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Ocrevus, Rituxan & Kesimpta: How They Work and When to Use Them

Mar 25, 2024
In the world of multiple sclerosis, B cell-depleting drugs like Ocravis Cassempta Rituximab and Ubly Tuxemab are probably some of the most effective drugs used to treat the disease. How exactly do

they

work

? What exactly does a B cell depleter like ocravis do? I'm going to explain that in this video now don't walk away because all of that starts right now. Hello, thank you for learning about Ms. Aaron Boster. I'm excited to share with you in this video exactly how B cell medications

work

to treat. multiple sclerosis now, if we go back a few steps

when

I was training in medical school,

they

taught us that Ms only involved T cells, they were wrong, it turns out that B cells, which are part of the humoral component of the immune system, play an important role. a very important role in causing damage in Ms and agents that deplete B cells drugs like ocravis or okalizumab kasempta also called ufatumumab

rituxan

called rituximab I did not make these names up these drugs that deplete B cells are extremely effective in helping treat multiple sclerosis, so in this video, I'm going to break down exactly how they work.
ocrevus rituxan kesimpta how they work and when to use them
Let's start the discussion by explaining what heihei is a B cell. Then we talk about B cell exhausters. Let's make sure we understand what exactly a B cell is, so it is part of the B cell. immune system our immune system has two halves, so so to speak, the innate immune system which we're not going to talk much about today and the adaptive immune system now, if you're curious about the innate immune system, I've made videos on the topic, so I'll post a link above and you can check it out, but focusing Our discussion on the adaptive immune response, this is the part of our immune response that we have studied the most and that we understand how to manipulate the most. is related to helping Mrs., which is good now that the adaptive immune response is called adaptive because it can learn things

when

adaptive immune cells are first born, they are not sure what they want to do when they grow up, literally undifferentiated as a college freshman and as these immune cells mature, they evolve toward the adaptive response specifically targeting particular bad guys, so, for example, the adaptive cells could learn to identify and attack chickenpox and those particular cells , that's all they do, there may be other adaptive cells that evolve in maturity specifically to identify, for example, tuberculosis, so their adaptive immune response is something that learns and evolves over time.
ocrevus rituxan kesimpta how they work and when to use them

More Interesting Facts About,

ocrevus rituxan kesimpta how they work and when to use them...

Now the adaptive immune response has two halves and there are also the T cells in the B cells that we have been on. Talking about T cells for 20 or 30 years, we know that T cells are the ones that actually attack myelin and damage the nervous system; They are actually the ones that attack, but what we didn't understand until recently, All Things Considered, was the role that B cells played, so let's talk about B and T cells. Now these adaptive immune cells are born in the bone marrow, that's where they start and they don't know what they want to do and when they get a little older some of the cells leave the bone marrow and travel down the neck to the thymus and in the thymus they mature and when you mature in the thymus you are called an A T cell for the thymus, some of the cells remain in the bone marrow until they finish growing fully mature in the bone marrow B for the bone marrow, so B cells are an immune system cell that is part of the adaptive immune system, cells BNT and they are cells that fully mature in the bone marrow, that is what B cells are now.
ocrevus rituxan kesimpta how they work and when to use them
Do B cells work well? B cells have several different functions in the immune system and it is beyond the scope of this discussion to go over

