2025/02/03 by Giovanni Maria Rossi, Eva Baier, Augusto Vaglio · 1 voice
Medicine · Immunology and Microbiology · #Autoimmune Bullous Skin Diseases #Renal Diseases and Glomerulopathies #Immunodeficiency and Autoimmune Disorders
paper · doi:10.1093/ndt/gfaf021
openalex publication_date 2025/02/03 · openalex created_date 2025/10/10 · openalex updated_date 2026/07/28
Since the discovery of the CD20 antigen as a target for B-cell depletion in the 1970s, anti-CD20 monoclonal antibodies have transformed treatment approaches for B-cell malignancies and antibody-mediated diseases. Rituximab, the first of its kind, was approved in 1997 and became a mainstay therapy for a variety of B-cell-driven conditions, including immune-mediated glomerular diseases. However, challenges such as incomplete responses, resistance, or hypersensitivity to rituximab have underscored the need for next-generation antibodies. Obinutuzumab, a fully humanized type II anti-CD20 monoclonal antibody engineered for enhanced immune activation and direct cell death, has emerged as a promising alternative, with ongoing studies exploring its efficacy and safety in conditions such as lupus nephritis (LN), membranous nephropathy (MN), anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitides (AAV), and other immune-mediated glomerular diseases. The CD20 antigen, a transmembrane protein on B cells, was identified as a target for B-cell depleting therapies in the 1970s, leading to the development of anti-CD20 antibodies [1]. Rituximab, the first anti-CD20 monoclonal antibody (mAb), was FDA approved in 1997 and became essential in treating B-cell malignancies and immune-mediated conditions [2, 3].