Перспективы анти-В-клеточной терапии системной красной волчанки


Е.А. Асеева, М.Э. Цанян, А.В. Торгашина

ФГБУ «НИИР им. В.А. Насоновой» РАМН, Москва
Системная красная волчанка (СКВ) остается заболеванием с высоким уровнем смертности, значительными органными повреждениями и низким качеством жизни, несмотря на имеющийся арсенал глюкокортикоидных гормонов и цитостатических препаратов. Появившиеся генно-инженерные биологические препараты, способные блокировать функцию В-лимфоцитов, дают ревматологам новые возможности в ведении пациентов с СКВ: купировать жизнеугрожающие ситуации (ритуксимаб), уменьшать развитие побочных эффектов от традиционной терапии (белимумаб и эпратузумаб). За этими препаратами будущее – улучшение качества жизни пациентов с СКВ.

Литература



  1. Arbuckle M.R., McClain M.T., Rubertone M.V., et al. Development of autoantibodies before the clinical onset of systemic lupus erythematosus. N. Engl. J. Med. 2003;349:1526–33.

  2. James J.A., Harley J.B., Scofield R.H. Epstein-Barr virus and systemic lupus erythematosus. Curr. Opin. Rheumatol. 2006;18:462–67.

  3. Costenbader K.H., Gay S., Alarcon-Riquelme M.E., Iaccarino L., Doria A. Genes, epigenetic regulation and environmental factors: which is the most relevant in developing autoimmune diseases? Autoimmun. Rev. 2012;11:604–09.

  4. Bertoli A.M., Alarcon G.S. Epidemiology of Systemic Lupus Erythematosus, in: G.C. Tsokos, C. Gordon, J.S. Smolen (Eds.), Systemic Lupus Erythematosus, Elsevier Inc., Philadelphia, 2007. P. 1–18.

  5. Pons-Estel G.J., Alarcon G.S., Scofield L., Reinlib L., Cooper G.S. Understanding the epidemiology and progression of systemic lupus erythematosus. Semin. Arthritis Rheum. 2010;39:257–68.

  6. Danchenko N., Satia J.A., Anthony M.S. Epidemiology of systemic lupus erythematosus: a comparison of worldwide disease burden. Lupus. 2006;15(5):308–18.

  7. Martin F, Chan AC. B cell immunobiology in disease: evolving concepts from the patients. Rheumatology (Oxford). 2005;44(12):1542–45.

  8. Carnahan J., Wang P., Kendall R., et al. Epratuzumab, a humanized monoclonal antibody targeting CD22: characterization of in vitro properties. Clin. Cancer Res. 2003;9(10 Pt 2):3982–90.

  9. Carnahan J., Stein R., Qu Z., et al. Epratuzumab, a CD22-targeting recombinant humanized antibody with a different mode of action from rituximab. Mol. Immunol. 2007;44(6):1331–41.

  10. Ding C., Jones G. Belimumab Human Genome Sciences/Cambridge Antibody Technology/GlaxoSmithKline. Curr. Opin. Investig Drugs. 2006;7(5):464–72.

  11. Dall’Era M., Chakravarty E., Wallace D., et al. Reduced B lymphocyte and immunoglobulin levels after atacicept treatment in patients with systemic lupus erythematosus: results of a multicenter,phase Ib, double-blind, placebo-controlled, dose-escalating trial. Arthritis Rheum. 2007;56:4142–50.

  12. Merrill J.T., Burgos-Vargas R., Westhovens R., et al. The efficacy and safety of abatacept in patients with non-lifethreatening manifestations of systemic lupus erythematosus: results of a twelve-month, multicenter, exploratory, phase IIb, randomized, double-blind, placebo-controlled trial. Arthritis Rheum. 2010;62:3077–87.

  13. Cardiel M.H., Tumlin J.A., Furie R.A., et al. Abetimus sodium for renal flare in systemic lupus erythematosus: results of a randomized, controlled phase III trial. Arthritis Rheum. 2008;8:2470–80.

