Clinical and immunological follow-up of B-cell depleting therapy in CNS demyelinating diseases

J Neurol Sci. 2013 May 15;328(1-2):77-82. doi: 10.1016/j.jns.2013.02.024. Epub 2013 Mar 21.

Abstract

The aim of this observational study was to analyze clinical and immunological effects of rituximab treatment in neuromyelitis optica (NMO) and longitudinally extensive transverse myelitis (LETM) patients. We report on four NMO and two recurrent LETM patients who were treated with rituximab. Overall, B-cell depletion resulted in profound clinical stabilization in all patients. Rituximab did not affect titers of antibodies to aquaporin-4 (AQP4-IgG) and myelin oligodendrocyte glycoprotein, immunoglobulin (Ig) isotypes and IgG subtype distribution, even after long-term B-cell depletion. Relapses were not associated with re-emerging B-cells, serum levels of B-cell activating factor (BAFF) or AQP4-IgG titers. BAFF serum levels increased following rituximab treatment.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Antibodies, Monoclonal, Murine-Derived / therapeutic use
  • Antigens, CD / metabolism
  • Aquaporin 4 / immunology
  • B-Cell Activating Factor / blood
  • B-Lymphocytes / physiology*
  • Female
  • Humans
  • Immunoglobulin G / metabolism
  • Immunologic Factors / metabolism
  • Longitudinal Studies
  • Lymphocyte Depletion / methods*
  • Male
  • Middle Aged
  • Myelitis, Transverse / blood
  • Myelitis, Transverse / immunology*
  • Myelitis, Transverse / therapy*
  • Neuromyelitis Optica / blood
  • Neuromyelitis Optica / immunology*
  • Neuromyelitis Optica / therapy*
  • Observation
  • Rituximab
  • Time Factors
  • Young Adult

Substances

  • AQP4 protein, human
  • Antibodies, Monoclonal, Murine-Derived
  • Antigens, CD
  • Aquaporin 4
  • B-Cell Activating Factor
  • Immunoglobulin G
  • Immunologic Factors
  • Rituximab