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瑞帕妥单抗治疗成人难治性肾病综合征的疗效及安全性分析
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Abstract:
难治性肾病综合征(refractory nephropathy syndrome, RNS)是一种复杂的临床综合征，患者通常对激素和免疫抑制剂治疗反应不佳，面临频繁复发的风险。CD20单抗通过靶向B细胞表面抗原，调节免疫反应，已被证明在改善RNS患者的临床症状和生化指标方面具有良好的疗效。CD20单抗分为三代，包括以利妥昔单抗为代表的第一代、以奥法木单抗为代表的第二代和以瑞帕妥单抗为代表的第三代。这些单抗通过耗竭CD20+ B淋巴细胞，减少蛋白尿，发挥治疗作用。本文通过阐述CD20单抗的分类、作用机制和瑞帕妥单抗的优势；同时分析不同代CD20单抗在RNS中的应用及其疗效和安全性，旨在对CD20单抗治疗RNS的研究进展作一综述。
Refractory nephropathy syndrome (RNS) is a complex clinical syndrome in which patients often do not respond well to hormone and immunosuppressive therapy and are at risk of frequent recurrence. CD20 monoclonal antibodies, by targeting B cell surface antigens, regulate the immune response and have been shown to be effective in improving clinical symptoms and biochemical indicators in patients with RNS. CD20 monoclonal antibodies are divided into three generations: the first generation, represented by rituximab; the second generation, represented by ofatumumab; and the third generation, represented by ripertamab. These monoclonal antibodies exert their therapeutic effects by depleting CD20+ B lymphocytes and reducing proteinuria. This review describes the classification of CD20 monoclonal antibodies, their mechanisms of action, and the advantages of ripertamab. It also analyzes the application, efficacy, and safety of different generations of CD20 monoclonal antibodies in RNS, aiming to provide an overview of the research progress in the treatment of RNS with CD20 monoclonal antibodies.
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