Skip to main content
Top
Published in: Arthritis Research & Therapy 4/2003

01-09-2003 | Commentary

SLE - Rituximab in lupus

Author: Robert Eisenberg

Published in: Arthritis Research & Therapy | Issue 4/2003

Login to get access

Abstract

B cells are essential to the development of systemic lupus erythematosus (SLE). The chimeric monoclonal antibody rituximab depletes B cells by targeting the pan-B-cell surface marker CD20. Preliminary experience with this agent in SLE and other autoimmune diseases has been encouraging. Controlled trials in SLE will be necessary to determine whether rituximab is useful therapy in this disease, and will teach us more about the roles of B cells in its pathogenesis.
Literature
1.
go back to reference Odendahl M, Jacobi A, Hansen A, Feist E, Hiepe F, Burmester GR, Lipsky PE, Radbruch A, Dorner T: Disturbed peripheral B lymphocyte homeostasis in systemic lupus erythematosus. J Immunol. 2000, 165: 5970-5979.CrossRefPubMed Odendahl M, Jacobi A, Hansen A, Feist E, Hiepe F, Burmester GR, Lipsky PE, Radbruch A, Dorner T: Disturbed peripheral B lymphocyte homeostasis in systemic lupus erythematosus. J Immunol. 2000, 165: 5970-5979.CrossRefPubMed
2.
go back to reference Chan OT, Madaio MP, Shlomchik MJ: The central and multiple roles of B cells in lupus pathogenesis. Immunol Rev. 1999, 169: 107-121.CrossRefPubMed Chan OT, Madaio MP, Shlomchik MJ: The central and multiple roles of B cells in lupus pathogenesis. Immunol Rev. 1999, 169: 107-121.CrossRefPubMed
3.
go back to reference Sobel ES, Katagiri T, Katagiri K, Morris SC, Cohen PL, Eisenberg RA: An intrinsic B cell defect is required for the production of autoantibodies in the lpr model of murine systemic autoimmunity. J Exp Med. 1991, 173: 1441-1449. 10.1084/jem.173.6.1441.CrossRefPubMed Sobel ES, Katagiri T, Katagiri K, Morris SC, Cohen PL, Eisenberg RA: An intrinsic B cell defect is required for the production of autoantibodies in the lpr model of murine systemic autoimmunity. J Exp Med. 1991, 173: 1441-1449. 10.1084/jem.173.6.1441.CrossRefPubMed
4.
go back to reference Lawman S, Ehrenstein MR: Many paths lead to lupus. Lupus. 2002, 11: 801-806. 10.1191/0961203302lu301rr.CrossRefPubMed Lawman S, Ehrenstein MR: Many paths lead to lupus. Lupus. 2002, 11: 801-806. 10.1191/0961203302lu301rr.CrossRefPubMed
5.
go back to reference Chan OT, Madaio MP, Shlomchik MJ: B cells are required for lupus nephritis in the polygenic, Fas-intact MRL model of systemic autoimmunity. J Immunol. 1999, 163: 3592-3596.PubMed Chan OT, Madaio MP, Shlomchik MJ: B cells are required for lupus nephritis in the polygenic, Fas-intact MRL model of systemic autoimmunity. J Immunol. 1999, 163: 3592-3596.PubMed
6.
go back to reference Chan OT, Hannum LG, Haberman AM, Madaio MP, Shlomchik MJ: A novel mouse with B cells but lacking serum antibody reveals an antibody-independent role for B cells in murine lupus. J Exp Med. 1999, 189: 1639-1648. 10.1084/jem.189.10.1639.PubMedCentralCrossRefPubMed Chan OT, Hannum LG, Haberman AM, Madaio MP, Shlomchik MJ: A novel mouse with B cells but lacking serum antibody reveals an antibody-independent role for B cells in murine lupus. J Exp Med. 1999, 189: 1639-1648. 10.1084/jem.189.10.1639.PubMedCentralCrossRefPubMed
7.
