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Targeting BAFF and APRIL in Systemic Lupus Erythemathosis

Wijs, F.A.L.M. de (2016) Targeting BAFF and APRIL in Systemic Lupus Erythemathosis. Master's Thesis / Essay, Biomedical Sciences.

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Abstract

Systemic Lupus Erythemathosis (SLE) is a complex autoimmune disease. Diagnosis and prognosis are difficult and have a lot of confounders. Progress of the disease is thus followed by a number of measures, such as damage indices like SELENA/SLEDAI and BILAG, B-cell numbers, immunoglobulin levels, in particular autoantibodies such as anti-dsDNA antibodies, and complement C3 and C4 levels. B-cell proliferation and activation are overstimulated in SLE, particularly through the BAFF/APRIL stimulated pathways. A number of BAFF/APRIL targeting biologicals have been approved for use in treatment of SLE or are currently in clinical trials. Three of these are highlighted here: Belimumab, Blisibimod and Atacicept. Belimumab, a fully humanized anti-BAFF antibody, is already approved by the USFDA. In clinical studies it has been show to lower the damage index, B-cell numbers and immunoglobulin levels, it increases complement levels and may reduce the need for steroids. Blisibimod, a synthetic peptibody, is in stage II trials. Like Belimumab, Blisbimod lowers the damage index and B-cell numbers, increases complement levels and may reduce the need for steroids. Ataticept, a fusion protein, is in stage III trials. Atacicept also lowers the damage index, B-cell numbers and immunoglobulin levels, increases complement and may reduce the need for steroids. The differences are relatively small and to determine the most promising of these treatments close attention has to be paid to the data from trials. So far, the fully human antibody Belimumab seems to retain the advantage over biologicals like Blisibimod and Atacicept.

Item Type: Thesis (Master's Thesis / Essay)
Degree programme: Biomedical Sciences
Thesis type: Master's Thesis / Essay
Language: English
Date Deposited: 15 Feb 2018 08:23
Last Modified: 15 Feb 2018 08:23
URI: http://fse.studenttheses.ub.rug.nl/id/eprint/14324

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