{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T05:09:00Z","timestamp":1789016940967,"version":"build-2803163510"},"reference-count":97,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T00:00:00Z","timestamp":1788998400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>B cells play a critical role in autoimmunity through autoantibody production, plasma cell differentiation, antigen presentation, cytokine secretion, and germinal center responses. The clinical efficacy, durability, and safety profiles vary across autoimmune diseases. Therefore, the objective is to assess B-cell therapeutic responses and their correlation with disease pathology in autoimmunity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Embase, Web of Science, and PubMed were systematically screened for clinical trials published between 2020 and July 2025.\u00a0A total of 24 clinical trials across five autoimmune conditions\u2014pemphigus vulgaris, myasthenia gravis, rheumatoid arthritis, systemic sclerosis, and Sj\u00f6gren\u2019s syndrome\u2014were evaluated for B-cell-targeted therapy. Interventions included B-cell depletion therapy, CAR-T cell therapy, BTK inhibition, rituximab and its biosimilars, and combination strategies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Across 24 clinical trials, more than 3,500 participants were included. We observed that autoantibody-mediated diseases pemphigus vulgaris and myasthenia gravis had the most superior and durable immune response to B-cell depletion by rituximab and inebilizumab, respectively. BTK inhibition showed rapid but non-durable responses. Immune complex diseases like rheumatoid arthritis and systemic sclerosis showed improvement in activity scores and partial response, and no clinical remission after treatment with rituximab and its biosimilars. The next-generation approach BCMA-directed CAR T-cell therapy showed promising results with potential durability in myasthenia gravis. Combination therapy using belimumab and rituximab resulted in a significantly better clinical outcome than monotherapy in Sj\u00f6gren\u2019s syndrome. Overall, B-cell therapy safety profiles showed no severe adversity and were well tolerated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The success of B-cell therapeutics appears to align with B-cell contribution, disease biology, and the depth of B-cell targeting in autoimmune conditions. Precision targeting is needed to effectively combat autoimmune diseases.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fimmu.2026.1906254","type":"journal-article","created":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T04:33:21Z","timestamp":1789014801000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["B-cell centrality dictates therapeutic efficacy across autoimmune diseases: a systematic review"],"prefix":"10.3389","volume":"17","author":[{"given":"Vishakha","family":"Hooda","sequence":"first","affiliation":[{"name":"Department of Medical Oncology, All India Institute of Medical Sciences","place":["New Delhi, India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harsh","family":"Goel","sequence":"additional","affiliation":[{"name":"Laboratory Oncology Unit, Dr. B.R. Ambedkar Institute Rotary Cancer Hospital, All India Institute of Medical Sciences","place":["New Delhi, India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taruna","family":"Madan","sequence":"additional","affiliation":[{"name":"Division of Development Research, Indian Council of Medical Research","place":["New Delhi, India"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alpana","family":"Sharma","sequence":"additional","affiliation":[{"name":"Division of Development Research, Indian Council of Medical Research","place":["New Delhi, India"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,10]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1038\/s41590-025-02102-0","article-title":"B cell immunometabolism in health and