them

all, but just to share the relevant ones, one of the things B cells do is make antibodies, so you have heard of antibodies for example when you get a vaccine you show your B cells the target and then a special type of B cell called a plasma cell makes a bunch of antibodies that way if you then see that infection your B cells have. it produced antibodies against infection and you can take advantage of it very quickly before continuing, do me a favor, if you like this video, please like it and if you haven't subscribed to the channel yet, consider doing so with those two actions.
ocrevus rituxan kesimpta how they work and when to use them
Show the YouTube algorithm that you really like this content and help spread it so more people affected by Ms can benefit. Thanks, another thing that B cells do a lot is irritate T cells to go fight, it's called costimulation and This is the aspect of B cell biology that we're trying to mess with when we're trying to help people. affected by Ms. So to explain this relationship between B cells and T cells in Ms. I'm going to use an analogy from a long time ago. I was in high school so I grew up in a suburb of Columbus Ohio and it was a big high school that was very overcrowded and there were a lot of people in the hallways and if two young people bumped into each other in the hallway where I came from, there was only one way to resolve it. that terrible dispute: they would meet behind building B at number 3:30 to beat each other.
I attended some of these social functions and noticed something: no young boxer shows up to defend his honor without six of his friends. behind him and what are those friends doing? They egg him on, they irritate him, they say things like go ahead, man, yell, I've got you, I'll hold your backpack, hey, if he hits you, I'll hit him, and they order him. to piss off the young man and then the two men can go and beat each other up a little now, what if one of the two young men from high school shows up to fight and looks back and doesn't have any friends he's not going to fight with suddenly not so interested, he will go home and in this analogy, the young man who fights, that is the T cell, if the T cell enters the central compartment and is stimulated appropriately, it will attack you, but it can't do it without its friends the B cells B cells are necessary to stimulate that T cell costimulate the T cell to irritate it so that it is adequately ready to attack with drugs depleted B cells, we literally kill the B cells So we kill all the friends, so when T cell enters the central compartment of the brain and spinal cord and attacks you, it does not have the costimulation of the B cells to go ahead and attack in the absence of friends, the B.
T cells, the T cells cannot attack you, so Which is really fascinating that by taking a drug that depletes B cells, we eliminate the cells that are needed to stimulate the T cells to hit you. It turns out to be very, very effective, which is kind of amazing now, how exactly do these B cell depleters deplete B cells? What do they do? All these B cell depleting drugs, okrivis cassempta

rituxan

, these drugs are monoclonal antibodies, so a monoclonal antibody is like a biological key, so imagine I'm. hold a key here this is my invisible accessory and I could hypothetically ask how many doors this key opens and the answer should be one the key is very very specific it only fits on one door so if I were to randomly walk around my neighborhood putting my key in other people's doors, I wouldn't open any, I would just open my door and a B cell depleter like okribus is a biological key, it's actually an antibody designed in a laboratory, they make an antibody and the antibody binds very, very specifically to adult B cells, so you can think of it as a key that only fits in the lock of an adult B cell, so if you take one of these B cell depleters and put it in the human body and it floats around the human body you literally can't see any cells in the body except adult B cells, so it will float past all the other cells, but when this smart key, this biological key, when this antibody sees a B cell, can join it and when it joins it tags it to die, it calls in its friends complement, which comes in and causes the B cells to die, so it will deplete the adult B cells.
Why do I keep saying adult B cells because it doesn't affect stem cells? It will grow back and that is why we take B cell depleters frequently. Medications like ocravis and rituxan that we take every six months because it takes six months for those cells to grow back. Consumpta is an injection that you apply once a month and so on for both. In some cases, we are constantly trying to deplete B cells. If you stop therapy, all of your B cells will eventually grow back because the stem cells have not been affected. Hey girl, wanna say hello to the internet?
Say hello, hello. You're a good girl, also another really very important point: the B cells that produce antibodies, the ones that fight viruses like Covid, are called plasma cells and B cell exhausters don't see plasma cells. Plasma cells evolve so that B cells a depleter like okrafis cannot see it when he receives a B cell depleter, he does not lose his existing immunity if he has received a chickenpox vaccine and then starts receiving a B cell depleter, the plasma cells that fight chickenpox do not disappear, they do not become depleted, so that immunity is maintained and that means that it is very important that we update all our vaccines before we start with B cell depletion.
Drugs that deplete cells B are some of the most effective medications I have. I have used

them

to treat multiple sclerosis, they are fascinating and I hope this video helps you better understand how they work. If you want to understand how other MS medications work, click on the video on your screen right now through next Monday morning. video or until the next time I see you on a monthly live stream or even better yet, the next time I see you at the Boston Center for Ms, this is Aaron Boster saying: take care of yourself and take care of yourself.

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