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Pharmacological Effects and Mechanisms of Action of Agents Blocking B Cells

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Drugs Targeting B-Cells in Autoimmune Diseases

Part of the book series: Milestones in Drug Therapy ((MDT))

Abstract

Spearheaded by the development of anti-CD20 monoclonal antibodies capable of effectively killing B cells, the FDA approval in 1999 of the anti-CD20 monoclonal antibody rituximab for the treatment of B cell malignancies and reassurance about the overall safety of B cell depletion, the field of anti-B cell therapies has expanded over the last decade to the treatment of multiple autoimmune diseases. Moreover, growing knowledge of the biology of B cells and their functional and phenotypic heterogeneity combined with advances in biotechnology have enabled investigators and pharmaceutical companies to develop new agents that target different types of B cells through multiple mechanisms of action. Together with improved understanding of the heterogeneous nature of autoimmune diseases and better approaches to their segmentation, these developments should provide in the near future multiple choices for the rationale design of clinical trials and eventually, multiple choices for safer and more effective modalities that allow clinicians to use different agents, either combined or sequentially, to induce and maintain disease remission. In this chapter, we shall discuss the rationale for B cell therapies, the different strategies that can be used to target B cells and the mechanisms of action of drugs currently used for the treatment of autoimmune diseases.

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Acknowledgments

Supported in part by NIH grants U19 AI56390 (Autoimmunity Center of Excellence, P01 AI078907 and R37 AI049660 MERIT Award.

The authors gratefully acknowledges the generous support of the Mason Lowance Chair and the Georgia Research Alliance.

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  1. Division of Rheumatology and Lowance Center for Human Immunology, Emory University, Atlanta, GA, USA

    Ignacio Sanz

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  1. Ignacio Sanz
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Correspondence to Ignacio Sanz .

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  1. Hospital Clinic, Department of Internal Medicine, University of Barcelona, Barcelona, Spain

    Xavier Bosch

  2. Department of Autoimmune Diseases, Hospital Clinic, Barcelona, Spain

    Manuel Ramos-Casals

  3. King's College, The Rayne Institute, St. Thomas' Hospital, London, United Kingdom

    Munther A Khamashta

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Sanz, I. (2014). Pharmacological Effects and Mechanisms of Action of Agents Blocking B Cells. In: Bosch, X., Ramos-Casals, M., Khamashta, M. (eds) Drugs Targeting B-Cells in Autoimmune Diseases. Milestones in Drug Therapy. Springer, Basel. https://doi.org/10.1007/978-3-0348-0706-7_3

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