disease","volume":"26","author":"Martinis","year":"2025","journal-title":"Nat Immunol"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2013.01.046","article-title":"B-cell biology and development","volume":"131","author":"Pieper","year":"2013","journal-title":"J Allergy Clin Immunol"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaut.2018.10.012","article-title":"Molecular mimicry and autoimmunity","volume":"95","author":"Rojas","year":"2018","journal-title":"J Autoimmun"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1016\/j.autrev.2025.103851","article-title":"Autoreactive B cells in autoimmune diseases: Mechanisms, functions and clinical implications","volume":"24","author":"Collet","year":"2025","journal-title":"Autoimmun Rev"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1016\/j.coi.2019.09.004","article-title":"B cell targeted therapies in autoimmune disease","volume":"61","author":"Barnas","year":"2019","journal-title":"Curr Opin Immunol"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1186\/s13075-017-1500-0","article-title":"Highly selective inhibition of Bruton\u2019s tyrosine kinase attenuates skin and brain disease in murine lupus","volume":"20","author":"Chalmers","year":"2018","journal-title":"Arthritis Res Ther"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1038\/nrrheum.2012.58","article-title":"Follicular helper T cells in immunity and systemic autoimmunity","volume":"8","author":"Craft","year":"2012","journal-title":"Nat Rev Rheumatol"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1038\/nrneph.2016.20","article-title":"Plasma cells as an innovative target in autoimmune disease with renal manifestations","volume":"12","author":"Hiepe","year":"2016","journal-title":"Nat Rev Nephrol"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2017.01986","article-title":"Bruton\u2019s tyrosine kinase, a component of B cell signaling pathways, has multiple roles in the pathogenesis of lupus","volume":"8","author":"Satterthwaite","year":"2017","journal-title":"Front Immunol"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2024.1454747","article-title":"Cutting-edge approaches to B-cell depletion in autoimmune diseases","volume":"15","author":"Robinson","year":"2024","journal-title":"Front Immunol"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1146\/annurev-immunol-083122-044829","article-title":"B cell\u2013directed therapy in autoimmunity","volume":"42","author":"Abeles","year":"2024","journal-title":"Annu Rev Immunol"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1016\/j.coi.2025.102591","article-title":"Immunotherapy for pemphigus and bullous pemphigoid","volume":"95","author":"Xu","year":"2025","journal-title":"Curr Opin Immunol"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1111\/1346-8138.16653","article-title":"B-cell targeted therapy of pemphigus","volume":"50","author":"Yamagami","year":"2023","journal-title":"J Dermatol"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.12703\/P6-32","article-title":"Management of pemphigus","volume":"6","author":"Daniel","year":"2014","journal-title":"F1000Prime Rep"},{"key":"B15","doi-asserted-by":"publisher","first-page":"3","DOI":"10.4103\/idoj.idoj_1059_24","article-title":"Consensus based Indian guidelines for the management of pemphigus vulgaris and pemphigus foliaceous","volume":"16","author":"De","year":"2025","journal-title":"Indian Dermatol Online J"},{"key":"B16","unstructured":"Search results drugbank"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.3390\/cells10112857","article-title":"Management of rheumatoid arthritis: an overview","volume":"10","author":"Radu","year":"2021","journal-title":"Cells"},{"key":"B18","doi-asserted-by":"publisher","first-page":"43","DOI":"10.1186\/s13075-024-03262-4","article-title":"Manifestations and management of Sj\u00f6gren\u2019s disease","volume":"26","author":"Maleki-Fischbach","year":"2024","journal-title":"Arthritis Res Ther"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.3238\/arztebl.2017.0354","article-title":"The