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B cell depletion therapies in autoimmune disease: advances and mechanistic insights

Open access
Lee, Dennis S. W., Rojas, Olga L., Gommerman, Jennifer L.·2021·Nature Reviews Drug Discovery

Abstract

In the past 15 years, B cells have been rediscovered to be not merely bystanders but rather active participants in autoimmune aetiology. This has been fuelled in part by the clinical success of B cell depletion therapies (BCDTs). Originally conceived as a method of eliminating cancerous B cells, BCDTs such as those targeting CD20, CD19 and BAFF are now used to treat autoimmune diseases, including systemic lupus erythematosus and multiple sclerosis. The use of BCDTs in autoimmune disease has led to some surprises. For example, although antibody-secreting plasma cells are thought to have a negative pathogenic role in autoimmune disease, BCDT, even when it controls the disease, has limited impact on these cells and on antibody levels. In this Review, we update our understanding of B cell biology, review the results of clinical trials using BCDT in autoimmune indications, discuss hypotheses for the mechanism of action of BCDT and speculate on evolving strategies for targeting B cells beyond depletion. Examining B cell depletion therapy (BCDT), an approved treatment for B cell malignancies, in autoimmune conditions has provided key insights into basic B cell biology. In this Review, Gommerman and colleagues discuss BCDT in autoimmune conditions, highlighting diseases in which BCDT has been clinically effective and the potential and pitfalls for BCDT in autoimmune conditions in which it has not yet been efficacious.

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Metadata

Authors
Lee, D. S. W., Rojas, O. L., & Gommerman, J. L.
Venue
Nature Reviews Drug Discovery
Published
2020-12-15
Volume
20
Issue
3
Pages
179-199
ISSN
  • 1474-1776 (ISSN-L)
  • 1474-1784
OpenAlex
W3111529194
Cited by
658
References
298
FWCI
5.58
Type
journal article
Language
en
Open access
bronze

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CoChat. (2026). Citation check: B cell depletion therapies in autoimmune disease: advances and mechanistic insights. https://app.cochat.ai/papers/10.1038/s41573-020-00092-2
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Lee, D. S. W., Rojas, O. L., & Gommerman, J. L. (2021). B cell depletion therapies in autoimmune disease: advances and mechanistic insights. Nature Reviews Drug Discovery. https://doi.org/10.1038/s41573-020-00092-2

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