Novel B cell depleting therapies as a path to tailored strategies in autoimmune kidney diseases

Depletion of B cells in autoimmune diseasesB cells form the backbone of adaptive immunity and contribute to the pathophysiology of autoimmune diseases via generation of autoantibodies, antigen presentation to T lymphocytes and cytokine production 1,2 .This makes B cells an important target for therapeutic approaches, including those leading to reduce their numberR B cell depletion, was first devised as a therapy for hematologic malignancies, but soon emerged as a therapeutic option for autoimmune diseases in which B cells have a role, including several glomerular diseases 1,3,4 .Such strategies are directed towards several distinct molecular targets, variably expressed by B cells based on their stage of maturation, particularly CD20, CD19 and CD38.A different approach relies on the immunomodulation of B cells, via antagonism of TNF-like cytokines like a proliferation-inducing ligand (APRIL) and B-cell activating factor (BAFF) and/or their receptor, transmembrane activator and calcium modulator and cyclophilin ligand interactor (TACI) 5 .