Mease Philip J
Seattle Rheumatology Associates, Seattle, Washington 98104, USA.
J Rheumatol. 2008 Jul;35(7):1245-55.
B cells play a critical role in the pathogenesis of rheumatoid arthritis (RA) and other autoimmune diseases. Recently, a number of biologic agents that target B cells have been tested as therapies for these conditions. These agents either deplete B cells, by targeting cell-surface antigens such as CD20, or block B cell function, for example by inhibiting the activity of B cell survival factors such as BLyS. Of this group of agents, the first in clinical use has been rituximab, a chimeric monoclonal antibody that depletes B cells by binding to the CD20 cell-surface antigen. Initially introduced as a treatment for non-Hodgkin's lymphoma, rituximab is now approved for the treatment of RA. In this review we explore the rationale behind B cell-targeted therapy, highlight the results of clinical trials with rituximab in RA and other autoimmune diseases, and describe other emerging therapies directed at B cells.
B细胞在类风湿关节炎（RA）及其他自身免疫性疾病的发病机制中起关键作用。最近，许多靶向B细胞的生物制剂已作为这些病症的治疗方法进行了测试。这些制剂要么通过靶向细胞表面抗原（如CD20）来消耗B细胞，要么通过抑制B细胞存活因子（如BLyS）的活性等方式来阻断B细胞功能。在这组制剂中，首个用于临床的是利妥昔单抗，它是一种嵌合单克隆抗体，通过与CD20细胞表面抗原结合来消耗B细胞。利妥昔单抗最初作为非霍奇金淋巴瘤的治疗药物引入，现在已被批准用于治疗RA。在本综述中，我们探讨了B细胞靶向治疗背后的基本原理，强调了利妥昔单抗在RA和其他自身免疫性疾病中的临床试验结果，并描述了其他针对B细胞的新兴疗法。
