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Targeting B Cells and Plasma Cells in Glomerular Diseases: Translational Perspectives.

Authors
  • Schrezenmeier, Eva1
  • Jayne, David2
  • Dörner, Thomas3
  • 1 Divisions of Nephrology and Intensive Care, and.
  • 2 Department of Medicine, University of Cambridge, Cambridge, United Kingdom. , (United Kingdom)
  • 3 Rheumatology and Clinical Immunology, Department of Medicine, Charité Universitätsmedizin Berlin, Campus Mitte, Berlin, Germany; and [email protected] , (Germany)
Type
Published Article
Journal
Journal of the American Society of Nephrology
Publisher
American Society of Nephrology
Publication Date
Mar 01, 2018
Volume
29
Issue
3
Pages
741–758
Identifiers
DOI: 10.1681/ASN.2017040367
PMID: 29326157
Source
Medline
Keywords
License
Unknown

Abstract

The unique contributions of memory B cells and plasma cells in kidney diseases remain unclear. In this review, we evaluate the clinical experience with treatments directed at B cells, such as rituximab, and at plasma cells, such as proteasome inhibition, to shed light on the role of these two B lineage compartments in glomerular diseases. Specifically, analysis of these targeted interventions in diseases such as ANCA-associated vasculitis, SLE, and antibody-mediated transplant rejection permits insight into the pathogenetic effect of these cells. Notwithstanding the limitations of preclinical models and clinical studies (heterogeneous populations, among others), the data suggest that memory B and plasma cells represent two engines of autoimmunity, with variable involvement in these diseases. Whereas memory B cells and plasma cells appear to be key in ANCA-associated vasculitis and antibody-mediated transplant rejection, respectively, SLE seems likely to be driven by both autoimmune compartments. These conclusions have implications for the future development of targeted therapeutics in immune-mediated renal disease.

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