diagnosis and treatment of sj\u00f6gren\u2019s syndrome","volume":"114","author":"Stefanski","year":"2017","journal-title":"Dtsch \u00c4rztebl Int"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.3390\/jcm11061597","article-title":"Current treatment of myasthenia gravis","volume":"11","author":"Alhaidar","year":"2022","journal-title":"J Clin Med"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.1007\/s13760-024-02552-7","article-title":"Recommendations for the management of myasthenia gravis in Belgium","volume":"124","author":"De Bleecker","year":"2024","journal-title":"Acta Neurol Belg"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.1097\/BOR.0000000000001082","article-title":"Management of cutaneous manifestations of systemic sclerosis: current approaches and emerging therapies","volume":"37","author":"Bautista Sanchez","year":"2025","journal-title":"Curr Opin Rheumatol"},{"key":"B23","doi-asserted-by":"publisher","first-page":"29","DOI":"10.1136\/ard-2024-226430","article-title":"EULAR recommendations for the treatment of systemic sclerosis: 2023 update","volume":"84","author":"Galdo","year":"2024","journal-title":"Ann Rheum Dis"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.1097\/BOR.0000000000000711","article-title":"Management of systemic sclerosis: the first five years","volume":"32","author":"Roofeh","year":"2020","journal-title":"Curr Opin Rheumatol"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2013-203993","article-title":"Rituximab versus an alternative TNF inhibitor in patients with rheumatoid arthritis who failed to respond to a single previous TNF inhibitor: SWITCH-RA, a global, observational, comparative effectiveness study","volume":"74","author":"Emery","year":"2015","journal-title":"Ann Rheum Dis"},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.150051","article-title":"Longterm safety of rituximab: final report of the rheumatoid arthritis global clinical trial program over 11 years","volume":"42","author":"Vollenhoven","year":"2015","journal-title":"J Rheumatol"},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.1016\/j.autrev.2014.12.002","article-title":"A comprehensive analysis of treatment outcomes in patients with pemphigus vulgaris treated with rituximab","volume":"14","author":"Ahmed","year":"2015","journal-title":"Autoimmun Rev"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.1093\/ced\/llaf118","article-title":"Comparison of clinical efficacy and cost-effectiveness of rituximab infusion and intravenous dexamethasone pulse therapy in pemphigus vulgaris: an open prospective randomized controlled pilot study","volume":"50","author":"Sharma","year":"2025","journal-title":"Clin Exp Dermatol"},{"key":"B29","doi-asserted-by":"publisher","DOI":"10.1002\/art.40093","article-title":"Randomized controlled trial of rituximab and cost-effectiveness analysis in treating fatigue and oral dryness in primary sj\u00f6gren\u2019s syndrome","volume":"69","author":"Bowman","year":"2017","journal-title":"Arthritis Rheumatol"},{"key":"B30","doi-asserted-by":"publisher","DOI":"10.7326\/M13-1085","article-title":"Treatment of primary Sj\u00f6gren syndrome with rituximab: a randomized trial","volume":"160","author":"Devauchelle-Pensec","year":"2014","journal-title":"Ann Intern Med"},{"key":"B31","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2013-204522","article-title":"Effects and safety of rituximab in systemic sclerosis: an analysis from the European Scleroderma Trial and Research (EUSTAR) group","volume":"74","author":"Jordan","year":"2015","journal-title":"Ann Rheum Dis"},{"key":"B32","doi-asserted-by":"publisher","first-page":"45","DOI":"10.1016\/S2213-2600(22)00359-9","article-title":"Rituximab versus intravenous cyclophosphamide in patients with connective tissue disease-associated interstitial lung disease in the UK (RECITAL): a double-blind, double-dummy, randomised, controlled, phase 2b trial","volume":"11","author":"Maher","year":"2023","journal-title":"Lancet