Rituximab reduces B cells and T cells in cerebrospinal fluid of multiple sclerosis patients

J Neuroimmunol. 2006 Nov;180(1-2):63-70. doi: 10.1016/j.jneuroim.2006.06.029. Epub 2006 Aug 14.

Abstract

Effects of B cell depletion by rituximab, a monoclonal antibody to CD20, were studied in patients with relapsing MS that had not responded optimally to standard immunomodulatory therapies. Flow cytometry demonstrated reduced cerebrospinal fluid (CSF) B cells and T cells in most patients at 6 months post-treatment. ELISAs demonstrated modest reductions in serum antibodies to myelin oligodendrocyte glycoprotein and myelin basic protein in some subjects. Beta-interferon neutralizing antibodies were reduced in three subjects, but developed anew after treatment in three others, suggesting caution in considering rituximab as a means to eliminate NABs. In summary, rituximab depleted B cells from CSF at 24 weeks after initial treatment, and this B cell depletion was associated with a reduction in CSF T cells as well.

Publication types

  • Clinical Trial, Phase II
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Antibodies, Monoclonal / immunology
  • Antibodies, Monoclonal / pharmacology*
  • Antibodies, Monoclonal / therapeutic use
  • Antibodies, Monoclonal, Murine-Derived
  • Antibody Formation / drug effects
  • Antibody Formation / immunology
  • Antigens, CD20 / immunology
  • Autoantibodies / analysis
  • Autoantibodies / blood
  • Autoantibodies / immunology
  • B-Lymphocytes / drug effects*
  • B-Lymphocytes / immunology
  • Cerebrospinal Fluid / cytology*
  • Cerebrospinal Fluid / immunology
  • Down-Regulation / drug effects
  • Down-Regulation / immunology
  • Female
  • Flow Cytometry
  • Glatiramer Acetate
  • Humans
  • Immunity, Cellular / drug effects
  • Immunity, Cellular / immunology
  • Immunologic Factors / immunology
  • Immunologic Factors / pharmacology
  • Immunologic Factors / therapeutic use
  • Immunosuppression / methods
  • Interferon beta-1a
  • Interferon beta-1b
  • Interferon-beta / therapeutic use
  • Male
  • Middle Aged
  • Multiple Sclerosis, Relapsing-Remitting / cerebrospinal fluid
  • Multiple Sclerosis, Relapsing-Remitting / drug therapy*
  • Multiple Sclerosis, Relapsing-Remitting / immunology*
  • Myelin Proteins / immunology
  • Peptides / therapeutic use
  • Rituximab
  • T-Lymphocytes / drug effects*
  • T-Lymphocytes / immunology
  • Treatment Outcome

Substances

  • Antibodies, Monoclonal
  • Antibodies, Monoclonal, Murine-Derived
  • Antigens, CD20
  • Autoantibodies
  • Immunologic Factors
  • Myelin Proteins
  • Peptides
  • Interferon beta-1b
  • Rituximab
  • Glatiramer Acetate
  • Interferon-beta
  • Interferon beta-1a