  14. Perosa F.E, Favoino M.A., Caragnano M.P., Dammacco F. CD20: a target antigen for immunotherapy of autoimmune diseases. Autoimmunity Rev. 2005;4(8):526–31.

  15. Leandro M.J., Edwards J.C., Cambridge G., et al. An open study of B lymphocyte depletion in systemic lupus erythematosus. Arthritis Rheum. 2002;46:2673–77.

  16. Wallace D.J. Advances in drug therapy for systemic lupus erythematosus, BMC Med. 2010;29:77.

  17. Jordan N., Lutalo P.M.K., D’Cruz D.P. Novel therapeutic agents in clinical development for systemic lupus erythematosus. BMC Medicine. 2013;11:120.

  18. Furtado J., Isenberg D.A. B cell elimination in systemic lupus erythematosus. Clinical Immunology. 2013;146:90–103.

  19. Catapano F., Chaudhry A.N., Jones R.B., et al. Long-term efficacy and safety of rituximab in refractory and relapsing systemic lupus erythematosus. Nephrol. Dial Transplant. 2010;25:3586–92.

  20. Vital E.M., Dass S., Buch M.H., et al. B cell biomarkers of rituximab responses in systemic lupus erythematosus, Arthritis Rheum. 2011;63:3038–47.

  21. Соловьев С.К., Торгашина А.В., Насонов Е.Л., Александрова Е.Н. Эффективность ритуксимаба у больных системной красной волчанкой. Собственные результаты. Научно-практическая ревматология. 2010;4:52–6.

  22. Левицки А., Линден С., ван Волленховен Р.Ф. Ритуксимаб в терапии системной красной волчанки. Научно-практическая ревматология. 2013;3:223–31.

  23. van Vollenhoven R.F., Gunnarsson I., Welin-Henriksson E., et al. Biopsy-verified response of severe lupus nephritis to treatment with rituximab (anti-CD20 monoclonal antibody) plus cyclophosphamide after biopsy-documented failure to respond to cyclophosphamide alone. Scand. J. Rheumatol. 2004;33:423–27.

  24. Gunnarsson I., Jonsdottir T. Rituximab treatment in lupus nephritis – where do we stand? Lupus. 2013;22:381–89.

  25. Melander C., Sallee M., Trolliet P., et al. Rituximab in severe lupus nephritis: Early B-cell depletion affects long-term renal outcome. Clin. J. Am. Soc. Nephrol. 2009;4:579–87.

  26. Li E.K., Tam L.S., Zhu T.Y., et al. Is combination rituximab with cyclophosphamide better than rituximab alone in the treatment of lupus nephritis? Rheumatology (Oxford). 2009;48:892–98.

  27. Gunnarsson I., Sundelin B., Jonsdottir T., et al. Histopathologic and clinical outcome of rituximab treatment in patients with cyclophosphamide-resistant proliferative lupus nephritis. Arthritis Rheum. 2007;56:1263–72.

  28. Торгашина А.В., Соловьев С.К., Александрова Е.Н. и др. Применение ритуксимаба у больных волчаночным нефритом. Научно-практическая ревматология. 2010;4:14–26.

  29. Diaz-Lagares C., Croca S., Sangle S., et al. Efficacy of rituximab in 164 patients with biopsy-proven lupus nephritis: Pooled data from European cohorts. Autoimmun Rev. 2012;11:357–64.

  30. Furie R., Rovin R., Latnis K.M., et al. Efficacy and safety of rituximab in subjects with active proliferative lupus nephritis (LN): results from the randomized, double-blind phase III LUNAR study. Arthritis Rheum. 2009;60:429.

  31. Merrill J.T., Neuwelt C.M., Wallace D.J., et al. Efficacy and safety of rituximab in moderately-to-severely active systemic lupus erythematosus: the randomized, double-blind, phase II/III systemic lupus erythematosus evaluation of rituximab trial. Arthritis Rheum. 2010;62:222–33.