Respir Med"},{"key":"B33","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000004341","article-title":"Rituximab as treatment for anti-MuSK myasthenia gravis: Multicenter blinded prospective review","volume":"89","author":"Hehir","year":"2017","journal-title":"Neurology"},{"key":"B34","doi-asserted-by":"publisher","first-page":"5345","DOI":"10.1182\/blood-2019-129600","article-title":"Comparative assessment of surface CD19 and CD20 expression on B-cell lymphomas from clinical biopsies: implications for targeted therapies","volume":"134","author":"Horna","year":"2019","journal-title":"Blood"},{"key":"B35","doi-asserted-by":"publisher","DOI":"10.1016\/j.jdcr.2025.08.042","article-title":"A recalcitrant case of pemphigus treated with inebilizumab","volume":"67","author":"Bear","year":"2025","journal-title":"JAAD Case Rep"},{"key":"B36","doi-asserted-by":"publisher","DOI":"10.1038\/s41573-020-00092-2","article-title":"B cell depletion therapies in autoimmune disease: advances and mechanistic insights","volume":"20","author":"Lee","year":"2021","journal-title":"Nat Rev Drug Discov"},{"key":"B37","doi-asserted-by":"publisher","DOI":"10.1007\/s00401-022-02411-w","article-title":"BTK inhibition limits B-cell-T-cell interaction through modulation of B-cell metabolism: implications for multiple sclerosis therapy","volume":"143","author":"Li","year":"2022","journal-title":"Acta Neuropathol (Berl)"},{"key":"B38","doi-asserted-by":"publisher","DOI":"10.1002\/art.41275","article-title":"Fenebrutinib versus placebo or adalimumab in rheumatoid arthritis: A randomized, double-blind, phase II trial (ANDES study)","volume":"72","author":"Cohen","year":"2020","journal-title":"Arthritis Rheumatol"},{"key":"B39","doi-asserted-by":"publisher","first-page":"385","DOI":"10.1007\/s40265-025-02259-w","article-title":"Rilzabrutinib: first approval","volume":"86","author":"Lee","year":"2025","journal-title":"Drugs"},{"key":"B40","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2024.1519671","article-title":"CAR-T cell therapy: developments, challenges and expanded applications from cancer to autoimmunity","volume":"15","author":"Kong","year":"2024","journal-title":"Front Immunol"},{"key":"B41","doi-asserted-by":"publisher","first-page":"103","DOI":"10.1007\/s12016-025-09114-6","article-title":"Chimeric antigen receptor T cell therapy in systemic lupus erythematosus: mechanisms, clinical advances, and future directions a comprehensive review","volume":"68","author":"Matarneh","year":"2025","journal-title":"Clin Rev Allergy Immunol"},{"key":"B42","doi-asserted-by":"publisher","DOI":"10.1038\/s41591-022-02017-5","article-title":"Anti-CD19 CAR T cell therapy for refractory systemic lupus erythematosus","volume":"28","author":"Mackensen","year":"2022","journal-title":"Nat Med"},{"key":"B43","doi-asserted-by":"publisher","first-page":"185","DOI":"10.1007\/s40259-024-00701-1","article-title":"New and emerging biological therapies for myasthenia gravis: A focussed review for clinical decision-making","volume":"39","author":"Gerischer","year":"2025","journal-title":"Biodrugs"},{"key":"B44","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp-2024-333924","article-title":"Neurotoxic complications of chimeric antigen receptor (CAR) T-cell therapy","volume":"96","author":"Vonberg","year":"2025","journal-title":"J Neurol Neurosurg Psychiatry"},{"key":"B45","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n71","article-title":"The PRISMA 2020 statement: an updated guideline for reporting systematic reviews","volume":"372","author":"Page","year":"2021","journal-title":"BMJ"},{"key":"B46","doi-asserted-by":"publisher","first-page":"2132","DOI":"10.1016\/j.jid.2021.01.031","article-title":"Rituximab and corticosteroid effect on desmoglein-specific B cells and desmoglein-specific T follicular helper cells in pemphigus","volume":"141","author":"Maho-Vaillant","year":"2021","journal-title":"J Invest