Systemic Lupus Erythematosus (SLE) is an autoimmune inflammatory condition with a wide spectrum of disease manifestations and severities, resulting in significant morbidity and mortality. The aetiopathogenesis of SLE is complex. Young women and certain ethnicities are commonly affected, suggesting a significant hormonal and genetic influence. Diverse immunological abnormalities have been described. A characteristic abnormality is the presence of autoantibodies, implicating a central role for B cells in disease pathogenesis and/or perpetuation. Whilst conventional therapies have improved outcomes, a great unmet need remains. Recently, biological therapies are being explored. B-cell depletion therapy with rituximab has been in use off-label for nearly two decades. Inconsistent results between uncontrolled and controlled studies have raised doubts about its efficacy. In this review, we will focus on B cell abnormalities and the rationale behind B-cell depletion therapy with anti-CD20 monoclonal antibody (mAb), rituximab, will be explored including an evaluation of clinical and trial experience. Finally, we will discuss the mechanistic basis for considering alternative anti-CD20 mAbs.

系统性红斑狼疮 (SLE) 是一种自身免疫性炎症性疾病，具有广泛的疾病表现和严重程度，导致显着的发病率和死亡率。 SLE的发病机制很复杂。年轻女性和某些种族通常会受到影响，这表明荷尔蒙和遗传的影响很大。已经描述了多种免疫学异常。一个特征性异常是自身抗体的存在，这表明 B 细胞在疾病发病机制和/或延续中发挥着核心作用。虽然传统疗法已经改善了结果，但仍然存在巨大的未满足的需求。最近，人们正在探索生物疗法。使用利妥昔单抗进行 B 细胞消除疗法已在适应症外使用了近二十年。非对照研究和对照研究之间的不一致结果引起了对其功效的怀疑。在这篇综述中，我们将重点关注 B 细胞异常，并探讨使用抗 CD20 单克隆抗体 (mAb)、利妥昔单抗进行 B 细胞消除治疗的基本原理，包括对临床和试验经验的评估。最后，我们将讨论考虑替代抗 CD20 mAb 的机制基础。