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Publication Detail
B lymphocyte depletion therapy in autoimmune disorders: Chasing trojan Horses
  • Publication Type:
  • Authors:
    Edwards JCW, Cambridge G, Leandro MJ
  • Publication date:
  • Pagination:
    291, 311
  • ISBN-10:
  • ISBN-13:
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  • Book title:
    Molecular Autoimmunity
Since the anti-CD20 therapeutic monoclonal antibody rituximab became available for clinical use in 1997 the effects of B lymphocyte depletion (BLyD) have been explored in a range of autoimmune disorders (Edwards et al., 2002). The results of a formal controlled trial in rheumatoid arthritis (RA) confirm that clinical benefit can be substantial (Edwards et al., 2004). Perhaps more significantly in the long term, the opportunity afforded by BLyD to study mechanisms underlying pathogenesis of many human autoimmune diseases is unique and exciting. This chapter reviews the rationale for BLyD in the context of changing ideas about the role of B cells in autoimmunity, and explores the emerging concept of autoimmune B cells as immunologic Trojan horses. The potential for clinical application, the logistics employed, and the clinical results obtained with rituximab so far are reviewed. Finally, evolving immunodynamic studies are described, which highlight correlations between clinical state and autoantibody profiles, and which may elucidate mechanisms of action and point to means of optimization of therapeutic benefit and development of further targeted approaches to therapy. © 2005 Springer Science+Business Media, Inc.
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