Zeitschrift für Rheumatologie

, Volume 68, Issue 5, pp 364–369

Translationale Aspekte zur Rolle von B-Zellen bei Autoimmunerkrankungen

„From bench to bedside“ und „From bed to benchside“
Leitthema
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Zusammenfassung

In den vergangenen Jahren sind erfolgreich Erkenntnisse der Immunologie in Therapieprinzipien entzündlicher Gelenkerkrankungen, vor allem der rheumatoiden Arthrtitis (RA) und Spondylarthritiden, überführt worden. Die Einführung der Zytokinblockade bei der RA mit Inhibition von Tumor-Nekrose-Faktor- (TNF-)α und Interleukin- (IL-)1 war eine erste originelle Therapiemodalität der Rheumatologie, nachdem die proliferationshemmenden Medikamente, wie z. B. Methotrexat oder Cyclophosphamid, von der Onkologie adaptiert worden waren. Dies wurde und wird mit der Kostimulationsblockade durch Abatacept und der IL-6-Rezeptor-Inhibition fortgesetzt. Eine Sonderstellung nimmt dabei die Anti-CD20-Therapie ein. Initial für die Non-Hodgkin-Lymphom- (NHL-)Therapie zugelassen, wurde diese Behandlungsmöglichkeit in den letzten Jahren nach TNF-Blocker-Versagen in die Therapie der RA eingeführt. Hinsichtlich der Rolle der B-Zellen bei entzündlichen Erkrankungen, aber auch der Wirkprinzipien B-Zell-gerichteter Behandlungen verbleiben Fragen. Sorgfältige klinische Beobachtungen von behandelten Patienten haben aber auch Antworten bzw. Bestätigungen für grundlagenwissenschaftliche Konzepte erbracht.

Schlüsselwörter

Autoimmunität B-Zellen Biologika Rheumatoide Arthritis Systemischer Lupus erythematodes Autoimmune Thrombozytopenie 

Translational aspects on the role of B-cells in autoimmune diseases

“From bench to bedside” and “from bed to benchside”

Abstract

In recent years, new findings in immunology have been successfully converted to therapeutic principles, in particular for rheumatoid arthritis (RA) and spondylarthritides. The introduction of cytokine blockers in RA using tumor necrosis factor (TNF)-alpha and interleukin (IL)-1 inhibitors presented the first original therapy modalities in rheumatology, after proliferation-inhibiting drugs, such as methotrexate and cyclophosphamide, had been accepted in oncology. This advance was and is still being extended with the co-stimulation blockade using abatacept and IL-6 receptor inhibition. Anti-CD20 therapies are of particular importance, initially approved for the treatment of non-Hodgkin’s lymphoma (NHL), this therapy modality has been approved in recent years for the treatment of RA following the failure of TNF-blockade. However, questions remain regarding the role of B cells in a number of autoimmune diseases, as well as the working principles of B-cell targeted therapy. In this context, close clinical observation of patients has yielded answers to and confirmation of basic scientific concepts.

Keywords

Autoimmunity B-cells Biologicals Rheumatoid arthritis Systemic lupus erythematosus Autoimmune thrombocytopenia 

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Copyright information

© Springer Medizin Verlag 2009

Authors and Affiliations

  1. 1.CharitéCentrum 12, Medizinische Klinik mit Schwerpunkt Rheumatologie und Klinische ImmunologieCharité-Universitätsmedizin Berlin und Deutsches RheumaforschungszentrumBerlinDeutschland

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