  32. Terrier B., Amoura Z., Ravaud P., et al. Safety and Efficacy of Rituximab in Systemic Lupus Erythematosus. Arthritis Rheum. 2010;62:2458–66.

  33. Witt M., Grunke M., Proft F., et al. Clinical outcomes and safety of rituximab treatment for patients with systemic lupus erythematosus (SLE) – results from a nationwide cohort in Germany (GRAID). Lupus. 2013;22:1142–49.

  34. Condon MB, Ashby D, Pepper RJ, et al. Prospective observational single-centre cohort study to evaluate the effectiveness of treating lupus nephritis with rituximab and mycophenolate mofetil but no oral steroids. Ann. Rheum. Dis. 2013;72:1280–86. doi:10.1136/annrheumdis-2012-202844.

  35. Traczewski P., Rudnicka L. Treatment of systemic lupus erythematosus with epratuzumab. Br. J. Clin. Pharmacol. 2011;71:175–82.

  36. Jacobi A.M., Goldenberg D.M., Hiepe F., et al. Differential effects of epratuzumab on peripheral blood B cells of patients with systemic lupus erythematosus versus normal controls. Ann. Rheum. Dis. 2008;67:450–57.

  37. Wallace D.J., Gordon C., Strand V., et al. Efficacy and safety of epratuzumab in patients with moderate/severe flaring systemic lupus erythematosus: results from two randomized, double-blind, placebo-controlled, multicentre studies (ALLEVIATE) and follow-up. Rheumatology (Oxford). 2013;52(7):1313–22. doi: 10.1093/rheumatology/ket129. Epub 2013 Mar 28.

  38. Dorner T., Kaufmann J., Wegener W.A., et al. Initial clinical trial of epratuzumab (humanized anti-CD22 antibody) for immunotherapy of systemic lupus erythematosus Arthritis Res. Ther. 2006;8(3):R74.

  39. Carnahan J., Stein R., Qu Z., et al. Epratuzumab, a CD22-targeting recombinant humanized antibody with a different mode of action from rituximab. Mol. Immunol. 2007;44(6):1331–41.

  40. FDA approves Benlysta to treat lupus. [Last accessed on 2011 Mar 28]. Available from:http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm246489.htm.

  41. Lied G.A., Berstad A. Functional and clinical aspects of the B cell-activation factor (BAFF): a narrative review. Scand. J. Immunol. 2011;73:1–7.

  42. Stohl W., Metyas S., Tan S.M., et al. B lymphocyte stimulator overexpression in patients with systemic lupus erythematosus: Longitudinal observations. Arthr Rheum. 2003;48:3475–86.

  43. Petri M., Stohl W., Chatham W., et al. Association of plasma B lymphocyte stimulator levels and disease activity in systemic lupus erythematosus. Arthr Rheum. 2008;58:2453–59.

  44. Baker K.P., Edwards B.M., Main S.H., et al. Generation and characterization of LymphoStat-B, a human monoclonal antibody that antagonizes the bioactivities of B lymphocyte stimulator. Arthr Rheum 2003;48:3253–65.

  45. Navarra S.V., Guzman R.M., Gallacher A.E., et al. BLISS-52 Study Group.Efficacy and safety of belimumab in patients with active systemic lupus erythematosus: A randomised, placebo-controlled, phase 3 trial. Lancet. 2011;377:721–31.


Об авторах / Для корреспонденции


Е.А. Асеева – к.м.н., с.н.с. лаборатории интенсивных методов терапии ревматических заболеваний ФГБУ «НИИР им. В.А. Насоновой» РАМН; e-mail: eaasseeva@mail.ru
М.Э. Цанян – младший научный сотрудник ФГБУ «НИИР им. В.А. Насоновой» РАМН
А.В. Торгашина – к.м.н, младший научный сотрудник ФГБУ «НИИР им. В.А. Насоновой» РАМН


Похожие статьи


Бионика Медиа