Dermatol"},{"key":"B47","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2028564","article-title":"Rituximab versus mycophenolate mofetil in patients with pemphigus vulgaris","volume":"384","author":"Werth","year":"2021","journal-title":"N Engl J Med"},{"key":"B48","doi-asserted-by":"publisher","DOI":"10.1001\/jamadermatol.2023.5679","article-title":"Sustained remission without corticosteroids among patients with pemphigus who had rituximab as first-line therapy: follow-up of the ritux 3 trial","volume":"160","author":"Tedbirt","year":"2024","journal-title":"JAMA Dermatol"},{"key":"B49","doi-asserted-by":"publisher","DOI":"10.1111\/bjd.20431","article-title":"Proof of concept for the clinical effects of oral rilzabrutinib, the first Bruton tyrosine kinase inhibitor for pemphigus vulgaris: the phase II BELIEVE study","volume":"185","author":"Murrell","year":"2021","journal-title":"Br J Dermatol"},{"key":"B50","doi-asserted-by":"publisher","DOI":"10.1016\/j.jdermsci.2021.07.002","article-title":"A multicenter, open-label, uncontrolled, single-arm phase 2 study of tirabrutinib, an oral Bruton\u2019s tyrosine kinase inhibitor, in pemphigus","volume":"103","author":"Yamagami","year":"2021","journal-title":"J Dermatol Sci"},{"key":"B51","doi-asserted-by":"publisher","DOI":"10.1136\/ard-2022-223759","article-title":"Irreversible covalent Bruton\u2019s tyrosine kinase inhibitor, TAS5315 versus placebo in rheumatoid arthritis patients with inadequate response to methotrexate: a randomised, double-blind, phase IIa trial","volume":"82","author":"Takeuchi","year":"2023","journal-title":"Ann Rheum Dis"},{"key":"B52","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/keab699","article-title":"SM03, an anti-human CD22 monoclonal antibody, for active rheumatoid arthritis: a phase II, randomized, double-blind, placebo-controlled study","volume":"61","author":"Li","year":"2022","journal-title":"Rheumatology"},{"key":"B53","doi-asserted-by":"publisher","first-page":"136","DOI":"10.1186\/s13075-022-02821-x","article-title":"Efficacy and safety of HLX01 in patients with moderate-to-severe rheumatoid arthritis despite methotrexate therapy: a phase 3 study","volume":"24","author":"Zeng","year":"2022","journal-title":"Arthritis Res Ther"},{"key":"B54","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/keaa234","article-title":"Efficacy and safety of Sandoz biosimilar rituximab for active rheumatoid arthritis: 52-week results from the randomized controlled ASSIST-RA trial","volume":"60","author":"Smolen","year":"2021","journal-title":"Rheumatology"},{"key":"B55","doi-asserted-by":"publisher","DOI":"10.1002\/cpdd.845","article-title":"A randomized, double-blind study comparing pharmacokinetics and pharmacodynamics of proposed biosimilar ABP 798 with rituximab reference product in subjects with moderate to severe rheumatoid arthritis","volume":"9","author":"Burmester","year":"2020","journal-title":"Clin Pharmacol Drug Dev"},{"key":"B56","doi-asserted-by":"publisher","first-page":"225","DOI":"10.1186\/s13075-024-03456-w","article-title":"Comparing immunogenicity and safety following transition from reference rituximab to biosimilar rituximab (DRL_RI) in patients with rheumatoid arthritis: a randomized, double-blind, phase 3 study","volume":"26","author":"Maharaj","year":"2024","journal-title":"Arthritis Res Ther"},{"key":"B57","doi-asserted-by":"publisher","first-page":"681","DOI":"10.1186\/s13063-024-08542-7","article-title":"Treat-to-target fixed dose rituximab retreatment versus fixed interval retreatment with disease activity-guided rituximab dose optimisation for patients with rheumatoid arthritis: study protocol for a multicentre randomised controlled superiority trial focusing on long-term disease impact (RITUXERA)","volume":"25","author":"De Meyst","year":"2024","journal-title":"Trials"},{"key":"B58","doi-asserted-by":"publisher","DOI":"10.1007\/s40259-020-00406-1","article-title":"Pharmacokinetic similarity and comparative pharmacodynamics, safety, efficacy, and immunogenicity