Rheumatoid Arthritis Unmasked: the Power of B Cell Depletion Therapy

Overview

Journal Mol Biol Rep

Specialty Molecular Biology

Date 2025 Feb 20

PMID 39976856

Authors

Tawfeeq Alghazali

Raed Obaid Saleh

Subasini Uthirapathy

Suhas Ballal

Shahabe Saquib Abullais

Rishiv Kalia

Renu Arya

Rsk Sharma

Abhinav Kumar

Resan Shakir Abdulamer

Affiliations

Soon will be listed here.

Abstract

Rheumatoid arthritis (RA) is an enduring autoimmune illness characterized by persistent inflammation and joint damage. Recent advancements in B cell depletion therapies (BCDTs) have provided new avenues for managing RA. This review article delves into the pathophysiology of RA, highlighting the pivotal role of B cells in disease progression. We explore the mechanisms underlying B cell depletion, focusing on monoclonal antibodies such as rituximab as well as innovative approaches like chimeric antigen receptor (CAR) T cell therapies. An in-depth analysis of clinical studies reveals the efficacy and limitations of these therapies, including success rates, side effects, and cost implications for patients. Despite promising outcomes, the incomplete depletion of B cells and associated risks underscore the need for further research. This review aims to provide a comprehensive understanding of BCDTs in RA, shed light on their potential and challenges, and guide future therapeutic strategies.

References

Szekanecz Z, Koch A, Tak P . Chemokine and chemokine receptor blockade in arthritis, a prototype of immune-mediated inflammatory diseases. Neth J Med. 2011; 69(9):356-66. View

Minichiello E, Semerano L, Boissier M . Time trends in the incidence, prevalence, and severity of rheumatoid arthritis: A systematic literature review. Joint Bone Spine. 2016; 83(6):625-630. DOI: 10.1016/j.jbspin.2016.07.007. View

Huang J, Fu X, Chen X, Li Z, Huang Y, Liang C . Promising Therapeutic Targets for Treatment of Rheumatoid Arthritis. Front Immunol. 2021; 12:686155. PMC: 8299711. DOI: 10.3389/fimmu.2021.686155. View

Sharma J, Bhar S, Subathra Devi C . A review on interleukins: The key manipulators in rheumatoid arthritis. Mod Rheumatol. 2016; 27(5):723-746. DOI: 10.1080/14397595.2016.1266071. View

Cheng Q, Wu H, Du Y . The roles of small-molecule inflammatory mediators in rheumatoid arthritis. Scand J Immunol. 2020; 93(3):e12982. DOI: 10.1111/sji.12982. View

Viatte S, Plant D, Raychaudhuri S . Genetics and epigenetics of rheumatoid arthritis. Nat Rev Rheumatol. 2013; 9(3):141-53. PMC: 3694322. DOI: 10.1038/nrrheum.2012.237. View

van Delft M, Huizinga T . An overview of autoantibodies in rheumatoid arthritis. J Autoimmun. 2020; 110:102392. DOI: 10.1016/j.jaut.2019.102392. View

Falconer J, Murphy A, Young S, Clark A, Tiziani S, Guma M . Review: Synovial Cell Metabolism and Chronic Inflammation in Rheumatoid Arthritis. Arthritis Rheumatol. 2018; 70(7):984-999. PMC: 6019623. DOI: 10.1002/art.40504. View

10.

Sweeney S, Firestein G . Rheumatoid arthritis: regulation of synovial inflammation. Int J Biochem Cell Biol. 2003; 36(3):372-8. DOI: 10.1016/s1357-2725(03)00259-0. View

11.

Taylor-Gjevre R, Nair B, Jin S, Quail J . Geographic variation in incidence and prevalence rates for rheumatoid arthritis in Saskatchewan, Canada 2001-2014. Can J Public Health. 2018; 109(3):427-435. PMC: 6964385. DOI: 10.17269/s41997-018-0045-6. View

12.

Ajeganova S, Huizinga T . Rheumatoid arthritis: Seronegative and seropositive RA: alike but different?. Nat Rev Rheumatol. 2014; 11(1):8-9. DOI: 10.1038/nrrheum.2014.194. View

13.

Radu A, Bungau S . Management of Rheumatoid Arthritis: An Overview. Cells. 2021; 10(11). PMC: 8616326. DOI: 10.3390/cells10112857. View

14.

Chang K, Yang S, Kim S, Han K, Park S, Shin J . Smoking and rheumatoid arthritis. Int J Mol Sci. 2014; 15(12):22279-95. PMC: 4284707. DOI: 10.3390/ijms151222279. View

15.

Mehta B, Pedro S, Ozen G, Kalil A, Wolfe F, Mikuls T . Serious infection risk in rheumatoid arthritis compared with non-inflammatory rheumatic and musculoskeletal diseases: a US national cohort study. RMD Open. 2019; 5(1):e000935. PMC: 6560658. DOI: 10.1136/rmdopen-2019-000935. View

16.

Perricone C, Ceccarelli F, Saccucci M, Di Carlo G, Bogdanos D, Lucchetti R . Porphyromonas gingivalis and rheumatoid arthritis. Curr Opin Rheumatol. 2019; 31(5):517-524. DOI: 10.1097/BOR.0000000000000638. View

17.

Curran A, Naik P, Giles J, Darrah E . PAD enzymes in rheumatoid arthritis: pathogenic effectors and autoimmune targets. Nat Rev Rheumatol. 2020; 16(6):301-315. DOI: 10.1038/s41584-020-0409-1. View

18.

Firestein G, McInnes I . Immunopathogenesis of Rheumatoid Arthritis. Immunity. 2017; 46(2):183-196. PMC: 5385708. DOI: 10.1016/j.immuni.2017.02.006. View

19.

McInnes I, Buckley C, Isaacs J . Cytokines in rheumatoid arthritis - shaping the immunological landscape. Nat Rev Rheumatol. 2015; 12(1):63-8. DOI: 10.1038/nrrheum.2015.171. View

20.

Damerau A, Gaber T . Modeling Rheumatoid Arthritis In Vitro: From Experimental Feasibility to Physiological Proximity. Int J Mol Sci. 2020; 21(21). PMC: 7663779. DOI: 10.3390/ijms21217916. View

21.

Cyster J, Allen C . B Cell Responses: Cell Interaction Dynamics and Decisions. Cell. 2019; 177(3):524-540. PMC: 6538279. DOI: 10.1016/j.cell.2019.03.016. View