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Clin Rev Allergy Immunol. 2008 Feb;34(1):74-9. doi: 10.1007/s12016-008-8074-1.

Rituximab: beyond simple B cell depletion.

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Division of Clinical Immunology and Allergy, Bnai Zion Medical Center, Technion, Rappaport Faculty of Medicine, Haifa, P.O.B. 4940, Israel.


Rituximab, a chimeric anti-CD20 monoclonal antibody, has a proven track record for over a decade in the treatment of lymphomas, where it has been used to eradicate malignant lymphocytes. In appreciation of the putative role of B cells, especially with respect to autoantibody production, in the pathogenesis of autoimmune diseases, successful trials of B-cell depletion therapy in RA, SLE, and other autoimmune diseases have been carried out. In these trials, clinical benefit has generally correlated with the extent and duration of B-cell depletion, but at times imperfectly, and autoantibody reduction only selectively. Additional mechanisms whereby rituximab may assert its clinical benefit in autoimmune diseases have been examined including a look at B-cell functions as T-cell modulator and antigen-presenting cell, T-regulatory cell behavior, NK cell activity, and macrophage activities in immune inflammation. The available data on rituximab's action in autoimmune diseases is reviewed.

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