B cell-targeted therapies in autoimmunity: rationale and progress.
B cells are recognized as main actors in the autoimmune process. Autoreactive B cells can arise in the bone marrow or in the periphery and, if not properly inhibited or eliminated, can lead to autoimmune diseases through several mechanisms: autoantibody production and immune complex formation, cytokine and chemokine synthesis, antigen presentation, T cell activation, and ectopic lymphogenesis. The availability of agents capable of depleting B cells (that is, anti-CD20 and anti-CD22 monoclonal antibodies) or targeting B cell survival factors (atacicept and belimumab) opens new perspectives in the treatment of diseases such as systemic lupus erythematosus, rheumatoid arthritis, type 1 diabetes, and multiple sclerosis.
Fiorina
Paolo
P
Transplantation Research Center, Children's Hospital and Brigham & Women's Hospital, Harvard Medical School 221 Longwood Ave, Boston, MA 02115 USA.
Sayegh
Mohamed H
MH