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Curr Opin Rheumatol. 2014 Mar;26(2):228-36. doi: 10.1097/BOR.0000000000000000.

B cells: depletion or functional modulation in rheumatic diseases.

Author information

1
aDepartment of Rheumatology and Clinical Immunology, CC12 Department of Medicine, Deutsches Rheuma-Forschungszentrum Berlin, Charité - Universitätsmedizin Berlin, Berlin, Germany bNIAMS, NIH, Bethesda, Maryland, USA.

Abstract

PURPOSE OF REVIEW:

The availability of drugs directly and indirectly targeting the B cells has refocussed attention on the role of B lymphocytes in rheumatic autoimmune/inflammatory diseases (RAIDs), but their distinct therapeutic potential for certain diseases remains to be further assessed.

RECENT FINDINGS:

Although additional drugs are currently in clinical development targeting surface molecules (CD19, CD20, CD22, etc.) and cytokines (IL-6, IL-21, BAFF and APRIL) with key effects on B cell/plasma cell survival and differentiation, respectively, recent studies have also provided further insights into the effects of currently available drugs on protective immunity and mechanisms of the initiation and progression of RAIDs (i.e. rituximab, belimumab, mycophenolate and azathioprine). A key aspect of B-cell-directed drugs is their impact on continuous immune activation and chronic maintenance which may differ between individual RAIDs.

SUMMARY:

The translational advances in the area of B-cell-depleting therapies and more sophisticated approaches to modulate key B-cell functions, such as blocking B-cell receptor downstream effects, interfering with the differentiation and survival of antigen-experienced memory B and plasma cells are of central interest. Differences in the efficacy and safety profiles of B-cell depletion compared with B-cell-modulating therapies (including antigen-specific tolerance induction) need to be further delineated.

PMID:
24126901
DOI:
10.1097/BOR.0000000000000000
[Indexed for MEDLINE]

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