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monoclonal antibodies for systemic lupus erythematosus (sle)单克隆抗体在系统性红斑狼疮(sle).pdf

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monoclonal antibodies for systemic lupus erythematosus (sle)单克隆抗体在系统性红斑狼疮(sle)

Pharmaceuticals 2010, 3, 300-322; doi:10.3390/ph3010300 OPEN ACCESS pharmaceuticals ISSN 1424-8247 /journal/pharmaceuticals Review Monoclonal Antibodies for Systemic Lupus Erythematosus (SLE) † Claudio Ponticelli 1,* and Gabriella Moroni 2 1 Division of Nephrology, Scientific Institute Humanitas, via Manzoni 56, 20089 Rozzano (Milano), Italy 2 Division of Nephrology, Scientific Institute Ospedale Maggiore, Milano, Italy; E-Mail: gmoroni@policlinico.mi.it (G.M.) † This paper belongs to the Special Issue “Monoclonal Antibody”, edited by Jagadeesh Bayry.  Author to whom correspondence should be addressed; E-Mail: claudio.ponticelli@fastwebnet.it; Tel.: +39 0226112952; Fax: +39 0226112951. Received: 3 December 2009; in revised form: 12 January 2010 / Accepted: 15 January 2010 / Published: 20 January 2010 Abstract: A number of monoclonal antibodies (mAb) are now under investigation in clinical trials to assess their potential role in Systemic Lupus Erythematosus (SLE). The most frequently used mAb is rituximab, which is directed against CD20, a membrane protein expressed on B lymphocytes. Uncontrolled trials reported an improvement of SLE activity in non-renal patients and other studies even reported an improvement of severe lupus nephritis unresponsive to conventional treatments. However two randomized trials failed to show the superiority of rituximab over conventional treatment in non renal SLE and in lupus nephritis. Preliminary trials repor