B cells have a pivotal function in the pathogenesis of autoimmune diseases, such as
rheumatoid arthritis, multiple sclerosis and systemic lupus erythematosus. In autoimmune
disease, B cells orchestrate antigen presentation, cytokine production and autoantibody
production, the latter via their differentiation into antibody-secreting plasmablasts
and plasma cells. This article addresses the current therapeutic strategies to deplete
B cells in order to ameliorate or potentially even cure autoimmune disease. It addresses
the main target antigens in the B-cell lineage that are used for therapeutic approaches.
Furthermore, it summarises the current evidence for successful treatment of autoimmune
disease with monoclonal antibodies targeting B cells and the limitations and challenges
of these approaches. Finally, the concept of deep B-cell depletion and immunological
reset by chimeric antigen receptor T cells is discussed, as well as the lessons from
this approach for better understanding the role of B cells in autoimmune disease.
