B cell Therapy to Treat an Axonal Neuropathy in Mixed Connective Tissue Disease

The B cell is a vital contributor to humoral immunity. The B cell-specific antigen CD20 is expressed during B cell development, starting at the pre-B cell level and persists through B cell differentiation, but is lost during terminal differentiation to plasma cells. Rituximab is a monoclonal antibody that destroys both normal and malignant B cells that have CD20 on their surfaces and is therefore used to treat diseases characterized by excessive B cells, overactive B cells, or dysfunctional B cells. The connective tissue diseases and vasculitis mediated by B cell may cause various disorders of the peripheral nervous system especially axonal neuropathy. B cell–directed therapies may represent a promising new treatment for autoimmune axonal neuropathies.