Research progress of the effect of rituximab therapy on T lymphocyte subsets in peripheral blood of patients with idiopathic membranous nephropathy

Membranous nephropathy (MN) is characterized by subepithelial immune complex deposition in the glomerular basement membrane and diffuse thickening of the basement membrane. Approximately 70% to 80% of these patients are termed idiopathic membranous nephropathy (IMN) due to the poorly defined pathogenesis. In recent years, the pathogenic role of B lymphocytes in MN has gained attention, as autoantibodies such as anti-phospholipase A2 receptor (PLA2R) antibodies and thrombospondin type-1 domain-containing 7A (THSD7A) have been identified in the peripheral blood of IMN patients. Rituximab (RTX), a human/mouse chimeric monoclonal antibody, can deplete CD20⁺ B lymphocytes by reducing the production of autoantibodies. B lymphocytes and T lymphocytes complement each other in function. Studies have confirmed that IMN patients also have disorders in the number and function of T lymphocyte subpopulations. Therefore, RTX correction of T lymphocyte subpopulations imbalance may be another important mechanism for its effect. This article reviewed the impact of rituximab treatment on peripheral blood T lymphocytes in patients with IMN and its clinical significance, providing a theoretical basis for multi-target treatment of IMN.