利妥昔单抗治疗特发性膜性肾病的研究进展  

Research Progress of Rituximab in the Treatment of Idiopathic Membranous Nephropathy

作　　者：刘晓辉 梅峰[2] 

机构地区：[1]青海大学研究生院,青海 西宁 [2]青海大学附属医院肾病内科,青海 西宁

出　　处：《临床医学进展》2023年第6期9807-9815,共9页Advances in Clinical Medicine

摘　　要：特发性膜性肾病(idiopathic membranous nephropathy, IMN),是一种病因未明的、由自身抗体介导的原发性肾小球肾炎,是构成原发性肾病综合征(nephrotic syndrome, NS)的常见病理类型之一。IMN治疗上主要包括非免疫抑制治疗和免疫抑制治疗,但随着对其发病机制的不断深入研究,B细胞在其中发挥重大作用。利妥昔单抗(RTX),是一种小型嵌合鼠/人单克隆免疫抗体,通过作用于靶向B淋巴细胞上的CD20表面抗原,选择性地耗尽这些细胞,但RTX治疗IMN的效果是否优于传统免疫抑制剂尚存在争议,且RTX不同剂量在IMN中的应用目前尚未明确。本文就IMN的发病机制、治疗及RTX与其他免疫抑制剂对比及不同剂量用药治疗IMN的方案做一综述。Idiopathic membranous nephropathy is a primary glomerulonephritis mediated by autoantibodies of unknown etiology, which is one of the common pathological types of primary nephrotic syndrome. The treatment of IMN mainly includes non-immunosuppressive therapy and immunosuppressive therapy, but with the continuous in-depth study of its pathogenesis, B cells play an important role in it. Rituximab, a small chimeric mouse/human monoclonal antibody, selectively depleted B lym-phocytes by targeting the CD20 surface antigen on these cells. However, the efficacy of RTX over conventional immunosuppressants in the treatment of IMN is controversial, and the application of different doses of RTX to IMN is not yet clear. This article reviews the pathogenesis and treatment of IMN, the comparison between RTX and other immunosuppressants, and the treatment of IMN with different doses.

关 键 词：利妥昔单抗 特发性膜性肾病 发病机制 治疗及研究进展 

分 类 号：R69[医药卫生—泌尿科学]