Effect of rituximab on the peripheral blood and cerebrospinal fluid B cells in patients with primary progressive multiple sclerosis

Arch Neurol. 2005 Feb;62(2):258-64. doi: 10.1001/archneur.62.2.258.


Background: Rituximab, an anti-CD20 monoclonal antibody that depletes CD20(+) B cells, has demonstrated efficacy in peripheral neurological diseases. Whether this efficacy can be translated to neurological diseases of the central nervous system with possible autoimmune B-cell involvement remains unknown.

Objective: To determine the effect of rituximab on cerebrospinal fluid B cells in patients with multiple sclerosis.

Design: Four patients with primary progressive multiple sclerosis were treated with rituximab. Cerebrospinal fluid and peripheral blood B-cell subsets were identified by flow cytometry from each patient before and after rituximab treatment.

Results: The B cells in cerebrospinal fluid were not as effectively depleted as their peripheral blood counterparts. Rituximab treatment temporarily suppressed the activation state of B cells in cerebrospinal fluid. The residual B cells underwent expansion after rituximab treatment.

Conclusion: The effect(s) of rituximab on the cerebrospinal fluid B-cell compartment is limited in comparison with the effect(s) on the B cells in the periphery, but this finding will need to be confirmed in a larger group of MS patients.

Publication types

  • Clinical Trial
  • Comparative Study
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Antibodies / therapeutic use
  • Antibodies, Monoclonal / pharmacology*
  • Antibodies, Monoclonal, Murine-Derived
  • Antigens, CD19 / metabolism
  • Antigens, CD20 / immunology*
  • B-Lymphocytes / drug effects*
  • B-Lymphocytes / metabolism
  • Chi-Square Distribution
  • Female
  • Flow Cytometry / methods
  • Humans
  • Middle Aged
  • Multiple Sclerosis, Chronic Progressive* / blood
  • Multiple Sclerosis, Chronic Progressive* / cerebrospinal fluid
  • Rituximab


  • Antibodies
  • Antibodies, Monoclonal
  • Antibodies, Monoclonal, Murine-Derived
  • Antigens, CD19
  • Antigens, CD20
  • Rituximab