特发性肾病综合征的CD20单抗治疗研究进展
Research Progress of CD20 Monoclonal Antibody Therapy in Idiopathic Nephrotic Syndrome
DOI: 10.12677/acm.2026.1651916, PDF,   
作者: 何思懿：浙江大学医学院儿科学部，浙江 杭州；毛建华*：浙江大学医学院附属儿童医院肾脏内科，国家儿童健康临床研究中心，浙江 杭州
关键词: 特发性肾病综合征；CD20单抗；利妥昔单抗；奥妥珠单抗；Idiopathic Nephrotic Syndrome； CD20 Monoclonal Antibody； Rituximab； Obinutuzumab
摘要: 特发性肾病综合征(INS)是儿童常见的原发性肾小球疾病，其中频复发和激素依赖患者常需长期激素及免疫抑制治疗，预防复发和毒副反应管理均较困难。近年来，靶向CD20的B细胞清除治疗明显改变了频复发和激素依赖INS患者的治疗策略。利妥昔单抗已成为复发性INS的重要激素节约方案；奥妥珠单抗因具有更深、更持久的B细胞耗竭作用，在利妥昔单抗疗效不足、出现抗药抗体或不耐受时显示出应用潜力；奥法妥木单抗等其他CD20单抗亦用于少数难治病例。基于以上背景，本文对CD20单抗治疗INS的理论基础、主要药物、联合策略及安全性研究进展进行综述。
Abstract: Idiopathic nephrotic syndrome (INS) is one of the most common primary glomerular diseases in children. Patients with frequent relapse and steroid-dependent INS often require long-term glucocorticoid and immunosuppressant therapy, facing major challenges in relapse prevention and toxicity management. In recent years, CD20-targeted B-cell depletion therapy has significantly altered the treatment landscape for these patients. Rituximab has become an important steroid-sparing regimen in relapsing INS. Obinutuzumab, due to its deeper and more durable B-cell depletion, has shown promising potential in cases with suboptimal response to rituximab, development of anti-drug antibodies, or intolerance. Additionally, other anti-CD20 monoclonal antibodies such as ofatumumab have been used in a few refractory cases. This article systematically reviews the research progress on the rationale, main agents, combination strategies, and safety profiles of CD20 monoclonal antibody therapy in INS.
文章引用：何思懿, 毛建华. 特发性肾病综合征的CD20单抗治疗研究进展[J]. 临床医学进展, 2026, 16(5): 1165-1173. https://doi.org/10.12677/acm.2026.1651916

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