靶向B细胞治疗系统性红斑狼疮研究进展

张舒晴; 张文博; 赵东宝

doi:10.16766/j.cnki.issn.1674-4152.004178

靶向B细胞治疗系统性红斑狼疮研究进展

doi: 10.16766/j.cnki.issn.1674-4152.004178

海军军医大学长海医院风湿免疫科, 上海 200433

基金项目:

上海市领军人才队伍建设专项基金 201444

详细信息

通讯作者:
赵东宝，E-mail：dongbaozhao@163.com

中图分类号: R593.241
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- 文章访问数: 5
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- 被引次数: 0
出版历程
- 收稿日期: 2024-10-13
- 网络出版日期: 2025-11-17

Advancements in B-cell targeted therapies for systemic lupus erythematosus

Department of Rheumatology, Changhai Hospital, Naval Medical University, Shanghai 200433, China

摘要

摘要: 系统性红斑狼疮(SLE)是一种多器官系统受累的自身免疫性疾病，以显著的临床和分子多样性为特征，可危及生命。在SLE的发病机制中，B细胞的异常活化及其产生的自身抗体扮演着核心角色。目前，糖皮质激素、羟氯喹、免疫抑制剂以及钙调蛋白酶抑制剂是主要的治疗手段，但仍有部分患者对治疗反应不佳或反复复发。随着对SLE病理机制认识的不断深化，特异性针对B细胞的靶向治疗策略逐渐成为SLE研究的新焦点，常规治疗基础上加用靶向B细胞治疗在提高患者疾病缓解率、降低疾病活动度、降低疾病复发率、减少激素用量等方面发挥了显著作用。为了推动靶向B细胞药物在临床上的广泛应用，并实现个性化治疗，深入理解各种药物的作用机制、适应症、疗效、安全性及潜在风险至关重要。本文对B细胞在SLE发病过程中的异常活化及其关键作用作一综述，并聚焦于当前SLE治疗中几种主要的靶向B细胞方法，系统梳理了相关基础和临床研究的最新进展，并深入探讨了部分试验未达到预期效果的原因。此外，本文还讨论了B细胞靶向治疗面临的挑战，并对未来的发展方向进行了展望，旨在为临床医生和科研工作者提供参考，以优化SLE患者的治疗策略，期望能为SLE患者带来更有效、更安全的治疗选择。
- 系统性红斑狼疮 /
- 狼疮性肾炎 /
- B细胞 /
- 靶向治疗 /
- 生物制剂
Abstract: Systemic lupus erythematosus (SLE), characterized by significant clinical and molecular diversity, is an autoimmune disease that can affect multiple organ systems, sometimes it can be life-threatening. The abnormal activation of B cells and the production of autoantibodies play a central role in the pathogenesis of SLE. Standard of care comprise glucocorticoids, hydroxychloroquine, immunosuppressive agents, and calcineurin inhibitors. Nevertheless, a subset of patients shows minimal improvement with treatment or undergo frequent relapses. As the understanding of the pathological mechanisms of SLE deepen, much more researchers focus on the area of B cell targeted therapies. Incorporating B cell targeted therapy into conventional treatment has significantly increased disease remission rates, reduced disease activity, decreased relapse rates, and minimized corticosteroid use in patients. A thorough comprehension of the mechanisms, indications, efficacy, safety, and potential risks of these therapies is essential for making targeted B cell drugs widely used in clinics and personalize treatment plans to individual patients. This review outlines the critical role of abnormal B cell activation in SLE, systematically review the latest advancements in both basic and clinical research, focusing on B cell targeted therapies, and explore the reasons why some trials have not met expected outcomes. Furthermore, the review discusses the challenges faced by targeted B cell therapy and provides a perspective on future development directions, offering valuable insights for clinicians and researchers and bringing better options to patients.
- Systemic lupus erythematosus /
- Lupus nephritis /
- B cells /
- Targeted therapy /
- Biologic agents

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