Mani Laila-Yasmin, Vogt Bruno, Burnier Michel, Golshayan Déla
Service de néphrologie et consultation d'hypertension, Département de médecine, CHUV, 1011 Lausanne.
Rev Med Suisse. 2011 Apr 13;7(290):819-24.
Autoimmune glomerulopathies are an important cause of chronic kidney disease. Conventional treatments based on steroids, antiproliferative and cytotoxic agents are efficacious, but highly toxic. Because of their central role in the pathogenesis of autoimmunity, B cells have become an attractive therapeutic target. Rituximab is a monoclonal antibody directed against CD20 expressed on the surface of B cells, inducing profound depletion of B cells in the peripheral blood. In spite of encouraging results regarding the off-label use of Rituximab in membranous nephropathy, systemic lupus erythematosus and small vessel vasculitis, controlled, long-term data, and data with specific renal endpoints are currently lacking.
自身免疫性肾小球病是慢性肾脏病的重要病因。基于类固醇、抗增殖和细胞毒性药物的传统治疗方法有效，但毒性很大。由于B细胞在自身免疫发病机制中起核心作用，它们已成为一个有吸引力的治疗靶点。利妥昔单抗是一种针对B细胞表面表达的CD20的单克隆抗体，可导致外周血中B细胞显著减少。尽管利妥昔单抗在膜性肾病、系统性红斑狼疮和小血管血管炎中的非标签使用取得了令人鼓舞的结果，但目前缺乏对照的长期数据以及具有特定肾脏终点的数据。
