title: Rationale of anti-CD19 immunotherapy: an option to target autoreactive plasma cells in autoimmunity.
abstract: Anti-CD20 therapy using rituximab directly targeting B cells has been approved for treatment of non-Hodgkin lymphoma, rheumatoid arthritis and anti-neutrophil cytoplasmic antibody-associated vasculitides and has led to reappreciation of B-lineage cells for anti-rheumatic treatment strategies. Moreover, blocking B-cell activating factor with belimumab, a drug that is licensed for treatment of active, seropositive systemic lupus erythematosus (SLE), represents an alternative, indirect anti-B-cell approach interfering with proper B-cell development. While these approaches apparently have no substantial impact on antibody-secreting plasma cells, challenges to improve the treatment of difficult-to-treat patients with SLE remain. In this context, anti-CD19 antibodies have the promise to directly target autoantibody-secreting plasmablasts and plasma cells as well as early B-cell differentiation stages not covered by anti-CD20 therapy. Currently known distinct expression profiles of CD19 by human plasma cell subsets, experiences with anti-CD19 therapies in malignant conditions as well as the rationale of targeting autoreactive plasma cells in patients with SLE are discussed in this review.
authors.affiliation: German Rheumatism Research Center, DRFZ, Charitéplatz 01, 10117 Berlin, Germany. mei@drfz.de
authors.forename: Henrik E
authors.initials: HE
authors.lastname: Mei
authors.forename: Stefanie
authors.initials: S
authors.lastname: Schmidt
authors.forename: Thomas
authors.initials: T
authors.lastname: Dörner
mesh_terms: D061067:Antibodies, Monoclonal, Humanized / Q000494:pharmacology; D018941:Antigens, CD19 / Q000276:immunology*; D001327:Autoimmune Diseases / Q000188:drug therapy* / Q000276:immunology; D015551:Autoimmunity / Q000276:immunology*; D006801:Humans; D007167:Immunotherapy / Q000379:methods*; D010950:Plasma Cells / Q000276:immunology*
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D018941:Antigens, CD19; C511911:belimumab