B cell-targeted therapy with rituximab and autoimmune neuromuscular disorders.
B lymphocytes play a central role in the pathogenesis of autoimmunity, so that B cell suppression is considered a potential treatment option for immune-mediated diseases. Rituximab, a chimeric anti-human CD20 antibody, is the only anti-B cell biological agent presently under study for the treatment of autoimmune neuromuscular diseases. Isolated case histories and series, pilot and retrospective studies report on the experimental administration of rituximab as treatment of a variety of immune-mediated neuropathy syndromes, treatment-refractory myasthenia gravis and inflammatory myopathies. Rituximab was used as monotherapy or in combination with other types of immunomodulation, and was well tolerated. The mechanism whereby B cell depletion shows benefit is uncertain and may vary depending on the inherent differences in the pathogenesis of various autoimmune neuromuscular disorders.
Stübgen
Joerg-Patrick
JP
Department of Neurology and Neuroscience, Weill Medical College of Cornell University/New York Presbyterian Hospital, 525 East 68th Street, New York, NY 10065-4897, USA. pstuebge@med.cornell.edu
D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D058846:Antibodies, Monoclonal, Murine-Derived; D018951:Antigens, CD20 / Q000276:immunology; D001327:Autoimmune Diseases / Q000150:complications / Q000188:drug therapy*; D001402:B-Lymphocytes / Q000187:drug effects / Q000276:immunology*; D006801:Humans; D007155:Immunologic Factors / Q000627:therapeutic use*; D009468:Neuromuscular Diseases / Q000150:complications / Q000188:drug therapy*; D000069283:Rituximab
D000911:Antibodies, Monoclonal; D058846:Antibodies, Monoclonal, Murine-Derived; D018951:Antigens, CD20; D007155:Immunologic Factors; D000069283:Rituximab