Rituximab resistance in ITP and beyond

Frontiers in Immunology

Immunology

Zhengrui Xiao¹  Irina Murakhovskaya¹ 

[1] Division of Hematology, Department of Hematology-Oncology, Montefiore Medical Center, Albert Einstein College of Medicine, New York City, NY, United States;

关键词: ITP;    immune thrombocytopenia;    rituximab;    rituximab refractory;    rituximab resistance;    novel therapies;   

DOI  :  10.3389/fimmu.2023.1215216

 received in 2023-05-01, accepted in 2023-07-10,  发布年份 2023

来源: Frontiers

【 摘 要 】

The pathophysiology of immune thrombocytopenia (ITP) is complex and encompasses innate and adaptive immune responses, as well as megakaryocyte dysfunction. Rituximab is administered in relapsed cases and has the added benefit of inducing treatment-free remission in over 50% of patients. Nevertheless, the responses to this therapy are not long-lasting, and resistance development is frequent. B cells, T cells, and plasma cells play a role in developing resistance. To overcome this resistance, targeting these pathways through splenectomy and novel therapies that target FcγR pathway, FcRn, complement, B cells, plasma cells, and T cells can be useful. This review will summarize the pathogenetic mechanisms implicated in rituximab resistance and examine the potential therapeutic interventions to overcome it. This review will explore the efficacy of established therapies, as well as novel therapeutic approaches and agents currently in development.

【 授权许可】

Unknown   
Copyright © 2023 Xiao and Murakhovskaya