B cell activating factor, its role in autoimmunity, and targeting in autoimmune diseases.

B cell activation factor (BAFF), a recently identified member of the tumour necrosis factor (TNF) family, is a key survival factor during B cell maturation and is essential for the development of B cell tolerance. Breakdown of the regulation of BAFF expression results in excessive BAFF production that impairs B cell tolerance and leads to autoimmune phenomena. Consistent with this, BAFF levels are elevated in plasma of patients with various autoimmune diseases. BAFF is considered to be one of the principal factors that regulate the size and composition of B cell compartment. BAFF acts as an important driving factor for B cell hyperplasia and autoantibody production in autoimmune processes. Thus BAFF has become a very attractive target for the treatment of autoimmune diseases with an altered B cell function. Results of clinical trials have confirmed a crucial role of BAFF in the pathogenesis of rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE). BAFF inhibitors in the treatment of RA, SLE and other autoimmune diseases are under intensive investigation. However, BAFF biology remains poorly understood. Nonetheless, results of the ongoing studies may enable the development of a new generation of BAFF inhibitors with more selective efficacy and increased safety (Fig. 2, Ref. 92). Full Text (Free, PDF) www.bmj.sk.