go back to reference Lipsky PE: Systemic lupus erythematosus: an autoimmune disease of B cell hyperactivity. Nat Immunol. 2001, 2: 764-766. 10.1038/ni0901-764.CrossRefPubMed Lipsky PE: Systemic lupus erythematosus: an autoimmune disease of B cell hyperactivity. Nat Immunol. 2001, 2: 764-766. 10.1038/ni0901-764.CrossRefPubMed
8.
go back to reference Rivera A, Chen CC, Ron N, Dougherty JP, Ron Y: Role of B cells as antigen-presenting cells in vivo revisited: antigen-specific B cells are essential for T cell expansion in lymph nodes and for systemic T cell responses to low antigen concentrations. Int Immunol. 2001, 13: 1583-1593. 10.1093/intimm/13.12.1583.CrossRefPubMed Rivera A, Chen CC, Ron N, Dougherty JP, Ron Y: Role of B cells as antigen-presenting cells in vivo revisited: antigen-specific B cells are essential for T cell expansion in lymph nodes and for systemic T cell responses to low antigen concentrations. Int Immunol. 2001, 13: 1583-1593. 10.1093/intimm/13.12.1583.CrossRefPubMed
9.
go back to reference Youinou P, Lydyard PM, Mageed RA: B cells underpin lupus immunopathology. Lupus. 2002, 11: 1-3. 10.1191/0961203302lu148ed.CrossRefPubMed Youinou P, Lydyard PM, Mageed RA: B cells underpin lupus immunopathology. Lupus. 2002, 11: 1-3. 10.1191/0961203302lu148ed.CrossRefPubMed
10.
go back to reference Swaak A, van den Brink HG: Case report: common variable immunodeficiency in a patient with systemic lupus erythematosus. Lupus. 1996, 5: 242-246.CrossRefPubMed Swaak A, van den Brink HG: Case report: common variable immunodeficiency in a patient with systemic lupus erythematosus. Lupus. 1996, 5: 242-246.CrossRefPubMed
12.
go back to reference Grillo-Lopez AJ, White CA, Varns C, Shen D, Wei A, McClure A, Dallaire BK: Overview of the clinical development of rituximab: first monoclonal antibody approved for the treatment of lymphoma. Semin Oncol. 1999, 26: 66-73.PubMed Grillo-Lopez AJ, White CA, Varns C, Shen D, Wei A, McClure A, Dallaire BK: Overview of the clinical development of rituximab: first monoclonal antibody approved for the treatment of lymphoma. Semin Oncol. 1999, 26: 66-73.PubMed
13.
go back to reference Tedder TF, Engel P: CD20: a regulator of cell-cycle progression of B lymphocytes. Immunol Today. 1994, 15: 450-454. 10.1016/0167-5699(94)90276-3.CrossRefPubMed Tedder TF, Engel P: CD20: a regulator of cell-cycle progression of B lymphocytes. Immunol Today. 1994, 15: 450-454. 10.1016/0167-5699(94)90276-3.CrossRefPubMed
14.
go back to reference O'Keefe TL, Williams GT, Davies SL, Neuberger MS: Mice carrying a CD20 gene disruption. Immunogenetics. 1998, 48: 125-132. 10.1007/s002510050412.CrossRefPubMed O'Keefe TL, Williams GT, Davies SL, Neuberger MS: Mice carrying a CD20 gene disruption. Immunogenetics. 1998, 48: 125-132. 10.1007/s002510050412.CrossRefPubMed
15.
go back to reference Riley JK, Sliwkowski MX: CD20: a gene in search of a function. Semin Oncol. 2000, 27: 17-24.PubMed Riley JK, Sliwkowski MX: CD20: a gene in search of a function. Semin Oncol. 2000, 27: 17-24.PubMed
16.
go back to reference Leandro MJ, Edwards JC, Cambridge G: Clinical outcome in 22 patients with rheumatoid arthritis treated with B lymphocyte depletion. Ann Rheum Dis. 2002, 61: 883-888. 10.1136/ard.61.10.883.PubMedCentralCrossRefPubMed Leandro MJ, Edwards JC, Cambridge G: Clinical outcome in 22 patients with rheumatoid arthritis treated with B lymphocyte depletion. Ann Rheum Dis. 2002, 61: 883-888. 10.1136/ard.61.10.883.PubMedCentralCrossRefPubMed
17.
