الفهرس 
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Abstract
Introduction: In recent years, the role of B cells in the regulation of the immune system has expanded. B cells are not only the source of autoantibodies but they have a broader pathogenetic role in the maintenance of autoreactive T cell activation and in secretion of proinflammatory cytokines. Hence the need for a biological agent that targets B cells for auto-antibody associated rheumatic diseases was introduced .This began in 1998 following the success of B cell depletion therapy by rituximab (RTX) in treating lymphoma. It is already established that many RA patients do benefit from RTX, and it is highly suggested that clinical benefit will be formally proven for many SLE patients as well. The therapeutic response seen with B cell depletion using RTX suggests that other approaches that interfere with B cell function or interfere with B cell trafficking to the joints or other sites of inflammation in patients with RA may prove useful. B cell targets other than CD20 that have been suggested include the following: Molecules involved in intracellular signaling pathways, TLR,Costimulatory receptor or ligands ,Surface markers other than CD20 (e.g. CD79, CD22) and B cell survival promoting molecule (B lymphocyte stimulator, BLyS). There is a suggestion that B-cell-targeted therapy might allow us to distinguish these classical autoantibody-associated diseases from the autoantibody-negative disorders. B-cell-targeted therapy promises to rapidly secure an important place in the treatment of autoimmune rheumatic disorders. Aim of the essay: The present essay aims to assess the role of B cells in autoimmune rheumatic diseases including RA, SLE and other rheumatic diseases and to review the value and efficacy of B-cell-targeted therapy in treatment of some rheumatic diseases. Conclusion: B cells play a pivotal role in several human autoimmune rheumatic diseases. B-cell-directed therapy is a promising therapeutic strategy for several diseases, including RA, SLE and a variety of other rheumatic diseases. Selective B-cell depletion with RTX therapy is a novel treatment option for patients with refractory autoimmune rheumatic diseases. RTX is now approved for the use in active RA and is under trials in other diseases as SLE and myositis. RTX is well-tolerated and generally safe. RTX provides a comparison point for the assessment of the value of alternative B-cell-directed approaches. RTX -based therapy is suggested to yield significant clinical benefits in a wide range of organ-specific and systemic autoimmune diseases. Recommendations: Future researches are needed to be focused on the optimization of responses with RTX in RA. More researches are needed to assess the value of RTX in SLE and other rheumatic diseases.