B cells as targets for managing glomerular diseases: A review of contemporary and novel therapies

B lymphocytes play a pivotal role in the pathogenesis of immune-mediated glomerular diseases by mediating autoantibody production, antigen presentation, cytokine signalling, co-stimulation, and intrarenal inflammation.While conventional immunosuppression remains the standard treatment, relapsing and refractory disease continues to pose significant therapeutic challenges.Recent advances in the understanding of B-cell activation, differentiation, survival, and plasma-cell biology have facilitated the development of therapies targeting CD20, CD38, B cell activating factor/B-lymphocyte stimulator, a proliferation-inducing ligand, CD40/CD40 L, CD19, and B-cell maturation antigen.This review provides an overview of established and emerging B-cell-and plasma-cell-directed therapies for glomerular disease, focusing on mechanisms of action, clinical indications, efficacy, safety, and their potential roles in the management of difficult-to-treat cases.The limitations of current evidence, such as study heterogeneity, small sample sizes, and insufficient long-term safety data, are also addressed.