New and emerging treatment approaches to lupus

Figures & data

Figure 1 Potential future targets and relevant drugs in connection with B-cells and T-cells in the management of systemic lupus erythematosus (SLE).

Abbreviations: MHC, major histocompatiability complex; CsA, cyclosporin A; IL-2, interleukin-2; mAb, monocloral antibodies; IFN, interferon; TNF, tumor necrosis factor; BAFF, B-cell activating factor; BLyS, B lymphocyte stimulator.

Table 1 New treatment approaches in patients with systemic lupus erythematosu

Therapeutics	Characteristics	Effect	References
Rituximab	Anti-CD20 mAB	Depletion of B-cells	^Citation10^–^Citation15
Ocrelizumab	Anti-CD20 mAB	Depletion of B-cells	ClinicalTrials.gov
Ofatumumab**	Anti-CD20 mAB	Depletion of B-cells	^Citation16
Veltumumab**	Anti-CD20 mAB	Depletion of B-cells	^Citation16
Epratuzumab	Anti-CD22 mAB	Reduction of B-cells, B cell modification	^Citation17, ^Citation18
Abetimus	Four dsDNA epitopes on a PEG platform	Cross-links anti-dsDNA Ig receptor, ⇓ anti-dsDNA	^Citation19, ^Citation20
Belimumab	Anti-BLyS mAB	Prevention of sBLYS binding to receptor	^Citation21, ^Citation22
Atacicept	sTACl-receptor	Antagonistic effect on BLyS/APRIL	ClinicalTrials.gov
Abatacept	CTLA4-Ig fusion protein	Interaction with B7 ⇒ co-stimulatory blockade, T-cell activation inhibition	^Citation11, ^Citation26ClinicalTrials.gov
Belatacept	CTLA4-Ig fusion protein	Interaction with B7 ⇒ co-stimulatory blockade	ClinicalTrials.gov
IDEC-131	Anti-CD154 mAB	CD40L blockade ⇒ co-stimulatory blockade	^Citation27
BG9588	Anti-CD40L mAB	CD40L blockade ⇒co-stimulatory blockade	^Citation28
Cyclosporine	Cyclic peptide of 11 amino acids	Calcineurin inhibitor, ⇓ T-cell activation/proliferation	^Citation30^–^Citation33
Tacrolimus	Macrolid	Calcineurin inhibitor, ⇓ T-cell activation/proliferation	^Citation34^–^Citation36
Sirolimus	Rapamycin- mTOR inhibitor	Blockade of T- and B-cell activation to IL-2	^Citation37^–^Citation39
Infliximab	Anti-TNF mAB	Neutralization of TNF	^Citation41
Etanercept and other anti-TNF biologicals	Fusion protein with part of TNF-R2	Neutralization of TNF	^Citation41
B-N10	Anti-IL-10	Reduction of B-cell proliferation	^Citation46
Tocilizumab	Anti-IL-6 receptor mAB	Inhibition of IL-6 ⇒ B-cell and T-cell differentiation ⇓	^Citation16,Citation48
Sifalimumab	Anti-human IFN-α mAB	Inhibition of IFN-α	^Citation51, ^Citation52ClinicalTrials.gov
Rontalizumab	Anti-human IFN-α mAB	Inhibition of IFN-α	ClinicalTrials.gov
Edratide	Synthetic peptide on CDR1 of pathogenic anti-DNA mAB	Downregulation of pro-inflammatory cytokines, pro-apoptotic molecules	^Citation53ClinicalTrials.gov
Eculizumab	Anti-C5b mAB	Blockade of terminal complement activation	^Citation54

Notes:

** denotes treatments not used in SLE yet.

Abbreviations: MHC, major histocompatiability complex; CsA, cyclosporin A; IL-2, interleukin-2; mAb, monocloral antibodies; IFN, interferon; TNF, tumor necrosis factor; BAFF, B-cell activating factor; BLyS, B lymphocyte stimulator.

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