appreciation of the contribution of B cells in multiple CNS autoimmune diseases. B cells have multiple functions in the initiation and propagation of CNS autoimmunity that extend beyond autoantibody production, including bidirectional interactions with T cells via B-cell antigen presentation. A deeper understanding of the cooperation between B cells and T cells in MS, NMO, and MOGAD should permit the development of more effective therapies across CNS autoimmune disorders.