This article is part of the supplement: B cells in autoimmune diseases: Part 1
Rationale of anti-CD19 immunotherapy: an option to target autoreactive plasma cells in autoimmunity
1 German Rheumatism Research Center (DRFZ), Charitéplatz 01, 10117 Berlin, Germany
2 Department of Medicine/Rheumatology and Clinical Immunology, Charité Center 12, Charité University Medicine Berlin, Charitéplatz 01, 10117 Berlin, Germany
Arthritis Research & Therapy 2012, 14(Suppl 5):S1 doi:10.1186/ar3909Published: 8 November 2012
Anti-CD20 therapy using rituximab directly targeting B cells has been approved for treatment of non-Hodgkin lymphoma, rheumatoid arthritis and anti-neutrophil cytoplasmic antibody-associated vasculitides and has led to reappreciation of B-lineage cells for anti-rheumatic treatment strategies. Moreover, blocking B-cell activating factor with belimumab, a drug that is licensed for treatment of active, seropositive systemic lupus erythematosus (SLE), represents an alternative, indirect anti-B-cell approach interfering with proper B-cell development. While these approaches apparently have no substantial impact on antibody-secreting plasma cells, challenges to improve the treatment of difficult-to-treat patients with SLE remain. In this context, anti-CD19 antibodies have the promise to directly target autoantibody-secreting plasmablasts and plasma cells as well as early B-cell differentiation stages not covered by anti-CD20 therapy. Currently known distinct expression profiles of CD19 by human plasma cell subsets, experiences with anti-CD19 therapies in malignant conditions as well as the rationale of targeting autoreactive plasma cells in patients with SLE are discussed in this review.