Figure 3.

Mechanism of action for the therapeutics discussed in NMO section. Lines ending with a flat dash indicate an inhibitory effect, and lines ending with an arrow indicate a positive/stimulating effect. Cinryze (a C1-esterase inhibitor), Eculizumab (monoclonal antibody inhibitor against C5), and Ravulizumab (a second-generation monoclonal antibody inhibitor against C5) are all complement inhibitors. Anti-apoptotic (A1AT) inhibits plasminogen activators, as well as elastases which are important for neutrophil activation. Rituximab and Ublituximab are anti-CD20 monoclonal antibodies that target and eliminate B cells. Inebilizumab is an anti-CD19 monoclonal antibody that also targets B cells. MMF is an immunosuppressant that blocks the proliferation of many cell types, mainly B and T lymphocytes. Immunoadsorption and plasma exchange has multiple effects, including the elimination of activated complement proteins, pathogenic antibodies and pro-inflammatory cytokines. All drawings of cells/molecules used in this figure were obtained and modified from Servier Medical Art by Servier, licensed under a Creative Commons Attribution 3.0 Unported License (https://smart.servier.com/).