The rationale for B lymphocyte depletion in Graves' disease. Monoclonal anti-CD20 antibody therapy as a novel treatment option.
We have reviewed the immunology of thyroid autoimmunity with special reference to the importance of B lymphocytes (B cells) in thyroidal and extrathyroidal Graves' disease (GD), thus providing a framework for the hypothesis that B cell depletion may be beneficial in GD. Additionally, after reviewing the efficacy and safety in other autoimmune diseases, we propose that treatment with the B cell-depleting agent Rituximab may become a clinically relevant treatment option in selected cases of GD, particularly when complicated with thyroid-associated ophthalmopathy.
El Fassi
Daniel
D
Department of Endocrinology and Metabolism, Odense University Hospital, Denmark. fassi@dadlnet.dk
Nielsen
Claus H
CH
Hasselbalch
Hans C
HC
Hegedüs
Laszlo
L
D000911:Antibodies, Monoclonal / Q000276:immunology* / Q000627:therapeutic use*; D018951:Antigens, CD20 / Q000276:immunology; D006111:Graves Disease / Q000188:drug therapy* / Q000276:immunology*; D006801:Humans; D008212:Lymphocyte Depletion / Q000379:methods*; D013961:Thyroid Gland / Q000276:immunology
D000911:Antibodies, Monoclonal; D018951:Antigens, CD20