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Novel B Cell Therapeutic Targets in Transplantation and Immune-Mediated Glomerular Diseases

Flavio Vincenti^*, Scott D. Cohen, and Gerald Appel

^* Kidney Transplant Service and the Glomerular Center, Columbia University Medical Center, New York Presbyterian Hospital, New York, New York

Correspondence: Dr. Flavio Vincenti, University of California, San Francisco, Kidney Transplant Service, 505 Parnassus Avenue, M884, San Francisco, CA 94143-0780. Phone: 415-353-1322; Fax: 415-353-8974; E-mail: flavio.vincenti{at}ucsfmedctr.org or Dr. Gerald Appel, Division of Nephrology, Department of Medicine, Columbia University Medical Center, 622 W 168th Street PH4-124, New York, NY 10032. Phone: 212-305-0320; Fax: 212-342-1814; E-mail: gba2{at}columbia.edu

B cells and antibodies play an important role in the alloresponse to renal grafts as well as in immune-mediated glomerular diseases. In transplantation, greater recognition and improved diagnosis of antibody-mediated rejection have been a catalyst to the introduction of newer drugs and regimens that target B cells, plasma cells, and donor-specific antibodies to improve the outcome associated with antibody-mediated rejection. In immune-mediated renal disease, novel and more selective B cell therapies are gradually modifying the traditional therapeutic approach that consists of steroids and other immunosuppressants. A new era of selective and more effective immunosuppression agents that target the humoral response is finally emerging in transplantation and renal diseases.