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
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Clinical Trial, Phase II
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Research Support, N.I.H., Extramural
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Research Support, Non-U.S. Gov't
MeSH terms
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Adult
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Antibodies, Monoclonal / immunology
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Antibodies, Monoclonal / pharmacology*
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Antibodies, Monoclonal / therapeutic use
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Antibodies, Monoclonal, Murine-Derived
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Antibody Formation / drug effects
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Antibody Formation / immunology
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Antigens, CD20 / immunology
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Autoantibodies / analysis
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Autoantibodies / blood
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Autoantibodies / immunology
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B-Lymphocytes / drug effects*
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B-Lymphocytes / immunology
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Cerebrospinal Fluid / cytology*
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Cerebrospinal Fluid / immunology
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Down-Regulation / drug effects
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Down-Regulation / immunology
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Female
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Flow Cytometry
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Glatiramer Acetate
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Humans
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Immunity, Cellular / drug effects
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Immunity, Cellular / immunology
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Immunologic Factors / immunology
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Immunologic Factors / pharmacology
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Immunologic Factors / therapeutic use
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Immunosuppression Therapy / methods
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Interferon beta-1a
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Interferon beta-1b
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Interferon-beta / therapeutic use
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Male
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Middle Aged
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Multiple Sclerosis, Relapsing-Remitting / cerebrospinal fluid
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Multiple Sclerosis, Relapsing-Remitting / drug therapy*
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Multiple Sclerosis, Relapsing-Remitting / immunology*
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Myelin Proteins / immunology
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Peptides / therapeutic use
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Rituximab
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T-Lymphocytes / drug effects*
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T-Lymphocytes / immunology
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Treatment Outcome
Substances
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Antibodies, Monoclonal
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Antibodies, Monoclonal, Murine-Derived
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Antigens, CD20
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Autoantibodies
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Immunologic Factors
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Myelin Proteins
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Peptides
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Interferon beta-1b
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Rituximab
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Glatiramer Acetate
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Interferon-beta
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Interferon beta-1a