B淋巴细胞耗竭疗法治疗血清抗体阳性脱髓鞘性视神经炎的研究进展  

Update on B cell depletion therapy for demyelinating optic neuritis with disease-specific antibody

作　　者：谢林丹 周欢粉[2] 魏世辉[2] Xie Lindan;Zhou Huanfen;Wei Shihui(Tianjin Eye Hospital,Nankai University Affiliated Eye Hospital,Clinical College of Ophthalmology of Tianjin Medical University,Tianjin Eye Institute,Tianjin Key Laboratory of Ophthalmology and Visual Science,Tianjin 300020,China;Ophthalmology Division of Chinese PLA General Hospital,Beijing 100853,China)

机构地区：[1]天津市眼科医院,南开大学附属眼科医院,天津医科大学眼科临床学院,天津市眼科研究所,天津市眼科学与视觉科学重点实验室,天津300020 [2]解放军总医院眼科医学部,北京100853

出　　处：《中华眼科杂志》2022年第11期964-969,共6页Chinese Journal of Ophthalmology

摘　　要：合并血清抗水通道蛋白4抗体或抗髓鞘少突胶质细胞糖蛋白抗体阳性的脱髓鞘性视神经炎(DON)在免疫机制、临床表现、影像学特征及治疗反应均有别于典型视神经炎。鉴于高复发率及潜在致盲风险, 往往需联合免疫抑制剂治疗。本文将就利妥昔单克隆抗体为主的B淋巴细胞耗竭疗法在两种不同抗体类型DON中治疗现状、研究进展及潜在争议进行汇总与分析, 以便优化临床决策。Demyelinating optic neuritis coexisting with seropositive aquaporin-4 antibody or myelin oligodendrocyte glycoprotein antibody is different from the typical optic neuritis in immunopathological,clinical and radiological features,as well as therapeutic response.Due to the high recurrence rate and the potential risk of blindness,immunosuppressive therapy is warranted in most cases.The current review tracks and summarizes both the update and the potential controversies of B cell depletion therapy with a special focus on rituximab for demyelinating optic neuritis to optimize clinical decision-making.

关 键 词：视神经炎 脱髓鞘疾病 水通道蛋白质4 自身抗体 髓鞘少突胶质细胞糖蛋白 B-淋巴细胞 淋巴细胞去除术 利妥昔单抗 

分 类 号：R744.52[医药卫生—神经病学与精神病学]