Rituximab and its potential for the treatment of rheumatoid arthritis.
Rituximab and its potential for the treatment of rheumatoid arthritis.
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DOI：
10.2147/tcrm.2006.2.2.207
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发表时间：
2006-06-01
影响因子：
2.8
通讯作者：
Moore, John
中科院分区：
文献类型：
--
作者：
Bryant, Adam;Moore, John
类风湿性关节炎（RA）是一种慢性全身性炎症性疾病，可导致关节变形和一系列关节外表现。疾病控制不佳可能导致功能障碍和丧失独立性。近年来，B细胞在RA发病机制中的重要作用已被提出。两个主要的理论已被假定来解释类风湿因子（RF）在RA炎症过程中的作用和RF过度产生的原因：耐受性丧失模型和自主突变的B细胞模型。考虑到这一点，已经采用了包括使用抗CD20抗体利妥昔单抗的策略来耗尽B细胞。利妥昔单抗导致补体介导的B细胞裂解以及抗体依赖性细胞毒性。据推测，利妥昔单抗也可能引发RA的细胞凋亡，并改变B细胞对抗原和其他刺激的反应能力。最近几项使用利妥昔单抗的研究表明RA活性显著下降，为B细胞在RA中的作用提供了证据。利妥昔单抗似乎是增加类风湿关节炎患者治疗选择的主要补充。
Rheumatoid arthritis (RA) is a chronic systemic inflammatory disorder which causes deforming joint disease and a spectrum of extraarticular manifestations. Poor disease control may lead to functional impairment and loss of independence. In recent times a prominent role for B cells in the pathogenesis of RA has been suggested. Two major theories have been postulated to explain the role of rheumatoid factor (RF) in the RA inflammatory process and the reason for RF overproduction; the loss of tolerance model and the autonomous mutated B cell model. With this in mind, strategies have been adopted to deplete B cells including the use of the anti-CD20 antibody rituximab. Rituximab leads to complement mediated lysis of B cells as well as antibody-dependant cellular cytotoxicity. It has been hypothesized that rituximab may also initiate apoptosis in RA and alter the ability of B cells to respond to antigen and other stimuli. Several recent studies using rituximab have demonstrated significant declines in RA activity providing evidence for the role of B cells in RA. Rituximab would appear to be a major addition to the increasing therapeutic options for sufferers of RA.