Agents that block B7 costimulators are approved for treatment of rheumatoid arthritis and psoriasis and are being tested in SLE and other diseases. Antibodies against CD40 ligand block T cell-mediated activation of B cells and macrophages and have been beneficial in patients with inflammatory bowel disease, but a small number of treated patients have developed thrombotic episodes, apparently because this molecule is expressed on human platelets (where its function is unknown). Antibodies against integrins have been used to inhibit leukocyte migration into tissues, particularly the central nervous system (CNS) in multiple sclerosis.
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