B cells as target for immunotherapy in rheumatic diseases - current status

Area of Science:

• Immunology
• Rheumatology
• Pharmacology

Background:

• Systemic autoimmune rheumatic diseases (SARDs) like rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), and primary Sjogren Syndrome (pSS) involve B cell hyperactivity.
• Targeting B cells represents a promising therapeutic avenue for managing these complex autoimmune conditions.

Purpose of the Study:

• To provide a concise overview of current and emerging therapeutic strategies aimed at B cells in SARDs.
• To discuss the rationale, efficacy, and limitations of various B cell-targeting approaches.

Main Methods:

• Literature review of therapeutic strategies targeting B cells and plasma cells.
• Analysis of B cell depletion (anti-CD20, anti-CD22) and long-lived plasma cell depletion (anti-CD19, anti-CD27, anti-CD38, anti-CD138) methods.
• Examination of strategies modulating B cell activation (anti-BAFF) and proteasome inhibition in plasma cells (bortezomib).

Main Results:

• Successful B cell depletion therapies have been established, while others show variable efficacy.
• Targeting long-lived plasma cells and B cell activation pathways offers alternative approaches.
• The review highlights both successful and less successful therapeutic outcomes, with discussions on potential reasons for failure.

Conclusions:

• B cell-targeted therapies offer diverse strategies for treating SARDs.
• Understanding the mechanisms of success and failure is crucial for optimizing future therapeutic development.
• Further research is needed to refine existing treatments and develop novel approaches for B cell-mediated autoimmune diseases.