B-cell-targeted therapy in adult glomerulonephritis. (December 2013)

• Record Type: Journal Article
• Authors: Tanna, Anisha; Tam, Frederick WK; Pusey, Charles D
• Is Part Of: Expert opinion on biological therapy. Volume 13:Number 12(2013:Dec.)
• Page Start: 1691
• Page End: 1706
• Publication Date: 2013-12
• Subjects: anti-CD20 -- B lymphocyte -- glomerulonephritis -- renal; Gene therapy -- Periodicals; Protein drugs -- Periodicals; Peptide drugs -- Periodicals; Immunotherapy -- Periodicals; Drug delivery systems -- Periodicals; 615.5
• DOI: 10.1517/14712598.2013.851191
• Languages: English
• ISSNs: 1471-2598

Abstract

Abstract : Introduction: 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. Areas covered: 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. Expert opinion: 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.