B Cells and Autoimmunity

Abstract

This chapter highlights the significant contribution of B cells to the development and pathogenesis of autoimmune diseases. It also reviews recent advances in the understanding of B-cell differentiation, both in normal individuals and in those with autoimmune diseases, and the role of B-cell intrinsic and extrinsic factors to the progression of autoimmune conditions, and reveals how these findings have illuminated possible new therapies for improved treatment of such diseases. Furthermore, recent work on mice and humans has identified pathogenic autoantibodies, which alone can cause tissue damage or adverse functional effects. In fact, these are probably the tip of an iceberg and tissue damage is likely triggered by several, if not different, autoantibodies, from patient to patient, with the challenge being to identify pathways by which they act. These ideas are fortified by the increasing range of autoimmune diseases alleviated by therapy with intravenous immunoglobulin for which the primary benefit depends on blocking of antibody-mediated effects.