title: B-cell-targeted therapy in adult glomerulonephritis.
abstract: BACKGROUND
  There are many mechanisms through which B lymphocytes have been implicated in the pathogenesis of glomerulonephritis. There are a number of trials and clinical studies in glomerulonephritis involving depletion of CD20(+) B lymphocytes using rituximab. Newer anti-CD20 agents are currently under evaluation, as are drugs targeting alternative B-cell targets such as B lymphocyte stimulator. Such selective, targeted B-cell therapies, if shown to be effective, may be of value in minimising toxicity from more conventional agents.
  
  
  METHODS
  This article reviews the role of B cells as a target for therapy in adult renal disease resulting from primary glomerulonephritis and that occurring secondary to systemic disease. It will not address intracellular signalling or co-stimulatory pathways as therapeutic targets.
  
  
  CONCLUSIONS
  There are indications for B-cell targeted therapies in a number of adult glomerulonephritides, with varying degrees of evidence. Further understanding of the mechanisms of B-cell depletion and repletion, and interplay with B-cell survival factors, is necessary in order to identify patients who will respond favourably.
authors.affiliation: Wellcome Trust Clinical Research Training Fellow, Imperial College London, Department of Medicine, Renal and Vascular Inflammation Section , Hammersmith Campus, Du Cane Road, London W12 0NN , UK.
authors.forename: Anisha
authors.initials: A
authors.lastname: Tanna
authors.forename: Frederick W K
authors.initials: FW
authors.lastname: Tam
authors.forename: Charles D
authors.initials: CD
authors.lastname: Pusey
mesh_terms: D000328:Adult; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D001402:B-Lymphocytes / Q000187:drug effects* / Q000276:immunology; D005921:Glomerulonephritis / Q000188:drug therapy* / Q000276:immunology; D006801:Humans; D058990:Molecular Targeted Therapy
chemical_list: D000911:Antibodies, Monoclonal