B-cell Directed Therapies in Antiphospholipid Antibody Syndrome--New Directions Based on Murine and Human Data

Autoimmun Rev. 2012 Aug;11(10):717-22. doi: 10.1016/j.autrev.2011.12.011. Epub 2012 Jan 16.

Abstract

The increased awareness of the role of humoral immunophysiology in antiphospholipid syndrome (APS) has aroused interest in B cells as therapeutic targets in this disease. This paper reviews the literature on B cell directed therapies in human and experimental APS. The clinical data is limited to B cell depletion with rituximab and comprises case reports and case series. Murine studies include use of modulators of B cell function such as belimumab and abatacept. In both human and murine studies, B cell directed therapies appeared to have clinical and serologic beneficial effects including a decrease in the antiphospholipid antibody titers after treatment. Randomized controlled clinical trials are needed to determine whether B cell depletors and/or B cell modulators can be effective agents for treating patients with APS.

Trial registration: ClinicalTrials.gov NCT00537290.

Publication types

  • Review

MeSH terms

  • Animals
  • Antiphospholipid Syndrome / diagnosis*
  • Antiphospholipid Syndrome / immunology*
  • Antiphospholipid Syndrome / pathology
  • Autoantibodies / adverse effects
  • Autoantibodies / biosynthesis
  • B-Lymphocytes / immunology*
  • B-Lymphocytes / metabolism
  • B-Lymphocytes / pathology
  • Disease Models, Animal*
  • Humans
  • Mice
  • Randomized Controlled Trials as Topic / methods
  • Randomized Controlled Trials as Topic / standards
  • beta 2-Glycoprotein I / immunology

Substances

  • Autoantibodies
  • beta 2-Glycoprotein I

Associated data

  • ClinicalTrials.gov/NCT00537290