Details

Autor(en) / Beteiligte

• Pescovitz, Mark D., MD
• Torgerson, Troy R., MD, PhD
• Ochs, Hans D., MD, Dr Med
• Ocheltree, Elizabeth, BS
• McGee, Paula, MS
• Krause-Steinrauf, Heidi, MS
• Lachin, John M., ScD
• Canniff, Jennifer, BS
• Greenbaum, Carla, MD
• Herold, Kevan C., MD
• Skyler, Jay S., MD
• Weinberg, Adriana, MD

Titel

Effect of rituximab on human in vivo antibody immune responses

Ist Teil von

• Journal of allergy and clinical immunology, 2011-12, Vol.128 (6), p.1295-1302.e5

Ort / Verlag

New York, NY: Elsevier Inc

Erscheinungsjahr

2011

Link zum Volltext

Quelle

MEDLINE

Beschreibungen/Notizen

• Background B-lymphocyte depletion with rituximab has been shown to benefit patients with various autoimmune diseases. We have previously demonstrated that this benefit is also apparent in patients with newly diagnosed type 1 diabetes. Objectives The effect of rituximab on in vivo antibody responses, particularly during the period of B-lymphocyte depletion, is incompletely determined. This study was designed to assess this knowledge void. Methods In patients with recent-onset type 1 diabetes treated with rituximab (n = 46) or placebo (n = 29), antibody responses to neoantigen phiX174 during B-lymphocyte depletion and with hepatitis A (as a second neoantigen) and tetanus/diphtheria (as recall antigens) after B-lymphocyte recovery were studied. Anti- tetanus, diphtheria, mumps, measles, and rubella titers were measured before and after treatment by means of ELISA. Antibody titers and percentage IgM versus percentage IgG to phiX174 were measured by means of phage neutralization. B-lymphocyte subsets were determined by means of flow cytometry. Results No change occurred in preexisting antibody titers. Tetanus/diphtheria and hepatitis A immunization responses were protective in the rituximab-treated subjects, although significantly blunted compared with those seen in the controls subjects, when immunized at the time of B-lymphocyte recovery. Anti-phiX174 responses were severely reduced during the period of B-lymphocyte depletion, but with B-lymphocyte recovery, anti-phiX174 responses were within the normal range. Conclusions During the time of B-lymphocyte depletion, rituximab recipients had a decreased antibody response to neoantigens and significantly lower titers after recall immunization with diphtheria and tetanus toxoid. With recovery, immune responses return toward normal. Immunization during the time of B-lymphocyte depletion, although ineffective, does not preclude a subsequent response to the antigen.