%0 Journal Article
%T B cell dysregulation and depletion therapy in primary membranous nephropathy: Prospects and potential challenges.
%A Wu Y
%A Jiang H
%A Hu Y
%A Dai H
%A Zhao Q
%A Zheng Y
%A Liu W
%A Rui H
%A Liu B
%J Int Immunopharmacol
%V 140
%N 0
%D 2024 Oct 25
%M 39098228
%F 5.714
%R 10.1016/j.intimp.2024.112769
%X B cells are crucial to the humoral immune response, originating in the bone marrow and maturing in the spleen and lymph nodes. They primarily function to protect against a wide range of infections through the secretion of antibodies. The role of B cells in primary membranous nephropathy (PMN) has gained significant attention, especially following the discovery of various autoantibodies that target podocyte antigens and the observed positive outcomes from B cell depletion therapy. Increasing evidence points to the presence of abnormal B cell subsets and functions in MN. B cells have varied roles during the different stages of disease onset, progression, and relapse. Initially, B cells facilitate self-antigen presentation, activate effector T cells, and initiate cellular immunity. Subsequently, the disruption of both central and peripheral immune tolerance results in the emergence of autoreactive B cells, with strong germinal center responses as a major source of MN autoantibodies. Additionally, critical B cell subsets, including Bregs, memory B cells, and plasma cells, play roles in the immune dysregulation observed in MN, assisting in predicting disease recurrence and guiding management strategies for MN. This review offers a detailed overview of research advancements on B cells and elucidates their pathological roles in MN.