of DRL_RI versus reference rituximab in biologics-na\u00efve patients with moderate-to-severe rheumatoid arthritis: a double-blind, randomized, three-arm study","volume":"34","author":"Haridas","year":"2020","journal-title":"BioDrugs"},{"key":"B59","doi-asserted-by":"publisher","DOI":"10.1016\/S2665-9913(23)00241-2","article-title":"Stratification of biological therapies by pathobiology in biologic-naive patients with rheumatoid arthritis (STRAP and STRAP-EU): two parallel, open-label, biopsy-driven, randomised trials","volume":"5","author":"Rivellese","year":"2023","journal-title":"Lancet Rheumatol"},{"key":"B60","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)32341-2","article-title":"Rituximab versus tocilizumab in anti-TNF inadequate responder patients with rheumatoid arthritis (R4RA): 16-week outcomes of a stratified, biopsy-driven, multicentre, open-label, phase 4 randomised controlled trial","volume":"397","author":"Humby","year":"2021","journal-title":"Lancet"},{"key":"B61","doi-asserted-by":"publisher","DOI":"10.1016\/S2665-9913(23)00089-9","article-title":"Evaluation of BMS-986142, a reversible Bruton\u2019s tyrosine kinase inhibitor, for the treatment of rheumatoid arthritis: a phase 2, randomised, double-blind, dose-ranging, placebo-controlled, adaptive design study","volume":"5","author":"Conaghan","year":"2023","journal-title":"Lancet Rheumatol"},{"key":"B62","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/keab153","article-title":"Rituximab plus leflunomide in rheumatoid arthritis: a randomized, placebo-controlled, investigator-initiated clinical trial (AMARA study)","volume":"60","author":"Behrens","year":"2021","journal-title":"Rheumatology"},{"key":"B63","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2501561","article-title":"A phase 3 trial of inebilizumab in generalized myasthenia gravis","volume":"392","author":"Nowak","year":"2025","journal-title":"N Engl J Med"},{"key":"B64","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(23)00194-1","article-title":"Safety and clinical activity of autologous RNA chimeric antigen receptor T-cell therapy in myasthenia gravis (MG-001): a prospective, multicentre, open-label, non-randomised phase 1b\/2a study","volume":"22","author":"Granit","year":"2023","journal-title":"Lancet Neurol"},{"key":"B65","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2022.2887","article-title":"Efficacy and safety of rituximab for new-onset generalized myasthenia gravis the RINOMAX randomized clinical trial","volume":"79","author":"Piehl","year":"2022","journal-title":"JAMA Neurol"},{"key":"B66","doi-asserted-by":"publisher","DOI":"10.1172\/jci.insight.163030","article-title":"A randomized, phase II study of sequential belimumab and rituximab in primary Sj\u00f6gren\u2019s syndrome","volume":"7","author":"Mariette","year":"2022","journal-title":"JCI Insight"},{"key":"B67","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/keac023","article-title":"Predictors of rituximab effect on modified Rodnan skin score in systemic sclerosis: a machine-learning analysis of the DesiReS\u2002trial","volume":"61","author":"Ebata","year":"2022","journal-title":"Rheumatology"},{"key":"B68","doi-asserted-by":"publisher","DOI":"10.1001\/jamadermatol.2022.6340","article-title":"Long-term outcomes after rituximab treatment for patients with systemic sclerosis","volume":"159","author":"Kuzumi","year":"2023","journal-title":"JAMA Dermatol"},{"key":"B69","doi-asserted-by":"publisher","DOI":"10.1002\/art.41275","article-title":"Fenebrutinib versus placebo or adalimumab in rheumatoid arthritis: a randomized, double-blind, phase II trial","volume":"72","author":"Cohen","year":"2020","journal-title":"Arthritis Rheumatol"},{"key":"B70","unstructured":"Home clinicaltrials.Gov"},{"key":"B71","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(17)30070-3","article-title":"First-line rituximab combined with short-term prednisone versus prednisone alone for the treatment of pemphigus (Ritux 3): a prospective, multicentre, parallel-group, open-label randomised trial","volume":"389","author":"Joly","year":"2017","journal-title":"Lancet"},{"key":"B72","unstructured":"Rituximab for rheumatoid arthritis refractory to anti\u2013tumor necrosis factor therapy: Results of a multicenter, randomized, double\u2010blind, placebo\u2010controlled, phase III trial evaluating primary efficacy and safety at twenty\u2010four weeks\n          \n          \n            \n              Cohen\n            \n          \n          \n          2006"},{"key":"B73","doi-asserted-by":"publisher","DOI":"10.1002\/art.21778","article-title":"The efficacy and safety of rituximab in patients with active rheumatoid arthritis despite methotrexate treatment: results of a phase IIB randomized, double-blind, placebo-controlled, dose-ranging trial","volume":"54","author":"Emery","year":"2006","journal-title":"Arthritis Rheum"},{"key":"B74","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2474-15-21","article-title":"The TRACTISS protocol: a randomised double blind placebo controlled clinical trial of anti-B-cell therapy in patients with primary Sj\u00f6gren\u2019s syndrome","volume":"15","author":"Brown","year":"2014","journal-title":"BMC Musculoskelet Disord"},{"key":"B75","doi-asserted-by":"publisher","DOI":"10.3390\/cells15020119","article-title":"B-cells and plasmablasts as architects of autoimmune disease: from molecular footprints to precision therapeutics","volume":"15","author":"Sarrand","year":"2026","journal-title":"Cells"},{"key":"B76","doi-asserted-by":"publisher","first-page":"909","DOI":"10.1016\/j.celrep.2019.06.066","article-title":"Single-cell analysis suggests that ongoing affinity maturation drives the emergence of pemphigus vulgaris autoimmune disease","volume":"28","author":"Cho","year":"2019","journal-title":"Cell Rep"},{"key":"B77","doi-asserted-by":"publisher","DOI":"10.1038\/jid.2014.291","article-title":"Persistence of anti-desmoglein 3 IgG(+) B-cell clones in pemphigus patients over years","volume":"135","author":"Hammers","year":"2015","journal-title":"J Invest Dermatol"},{"key":"B78","doi-asserted-by":"publisher","DOI":"10.1002\/mus.25973","article-title":"B cells in the pathophysiology of myasthenia gravis","volume":"57","author":"Yi","year":"2018","journal-title":"Muscle Nerve"},{"key":"B79","doi-asserted-by":"publisher","first-page":"99","DOI":"10.1007\/s40744-015-0016-9","article-title":"Rituximab for rheumatoid arthritis","volume":"2","author":"Cohen","year":"2015","journal-title":"Rheumatol Ther"},{"key":"B80","doi-asserted-by":"publisher","DOI":"10.3390\/ijms23020905","article-title":"Rheumatoid arthritis: pathogenic roles of diverse immune cells","volume":"23","author":"Jang","year":"2022","journal-title":"Int J Mol Sci"},{"key":"B81","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2018-214898","article-title":"Non-response to rituximab therapy in rheumatoid arthritis is associated with incomplete disruption of the B cell receptor repertoire","volume":"78","author":"Pollastro","year":"2019","journal-title":"Ann Rheum Dis"},{"key":"B82","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2021.750753","article-title":"B cells in rheumatoid arthritis:pathogenic mechanisms and treatment prospects","volume":"12","author":"Wu","year":"2021","journal-title":"Front Immunol"},{"key":"B83","doi-asserted-by":"publisher","first-page":"457","DOI":"10.1186\/ar128","article-title":"Cell-cell interactions in synovitis: interactions between T cells and B cells in rheumatoid arthritis","volume":"2","author":"Weyand","year":"2000","journal-title":"Arthritis Res Ther"},{"key":"B84","unstructured":"Translational Mini-Review Series on B Cell-Directed Therapies: The pathogenic role of B cells in autoantibody-associated autoimmune diseases \u2013 lessons from B cell-depletion therapy"},{"key":"B85","doi-asserted-by":"publisher","DOI":"10.3390\/ijms222212386","article-title":"The genetic, environmental, and immunopathological