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首页> 外文期刊>Nature clinical practice. Rheumatology >Drug insight: the mechanism of action of rituximab in autoimmune disease--the immune complex decoy hypothesis.
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Drug insight: the mechanism of action of rituximab in autoimmune disease--the immune complex decoy hypothesis.

机译：药物洞察力：利妥昔单抗在自身免疫性疾病中的作用机理-免疫复合物诱饵假设。

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Inflammatory responses to cell-associated or tissue-associated immune complexes are key elements in the pathogenesis of several autoimmune diseases, including rheumatoid arthritis, systemic lupus erythematosus and immune thrombocytopenic purpura. Effector cells, such as monocytes, macrophages and neutrophils, bind immune complexes in a process mediated by Fcgamma receptors, and these cells then initiate inflammatory reactions that lead to tissue destruction. Rituximab is an anti-CD20 monoclonal antibody that suppresses inflammation effectively in autoimmune diseases. It was initially approved by the FDA for the treatment of B-cell lymphomas and later for rheumatoid arthritis refractory to anti-tumor necrosis factor therapies. Rituximab is hypothesized to suppress disease injury in autoimmune diseases by promoting rapid and long-term elimination of circulating and possibly lymphoid-tissue-associated B cells. We suggest, however, that a different mechanism may underlie much of the therapeutic action of rituximab in autoimmune diseases: binding of tens of thousands of rituximab-IgG molecules to B cells generates decoy sacrificial cellular immune complexes that efficiently attract and bind Fcgamma receptor-expressing effector cells, which diminishes recruitment of these effector cells at sites of immune complex deposition and, therefore, reduces inflammation and tissue damage.
机译：对细胞相关或组织相关免疫复合物的炎性反应是几种自身免疫疾病（包括类风湿性关节炎，系统性红斑狼疮和免疫性血小板减少性紫癜）发病机理中的关键要素。效应细胞，例如单核细胞，巨噬细胞和嗜中性粒细胞，在由Fcγ受体介导的过程中结合免疫复合物，然后这些细胞引发导致组织破坏的炎症反应。利妥昔单抗是一种抗CD20单克隆抗体，可在自身免疫性疾病中有效抑制炎症。它最初被FDA批准用于治疗B细胞淋巴瘤，后来用于抗肿瘤坏死因子疗法难以治疗的类风湿关节炎。假定利妥昔单抗通过促进快速和长期消除循环的和可能与淋巴组织相关的B细胞来抑制自身免疫疾病中的疾病损伤。但是，我们建议一种不同的机制可能是利妥昔单抗在自身免疫性疾病中的许多治疗作用的基础：成千上万的利妥昔单抗-IgG分子与B细胞结合会产生诱饵的牺牲性细胞免疫复合物，该复合物可以有效地吸引并结合表达Fcgamma受体的细胞效应细胞，其减少了这些效应细胞在免疫复合物沉积部位的募集，因此减少了炎症和组织损伤。

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