›› 2018, Vol. 38 ›› Issue (3): 333-.doi: 10.3969/j.issn.1674-8115.2018.03.017

• Review • Previous Articles     Next Articles

Advances in application of rituximab in treatment of primary glomerulonephritis

YANG Xiao-qian1 , XIE Jing-yuan1, 2, MOU Shan2, 3   

  1. 1. Department of Nephrology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China; 2. Institute of Nephrology, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China ; 3. Renal Division, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
  • Online:2018-03-28 Published:2018-05-03
  • Supported by:
    Shanghai Municipal Education Commission— Gaofeng Clinical Medicine Grant Support, 20152207; International Cooperation and Exchange Program of Science and Technology Committee of Shanghai Municipality, 14430721000; Multicenter Clinical Research Project of Shanghai Jiao Tong University School of Medicine, DLY201510; National Natural Science Foundation of China, 81373865, 81573748; Program of Shanghai Excellent Academic Leader, 16XD1401900

Abstract:  Primary glomerulonephritis (PGN) remains the major cause of end-stage renal disease (ESRD) in our country. The histologic entity of PGN mainly includes immunoglobulin A nephropathy (IgAN), idiopathic membranous nephropathy (IMN), minimal change disease (MCD), focal and segmental glomerulosclerosis (FSGS) and membranoproliferative glomerulonephritis (MPGN). The pathogenesis of PGN is correlated with renal immune complex deposition, podocyte injury, infection and abnormal regulation of complement system. Nowadays PGN is short of specific treatments, the main therapeutic methods of PGN consists of renin angiotensin aldosterone system (RAAS) inhibitor, corticosteroids, cytotoxic drugs, lipid-lowering agents, anticoagulant therapy and antiplatelet adhesion. Patients who are drug-resistant or intolerance of the side effects will have a poor prognosis. Rituximab (RTX) is a chimeric monoclonal anti-CD20 antibody. The binding of RTX to CD20 on the cell membrane of B lymphocytes leads to significant depletion of peripheral B lymphocytes, which plays an immunosuppressive role. Rituximab is originally approved for the treatment of lymphoma, after that there was growing evidence showed RTX was effective in part of immunological diseases, including systemic lupus erythematosus and anitneutrophil cytoplasmic antibody associated vasculitis. As a result, whether RTX will act as an effective treatment modality in PGN has aroused extensive attention. In recently years, clinical researches concerning RTX used for the treatment of PGN have been published in succession. This paper reviewed clinical studies focused on the use of rituximab in the treatment of IMN, MCD, FSGS and IgAN.

Key words: rituximab (RTX), primary glomerulonephritis (PGN), treatments, B lymphocytes