Перспективы анти-В-клеточной терапии системной склеродермии

Системная склеродермия (ССД) – тяжелое системное аутоиммунное ревматическое заболевание (САРЗ), патогенетически связанное с воспалением и патологическими нарушениями в микрососудистом русле, ведущими к развитию аутоиммунного фиброза и васкулопатии. Важную роль в патогенезе ССД играет патологическая активация В-клеточного иммунитета, проявляющаяся в нарушении В-клеточной сигнализации, В-клеточного гомеостаза, гиперпродукции «про-фибротических» цитокинов и «патогенных» аутоантител.

Несмотря на то, что патогенетические механизмы ССД, связанные с дисрегуляцией В-клеток и синтезом «склеродермических» аутоантител, изучены недостаточно, анти-В-клеточная терапия рассматривается как одно из важных направлений лечения этого заболевания. В статье рассматриваются современные представления о месте анти-В-клеточной терапии в лечении ССД, в первую очередь в отношении прогрессирования интерстициальных заболеваний легких и поражения кожи, обсуждаются результаты применения новых типом моноклональных антител к В-клеткам и CAR-T-клеточной терапии.

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