[Rituximab and autoimmune disorders therapy].
BACKGROUND
B lymphocytes play a central role in pathogenesis of autoimmune disease. This suggests that therapies directed against B lymphocytes may be effective for the treatment of human autoimmune mediated disease.


METHODS
Rituximab is a chimeric monoclonal antibody directed against the CD20 antigen expressed on most B cells and is used to treat B cell non Hodgkin lymphoma. Rituximab is highly effective in depleting B lymphocytes in vivo. Such treatment could presumably eliminate B cells producing autoantibodies. Main mechanisms of action of Rituximab are discussed with implication in the management of autoimmune diseases.


CONCLUSIONS
Use of Rituximab for autoimmune disorders therapy is attractive because of its effect on B lymphocytes. However, therapeutics indications have to be adapted to the inherent differences in the pathogenesis of autoimmune diseases to assess efficiency.
Service de médecine interne, institut mutualiste-Montsouris, 42 boulevard Jourdan, 75014 Paris, France. laurent.quint@imm.fr
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D000305:Adrenal Cortex Hormones / Q000008:administration & dosage / Q000627:therapeutic use; D000818:Animals; D000911:Antibodies, Monoclonal / Q000008:administration & dosage / Q000009:adverse effects / Q000276:immunology* / Q000494:pharmacology / Q000627:therapeutic use*; D058846:Antibodies, Monoclonal, Murine-Derived; D018951:Antigens, CD20 / Q000276:immunology*; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use; D001327:Autoimmune Diseases / Q000188:drug therapy* / Q000276:immunology; D001402:B-Lymphocytes / Q000187:drug effects; D003520:Cyclophosphamide / Q000008:administration & dosage / Q000627:therapeutic use; D004317:Doxorubicin / Q000008:administration & dosage / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D006801:Humans; D007140:Immunoglobulin Fab Fragments / Q000276:immunology; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D007275:Injections, Intravenous; D016393:Lymphoma, B-Cell / Q000188:drug therapy; D051379:Mice; D011241:Prednisone / Q000008:administration & dosage / Q000627:therapeutic use; D000069283:Rituximab; D013997:Time Factors; D014750:Vincristine / Q000008:administration & dosage / Q000627:therapeutic use
D000305:Adrenal Cortex Hormones; D000911:Antibodies, Monoclonal; D058846:Antibodies, Monoclonal, Murine-Derived; D018951:Antigens, CD20; D000970:Antineoplastic Agents; D007140:Immunoglobulin Fab Fragments; D007166:Immunosuppressive Agents; D000069283:Rituximab; D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D011241:Prednisone