Are autoantibodies the targets of B-cell-directed therapy?
Are autoantibodies the targets of B-cell-directed therapy?
复制标题
DOI：
10.1038/nrrheum.2011.108
复制
发表时间：
2011-09
影响因子：
33.7
通讯作者：
D. Pisetsky;A. Grammer;Tony C. Ning;P. Lipsky
中科院分区：
文献类型：
--
作者：
D. Pisetsky;A. Grammer;Tony C. Ning;P. Lipsky
B细胞导向疗法--使用消除B细胞或阻断对B细胞功能重要的细胞因子的药物--正在成为治疗风湿性疾病的一种有希望的方法。包括系统性红斑狼疮（SLE）在内的靶疾病显示出自身抗体产生和B细胞异常活化的不同模式。尽管这种一般方法取得了成功，但B细胞定向治疗改善疾病的机制以及自身抗体作为临床反应生物标志物的作用仍不清楚。重要的是，虽然B细胞定向治疗可以减少一些自身抗体的产生，但效果可能是可变的和异质的，可能反映了不同B细胞和浆细胞群体在自身抗体产生中的关键（但不明确）作用。需要在这些药物的临床试验期间进行未来的研究，以确定哪些B细胞和自身抗体群体受到影响（或应该受到影响），并发现可用于推进这种治疗方法的临床反应的信息性生物标志物。
B-cell-directed therapy—the use of agents that eliminate B cells or block cytokines important for B-cell function—is emerging as a promising approach to the treatment of rheumatic disease. Target diseases, including systemic lupus erythematosus (SLE), display diverse patterns of autoantibody production and aberrant activation of B cells. Despite the success of this general approach, the mechanisms by which B-cell-directed therapy ameliorates disease, and the role of autoantibodies as biomarkers of clinical response remain unclear. Importantly, although B-cell-directed therapy can reduce the production of some autoantibodies, the effects can be variable and heterogeneous, probably reflecting the critical (but ill-defined) roles of different B-cell and plasma cell populations in autoantibody production. Future studies during clinical trials of these agents are needed to define which B-cell and autoantibody populations are affected (or ought to be), and to discover informative biomarkers of clinical response that can be used to advance this therapeutic approach.