B cell targeted therapy for immunoglobulin G4-related disease
B cell targeted therapy for immunoglobulin G4-related disease
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DOI：
10.1080/25785826.2021.1886630
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发表时间：
2021-02
影响因子：
4.4
通讯作者：
M. Yamamoto
中科院分区：
文献类型：
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作者：
M. Yamamoto
摘要糖皮质激素是诱导缓解治疗免疫球蛋白（IG）G4相关疾病的一线药物。然而，单用糖皮质激素实现无药物缓解是困难的，许多患者需要糖皮质激素和免疫抑制剂的维持治疗。最近的研究发现，外周记忆B细胞和浆母细胞的数量在IgG 4相关疾病中增加，并表明利妥昔单抗的疗效，其在缓解诱导治疗中迅速降低血清IgG 4水平，并具有糖皮质激素的递减效应。利妥昔单抗已被证明比口服免疫抑制剂（如硫唑嘌呤）更能降低复发风险。然而，单用利妥昔单抗很难维持无药物缓解，许多病例需要利妥昔单抗维持治疗。本文概述了B细胞靶向治疗的潜力，重点是利妥昔单抗对IgG 4相关疾病的疗效和安全性。
Abstract Glucocorticoids are the first-line drug for the remission induction therapy of immunoglobulin (Ig) G4-related disease. Achieving drug-free remission using glucocorticoids alone is difficult, however, and many patients require maintenance therapy with glucocorticoids and immunosuppressants. Studies have recently found that the number of peripheral memory B cells and plasmablasts is increased in IgG4-related disease and have indicated the efficacy of rituximab, which, in remission induction therapy, rapidly reduces serum IgG4 levels and has the tapering effect of glucocorticoids. Rituximab has been shown to reduce the risk of relapse more than oral immunosuppressants such as azathioprine. However, maintaining drug-free remission is difficult with a single course of rituximab alone, and many cases require maintenance therapy with rituximab. This article outlines the potential of B-cell targeted therapy, focusing on the efficacy, and safety of rituximab for IgG4-related disease.