go back to reference Leandro MJ, Edwards JC, Cambridge G, Ehrenstein MR, Isenberg DA: An open study of B lymphocyte depletion in systemic lupus erythematosus. Arthritis Rheum. 2002, 46: 2673-2677. 10.1002/art.10541.CrossRefPubMed Leandro MJ, Edwards JC, Cambridge G, Ehrenstein MR, Isenberg DA: An open study of B lymphocyte depletion in systemic lupus erythematosus. Arthritis Rheum. 2002, 46: 2673-2677. 10.1002/art.10541.CrossRefPubMed
18.
go back to reference Stasi R, Pagano A, Stipa E, Amadori S: Rituximab chimeric anti-CD20 monoclonal antibody treatment for adults with chronic idiopathic thrombocytopenic purpura. Blood. 2001, 98: 952-957. 10.1182/blood.V98.4.952.CrossRefPubMed Stasi R, Pagano A, Stipa E, Amadori S: Rituximab chimeric anti-CD20 monoclonal antibody treatment for adults with chronic idiopathic thrombocytopenic purpura. Blood. 2001, 98: 952-957. 10.1182/blood.V98.4.952.CrossRefPubMed
19.
go back to reference Levine TD, Pestronk A: IgM antibody-related polyneuropathies: B-cell depletion chemotherapy using Rituximab. Neurology. 1999, 52: 1701-1704.CrossRefPubMed Levine TD, Pestronk A: IgM antibody-related polyneuropathies: B-cell depletion chemotherapy using Rituximab. Neurology. 1999, 52: 1701-1704.CrossRefPubMed
20.
go back to reference Weide R, Heymanns J, Koppler H: The polyneuropathy associated with Waldenstrom's macroglobulinaemia can be treated effectively with chemotherapy and the anti-CD20 monoclonal antibody rituximab. Br J Haematol. 2000, 109: 838-841. 10.1046/j.1365-2141.2000.02086.x.CrossRefPubMed Weide R, Heymanns J, Koppler H: The polyneuropathy associated with Waldenstrom's macroglobulinaemia can be treated effectively with chemotherapy and the anti-CD20 monoclonal antibody rituximab. Br J Haematol. 2000, 109: 838-841. 10.1046/j.1365-2141.2000.02086.x.CrossRefPubMed
21.
go back to reference Specks U, Fervenza FC, McDonald TJ, Hogan MC: Response of Wegener's granulomatosis to anti-CD20 chimeric monoclonal antibody therapy. Arthritis Rheum. 2001, 44: 2836-2840. 10.1002/1529-0131(200112)44:12<2836::AID-ART471>3.0.CO;2-W.CrossRefPubMed Specks U, Fervenza FC, McDonald TJ, Hogan MC: Response of Wegener's granulomatosis to anti-CD20 chimeric monoclonal antibody therapy. Arthritis Rheum. 2001, 44: 2836-2840. 10.1002/1529-0131(200112)44:12<2836::AID-ART471>3.0.CO;2-W.CrossRefPubMed
22.
go back to reference Zaja F, Russo D, Fuga G, Perella G, Baccarani M: Rituximab for myasthenia gravis developing after bone marrow transplant. Neurology. 2000, 55: 1062-1063.CrossRefPubMed Zaja F, Russo D, Fuga G, Perella G, Baccarani M: Rituximab for myasthenia gravis developing after bone marrow transplant. Neurology. 2000, 55: 1062-1063.CrossRefPubMed
23.
go back to reference Treon SP, Anderson KC: The use of rituximab in the treatment of malignant and nonmalignant plasma cell disorders. Semin Oncol. 2000, 27: 79-85.PubMed Treon SP, Anderson KC: The use of rituximab in the treatment of malignant and nonmalignant plasma cell disorders. Semin Oncol. 2000, 27: 79-85.PubMed
24.
go back to reference Edwards JCW, Szczepanski L, Szechinski J, Filipowicz-Sos-nowska A, Close D, Stevens RM, Shaw TM: Efficacy and safety of rituximab, a B-cell targeted chimeric monoclonal antibody: a randomized, placebo-controlled trial in patients with rheumatoid arthritis [abstract]. Arthritis Rheum. 2002, 46: S197-10.1002/art.10507.CrossRef Edwards JCW, Szczepanski L, Szechinski J, Filipowicz-Sos-nowska A, Close D, Stevens RM, Shaw TM: Efficacy and safety of rituximab, a B-cell targeted chimeric monoclonal antibody: a randomized, placebo-controlled trial in patients with rheumatoid arthritis [abstract]. Arthritis Rheum. 2002, 46: S197-10.1002/art.10507.CrossRef
