Anolik Jennifer, Sanz Iñaki, Looney R John
Department of Medicine: Immunology and Rheumatology, University of Rochester School of Medicine, 601 Elmwood Avenue, Box 695, Rochester, NY 14642, USA.
Curr Rheumatol Rep. 2003 Oct;5(5):350-6. doi: 10.1007/s11926-003-0020-x.
There is a growing body of experimental evidence that B lymphocytes play a central role in the pathogenesis of systemic lupus erythematosus (SLE). B cells are, by definition, the precursors of antibody-secreting cells, and thus are the source of pathogenic autoantibodies. However, recent data indicate that B cells are not merely the passive producers of immunoglobulins, but also play a central role in autoimmunity via nonconventional mechanisms, including autoantigen presentation and modulation of other immune cells. Thus, B lymphocyte depletion has recently emerged as a promising therapeutic approach to the treatment of autoimmune diseases, including SLE. Rituximab is a chimeric mouse-human monoclonal antibody against the B cell-specific antigen CD20, which selectively and profoundly depletes B lymphocytes and has been widely used to treat B cell lymphomas. Recent open-label studies indicate that rituximab is safe and may be efficacious in the treatment of SLE, and continued study with randomized clinical trials is justified.
越来越多的实验证据表明，B淋巴细胞在系统性红斑狼疮（SLE）的发病机制中起核心作用。根据定义，B细胞是抗体分泌细胞的前体，因此是致病性自身抗体的来源。然而，最近的数据表明，B细胞不仅是免疫球蛋白的被动生产者，还通过非传统机制在自身免疫中起核心作用，包括自身抗原呈递和对其他免疫细胞的调节。因此，B淋巴细胞耗竭最近已成为治疗包括SLE在内的自身免疫性疾病的一种有前景的治疗方法。利妥昔单抗是一种针对B细胞特异性抗原CD20的嵌合鼠源-人源单克隆抗体，它能选择性且显著地耗竭B淋巴细胞，并已广泛用于治疗B细胞淋巴瘤。最近的开放标签研究表明，利妥昔单抗在治疗SLE方面是安全的且可能有效，因此有理由通过随机临床试验继续进行研究。