complexity of autoantibody-negative rheumatoid arthritis","volume":"22","author":"De Stefano","year":"2021","journal-title":"Int J Mol Sci"},{"key":"B86","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2022.999008","article-title":"Dysregulated B cell function and disease pathogenesis in systemic sclerosis","volume":"13","author":"Beesley","year":"2023","journal-title":"Front Immunol"},{"key":"B87","unstructured":"B-cells paradigm in systemic sclerosis: an update on pathophysiology and B-cell-targeted therapies"},{"key":"B88","doi-asserted-by":"publisher","DOI":"10.1002\/eji.202149675","article-title":"Targeting B cells and plasma cells in autoimmune diseases: from established treatments to novel therapeutic approaches","volume":"53","author":"Merino-Vico","year":"2023","journal-title":"Eur J Immunol"},{"key":"B89","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/keae248","article-title":"B cell depletion after treatment with rituximab predicts relapse of IgG4-related disease","volume":"64","author":"Lanzillotta","year":"2025","journal-title":"Rheumatology"},{"key":"B90","doi-asserted-by":"publisher","DOI":"10.1111\/all.15261","article-title":"Bruton\u2019s tyrosine kinase inhibition-an emerging therapeutic strategy in immune-mediated dermatological conditions","volume":"77","author":"Mendes-Bastos","year":"2022","journal-title":"Allergy"},{"key":"B91","doi-asserted-by":"publisher","first-page":"1762","DOI":"10.1016\/j.jid.2024.02.023","article-title":"Efficacy and safety of rilzabrutinib in pemphigus: PEGASUS phase 3 randomized study","volume":"144","author":"Murrell","year":"2024","journal-title":"J Invest Dermatol"},{"key":"B92","doi-asserted-by":"publisher","first-page":"687","DOI":"10.1056\/NEJMoa2308917","article-title":"CD19 CAR T-cell therapy in autoimmune disease - a case series with follow-up","volume":"390","author":"M\u00fcller","year":"2024","journal-title":"N Engl J Med"},{"key":"B93","doi-asserted-by":"publisher","DOI":"10.1002\/art.22211","article-title":"B cell depletion therapy in systemic lupus erythematosus: effect on autoantibody and antimicrobial antibody profiles","volume":"54","author":"Cambridge","year":"2006","journal-title":"Arthritis Rheum"},{"key":"B94","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2006.060772","article-title":"Increase of B cell-activating factor of the TNF family (BAFF) after rituximab treatment: insights into a new regulating system of BAFF production","volume":"66","author":"Lavie","year":"2007","journal-title":"Ann Rheum Dis"},{"key":"B95","doi-asserted-by":"publisher","DOI":"10.7326\/M21-2078","article-title":"Effectiveness of belimumab after rituximab in systemic lupus erythematosus: a randomized controlled trial","volume":"174","author":"Shipa","year":"2021","journal-title":"Ann Intern Med"},{"key":"B96","doi-asserted-by":"publisher","first-page":"687","DOI":"10.1056\/NEJMoa2308917","article-title":"CD19 CAR T-cell therapy in autoimmune disease \u2014 a case series with follow-up","volume":"390","author":"M\u00fcller","year":"2024","journal-title":"N Engl J Med"},{"key":"B97","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2026.1853170","article-title":"CAR-T cell therapy for autoimmune diseases: current clinical trial landscape and the next wave of development","volume":"17","author":"Chen","year":"2026","journal-title":"Front Immunol"}],"container-title":["Frontiers in Immunology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fimmu.2026.1906254\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T04:33:29Z","timestamp":1789014809000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fimmu.2026.1906254\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,10]]},"references-count":97,"alternative-id":["10.3389\/fimmu.2026.1906254"],"URL":"https:\/\/doi.org\/10.3389\/fimmu.2026.1906254","relation":{},"ISSN":["1664-3224"],"issn-type":[{"value":"1664-3224","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,10]]},"article-number":"1906254"}}