Multiple Sclerosis (MS) is a chronic autoimmune disorder of the central nervous system (CNS), characterized by inflammation, demyelination, and axonal degeneration. MS is widely considered a T cell–mediated disease that recognize myelin autoantigens. Yet the most effective treatments target CD20, a marker typically found on B cells. This paradox remains one of MS’s biggest mysteries. Our research is focused on shedding new light on this disconnect: We are actively investigating the hypothesis that current therapies work by unintentionally depleting DEs. In support of this hypothesis, DEs are highly enriched reactivities for myelin autoantigens express CD20 and are present in the cerebrospinal fluid of MS patients. If DEs prove to be a major driver of MS, our discovery paves the way for the development of targeted DE-specific therapies, offering a more precise and immune-sparing approach to treating this debilitating disease. If DEs are indeed key drivers of MS, this discovery opens the door to precision immunotherapies that target DEs specifically—offering effective treatment while preserving the rest of the immune system.
