Successful treatment of refractory anterior scleritis in primary Sjogren's syndrome with rituximab
Successful treatment of refractory anterior scleritis in primary Sjogren's syndrome with rituximab
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DOI：
10.1136/ard.2004.027128
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发表时间：
2005-07-01
影响因子：
27.4
通讯作者：
Gross, WL
中科院分区：
文献类型：
--
作者：
Ahmadi-Simab, K;Lamprecht, P;Gross, WL
讨论利妥昔单抗介导的CD20阳性细胞的杀伤是由几种机制引起的，包括补体依赖性细胞毒性，抗体依赖性细胞介导的细胞毒性和诱导细胞凋亡。4利妥昔单抗诱导恶性B细胞淋巴瘤的缓解。5临床研究结果、动物模型数据和体外实验表明，B细胞在许多风湿性疾病如类风湿性关节炎和原发性干燥综合征中起关键作用。利妥昔单抗成功地诱导了许多难治性系统性红斑狼疮、皮肌炎和丙型肝炎病毒相关的冷球蛋白血症性血管炎的缓解。6-8与利妥昔单抗的免疫抑制组合治疗也诱导难治性类风湿性关节炎的缓解。9 B细胞可能在原发性干燥综合征中起重要作用。异位淋巴组织形成和淋巴组织增生是原发性干燥综合征的标志。干燥综合征患者发生恶性B细胞淋巴瘤的风险增加近40倍。在原发性干燥综合征中观察到B细胞室的改变。在原发性干燥综合征中，循环记忆CD 27 + B细胞显著减少，记忆B细胞在唾液腺中蓄积。10
DISCUSSION Killing of CD20 positive cells mediated by rituximab is caused by several mechanisms, including complement dependent cytotoxicity, antibody dependent cell mediated cytotoxicity, and induction of apoptosis. 4 Rituximab induces remission of malignant B cell lymphomas. 5 Clinical findings, data from animal models, and in vitro experiments suggest that B cells have a pivotal role in a number of rheumatic conditions such as rheumatoid arthritis and primary Sjögren’s syndrome.Rituximab successfully induced remission in a number of cases of refractory systemic lupus erythematosus, dermatomyositis, and cryoglubulinaemic vasculitis associated with hepatitis C virus. 6–8 An immunosuppressive combination treatment with rituximab also induces remission in refractory rheumatoid arthritis. 9 B cells may play an important part in primary Sjögren’s syndrome. Ectopic lymphoid tissue formation and lymphoproliferation are a hallmark of primary Sjögren’s syndrome. The risk for malignant B cell lymphoma is increased nearly 40-fold in patients with Sjögren’s syndrome. Alterations in the B cell compartment have been noted in primary Sjögren’s syndrome. A significant reduction in circulating memory CD27+ B cells and accumulation of memory B cells in the salivary glands is seen in primary Sjögren’s syndrome. 10