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Targeting the B cell in vasculitis

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Abstract

The treatment of severe vasculitides, such as antineutrophil cytoplasmic autoantibodies (ANCA)-associated vasculitis, is associated with both short- and long-term toxicities that limit its use in paediatric patients and is complicated by refractory and relapsing disease that requires increased exposure to these toxic therapies. B cells have been implicated in the pathogenesis of autoimmune diseases, including vasculitis, and represent a potential target for new therapies that may have a more acceptable toxicity profile. The use of rituximab, a biologic therapy directed against B cells, has provided valuable insight into the potential role of B-cell targeted therapies for vasculitis. Rituximab appears to be a potentially useful treatment for vasculitis in adult patients, but randomized evidence comparing it to cyclophosphamide in terms of both efficacy and toxicity is lacking, as is long-term safety data. Several other B-cell-directed therapies are in development and may offer rational alternatives or adjunctives to traditional treatments.

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Acknowledgments

MW is supported by the Kidney Research Scientist Core Education National Training (KRESCENT) Program and the Alberta Heritage Foundation for Medical Research.

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  1. Vasculitis Clinic, Addenbrooke’s Hospital, Hills Road, Box 118, Cambridge, CB2 2QQ, UK

    Michael Walsh & David Jayne

  2. University of Calgary, Calgary, UK

    Michael Walsh

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  1. Michael Walsh
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Correspondence to Michael Walsh.

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Walsh, M., Jayne, D. Targeting the B cell in vasculitis. Pediatr Nephrol 24, 1267–1275 (2009). https://doi.org/10.1007/s00467-008-1010-z

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