25.
go back to reference Anolik JH, Campbell D, Felgar R, Rosenblatt J, Young F, Looney RJ: B lymphocyte depletion in the treatment of systemic lupus (SLE): phase I/II trial of rituximab (Rituxan®) in SLE [abstract]. Arthritis Rheum. 2002, 46: S289. Anolik JH, Campbell D, Felgar R, Rosenblatt J, Young F, Looney RJ: B lymphocyte depletion in the treatment of systemic lupus (SLE): phase I/II trial of rituximab (Rituxan®) in SLE [abstract]. Arthritis Rheum. 2002, 46: S289.
26.
go back to reference Kunkel L, Wong A, Maneatis T, Nickas J, Brown T, Grillo-Lopez A, Benyunes M, Grobman B, Dillman RO: Optimizing the use of rituximab for treatment of B-cell non-Hodgkin's lymphoma: a benefit-risk update. Semin Oncol. 2000, 27: 53-61.PubMed Kunkel L, Wong A, Maneatis T, Nickas J, Brown T, Grillo-Lopez A, Benyunes M, Grobman B, Dillman RO: Optimizing the use of rituximab for treatment of B-cell non-Hodgkin's lymphoma: a benefit-risk update. Semin Oncol. 2000, 27: 53-61.PubMed
27.
go back to reference Cambridge G, Leandro MJ, Edwards JCW, Ehrenstein M, Salden M, Webster D: B lymphocyte depletion in patients with rheumatoid arthritis: serial studies of immunological parameters [abstract]. Arthritis Rheum. 2002, 46: S506. Cambridge G, Leandro MJ, Edwards JCW, Ehrenstein M, Salden M, Webster D: B lymphocyte depletion in patients with rheumatoid arthritis: serial studies of immunological parameters [abstract]. Arthritis Rheum. 2002, 46: S506.
28.
go back to reference Maini RN, Breedveld FC, Kalden JR, Smolen JS, Davis D, Macfarlane JD, Antoni C, Leeb B, Elliott MJ, Woody JN, Schaible TF, Feldmann M: Therapeutic efficacy of multiple intravenous infusions of anti-tumor necrosis factor alpha monoclonal antibody combined with low-dose weekly methotrexate in rheumatoid arthritis. Arthritis Rheum. 1998, 41: 1552-1563. 10.1002/1529-0131(199803)41:3<565::AID-ART28>3.3.CO;2-#.CrossRefPubMed Maini RN, Breedveld FC, Kalden JR, Smolen JS, Davis D, Macfarlane JD, Antoni C, Leeb B, Elliott MJ, Woody JN, Schaible TF, Feldmann M: Therapeutic efficacy of multiple intravenous infusions of anti-tumor necrosis factor alpha monoclonal antibody combined with low-dose weekly methotrexate in rheumatoid arthritis. Arthritis Rheum. 1998, 41: 1552-1563. 10.1002/1529-0131(199803)41:3<565::AID-ART28>3.3.CO;2-#.CrossRefPubMed
29.
go back to reference Slifka MK, Ahmed R: Long-lived plasma cells: a mechanism for maintaining persistent antibody production. Curr Opin Immunol. 1998, 10: 252-258. 10.1016/S0952-7915(98)80162-3.CrossRefPubMed Slifka MK, Ahmed R: Long-lived plasma cells: a mechanism for maintaining persistent antibody production. Curr Opin Immunol. 1998, 10: 252-258. 10.1016/S0952-7915(98)80162-3.CrossRefPubMed
Metadata
Title
SLE - Rituximab in lupus
Author
Robert Eisenberg
Publication date
01-09-2003
Publisher
BioMed Central
Published in
Arthritis Research & Therapy / Issue 4/2003
Electronic ISSN: 1478-6362
DOI
https://doi.org/10.1186/ar759

Other articles of this Issue 4/2003

Arthritis Research & Therapy 4/2003 Go to the issue
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine