Autoimmune diseases are characterized by the recognition of
self-antigens by the immune system, which leads to
inflammation and tissue damage. B cells are directly and indirectly involved in the pathophysiology of autoimmunity, both via antigen-presentation to T cells and production of proinflammatory
cytokines and/or
autoantibodies. Consequently, B lineage cells have been identified as therapeutic targets in
autoimmune diseases. B cell depleting strategies have proven beneficial in the treatment of
rheumatoid arthritis (RA), systemic lupus erythematous (SLE),
ANCA-associated vasculitis (AAV),
multiple sclerosis (MS), and a wide range of other immune-mediated inflammatory diseases (
IMIDs). However, not all patients respond to treatment or may not reach (drug-free) remission. Moreover, B cell depleting
therapies do not always target all B cell subsets, such as short-lived and long-lived plasma cells. These cells play an active role in autoimmunity and in certain diseases their depletion would be beneficial to achieve disease remission. In the current review article, we provide an overview of novel strategies to target B lineage cells in
autoimmune diseases, with the focus on
rheumatic diseases. Both advanced
therapies that have recently become available and more experimental treatments that may reach the clinic in the near future are discussed.