Marinaki S, Skalioti C, Boletis J N
Department of Nephrology and Renal Transplant Unit, General Hospital 'Laiko', Athens, Greece.
Nephron Extra. 2013 Dec 31;3(1):125-30. doi: 10.1159/000356050. eCollection 2013 Jan.
B cells play a central role in the pathogenesis of many autoimmune diseases. Selective targeting can be achieved with the use of the monoclonal antibody rituximab. In addition to being a drug for non-Hodgkin's lymphoma, rituximab is also an FDA-approved treatment for refractory rheumatoid arthritis and, since recently, ANCA vasculitis. It has shown efficacy in many autoimmune diseases. This review will discuss current evidence and the rationale of the use of rituximab in glomerular diseases, including randomized controlled trials. The focus will be on the use of rituximab in idiopathic membranous nephropathy, systemic lupus erythematosus and ANCA-associated vasculitis. The emerging role of rituximab in renal transplantation, where it seems to be important for the desensitization protocols for highly sensitized patients as well as for the preconditioning of ABO-incompatible recipients and the treatment of antibody-mediated rejection, will also be addressed.
B细胞在许多自身免疫性疾病的发病机制中起核心作用。使用单克隆抗体利妥昔单抗可实现选择性靶向治疗。除了作为治疗非霍奇金淋巴瘤的药物外，利妥昔单抗还是美国食品药品监督管理局（FDA）批准的用于治疗难治性类风湿关节炎的药物，并且最近也被用于治疗抗中性粒细胞胞浆抗体（ANCA）血管炎。它在许多自身免疫性疾病中已显示出疗效。本综述将讨论利妥昔单抗在肾小球疾病中应用当前的证据及理论依据，包括随机对照试验。重点将放在利妥昔单抗在特发性膜性肾病、系统性红斑狼疮和ANCA相关血管炎中的应用。利妥昔单抗在肾移植中的新作用也将被探讨，在肾移植中，它对于高度致敏患者的脱敏方案以及ABO血型不相容受者的预处理和抗体介导的排斥反应的治疗似乎都很重要。
