Rituximab treatment in rheumatoid arthritis how does it work 英文参考文献.docVIP

Available online /content/11/6/134 Editorial Rituximab treatment in rheumatoid arthritis: how does it work? Maria JH Boumans and Paul P Tak Division of Clinical Immunology and Rheumatology, Academic Medical Center/University of Amsterdam, 1100 DE Amsterdam, the Netherlands Corresponding author: Paul P Tak, p.p.tak@amc.uva.nl Published: 24 November 2009 Arthritis Research Therapy 2009, 11:134 (doi:10.1186/ar2852) This article is online at /content/11/6/134 ? 2009 BioMed Central Ltd See related research by Nakou et al., /content/11/4/R131 Abstract RA, which include antigen presentation, stimulation of T cells, cytokine production and production of autoantibodies. Of note, B cells are the precursors of immunoglobulin-producing plasma cells. Studies on the effects of rituximab treatment on different compartments (like peripheral blood, synovial tissue, and bone marrow) in relation to the clinical response may provide insight into the mechanism of action in RA. We and others have previously shown that rituximab causes a rapid decrease in numbers of B cells in the synovial tissue of RA patients (reviewed in [3]). The early synovial tissue response varies between patients, which is in contrast to the marked B cell depletion observed in the peripheral blood of nearly all patients with RA. Similar to incomplete depletion of B cells in the synovium of a subset of patients, persistent B cells might be found in the bone marrow of some RA patients after rituximab treatment, although at low numbers [3]. It should be noted, however, that data on the effect on bone marrow are still limited. Persistence of B cell subpopulations at specific sites could be related to the fact that different effector mechanisms may be important for B cell depletion in the Treatment with the chimerical monoclonal antibody rituximab results in CD20-directed B cell depl