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利妥昔单抗是一种与CD20抗原特异性结合的单克隆抗体,广泛应用于B细胞性非霍奇金淋巴瘤(B-NHL)、霍奇金淋巴瘤(HL)及其他B细胞恶性肿瘤的治疗。利妥昔单抗主要通过抗体依赖性细胞介导的细胞毒作用(ADCC)、补体依赖性细胞毒作用(CDC)和直接凋亡效应杀伤肿瘤细胞,其中CDC是利妥昔单抗杀伤肿瘤细胞最主要机制,而CDC的强度受补体调节蛋白影响,因此补体系统在利妥昔单抗临床抗肿瘤治疗中发挥重要作用。此外,肿瘤细胞对利妥昔单抗耐受也与补体系统密切相关。本文综述利妥昔单抗治疗淋巴瘤的耐药机制,尤其是补体相关耐药机制的研究现状,并对改善耐药的补体性治疗策略进行总结。
Rituximab is a monoclonal antibody that specifically binds to the CD20 antigen and is widely used in B-cell non-Hodgkin lymphoma (B-NHL), Hodgkin’s lymphoma (HL) and other B-cell malignancies Tumor treatment. Rituximab kills tumor cells primarily through antibody-dependent cell-mediated cytotoxicity (ADCC), complement dependent cytotoxicity (CDC) and direct apoptosis effects, where CDC is the product of rituximab-killed tumor cells The most important mechanism, and the intensity of CDC is affected by complement regulatory proteins, the complement system plays an important role in the clinical anti-tumor therapy of rituximab. In addition, the tolerance of tumor cells to rituximab is also closely related to the complement system. This article reviews the mechanisms of rituximab in the treatment of lymphoma, in particular the current status of complement-related drug resistance mechanisms, and summarizes strategies to improve complement-resistant treatment.