Liossis Stamatis-Nick C, Sfikakis Petros P
Division of Rheumatology, Department of Internal Medicine, University of Patras Medical School, 26504 Rion, Patras, Greece.
Clin Immunol. 2008 Jun;127(3):280-5. doi: 10.1016/j.clim.2008.01.011. Epub 2008 Mar 11.
Peripheral B cell depletion strategies have been employed recently in the treatment of systemic autoimmune diseases and the initial clinical results have been encouraging. Although the major target of rituximab-based treatments was to reduce the levels of circulating autoantibodies, additional mechanisms of action may operate. Recent studies have addressed the question of potential effects of transient B cell depletion on other, non-B cell populations. The data, albeit uncontrolled, suggest that anti-CD20 monoclonal antibody treatment is associated with significant effects in the T cell pool, whereas individual clinical responses do not always correlate with changes in autoantibody titers. More specifically, it has been reported that rituximab administration may decrease the activated phenotype of peripheral and tissue-resident T cells by abolishing antigen presentation by B cells, and may enhance the numbers and function of regulatory T cells. In this review we analyze and discuss available data emerging from B cell depletion studies in patients with systemic lupus erythematosus, rheumatoid arthritis and other autoimmune conditions. Further controlled studies are needed to confirm the role of B cell depletion in modifying T cell function in vivo.
外周B细胞清除策略最近已被应用于系统性自身免疫性疾病的治疗，初步临床结果令人鼓舞。尽管基于利妥昔单抗的治疗的主要目标是降低循环自身抗体水平，但可能还有其他作用机制。最近的研究探讨了短暂性B细胞清除对其他非B细胞群体的潜在影响问题。这些数据虽然未经对照，但表明抗CD20单克隆抗体治疗与T细胞库中的显著效应相关，而个体临床反应并不总是与自身抗体滴度的变化相关。更具体地说，有报道称，利妥昔单抗给药可能通过消除B细胞的抗原呈递来降低外周和组织驻留T细胞的活化表型，并可能增加调节性T细胞的数量和功能。在这篇综述中，我们分析和讨论了系统性红斑狼疮、类风湿关节炎和其他自身免疫性疾病患者B细胞清除研究中出现的现有数据。需要进一步的对照研究来证实B细胞清除在体内调节T细胞功能中的作用。
