Rituximab in a patient with multiple sclerosis–effect on B cells, plasma cells and intrathecal IgG synthesis
HF Petereit, W Moeller‐Hartmann… - Acta Neurologica …, 2008 - Wiley Online Library
HF Petereit, W Moeller‐Hartmann, D Reske, A Rubbert
Acta Neurologica Scandinavica, 2008•Wiley Online LibraryObjective–To study the time course of immunoglobulin, B and plasma cells in the blood and
cerebrospinal fluid (CSF) before and during rituximab treatment in a patient with severe
relapsing–remitting multiple sclerosis (MS) in relation to clinical and MRI findings. Methods–
Immunoglobulins in the CSF were measured by nephelometry and detected by isoelectrical
focussing. CSF and blood cell subtypes from seven time points were analysed by flow
cytometry. Results–Treatment with rituximab induced a dramatic and sustained improvement …
cerebrospinal fluid (CSF) before and during rituximab treatment in a patient with severe
relapsing–remitting multiple sclerosis (MS) in relation to clinical and MRI findings. Methods–
Immunoglobulins in the CSF were measured by nephelometry and detected by isoelectrical
focussing. CSF and blood cell subtypes from seven time points were analysed by flow
cytometry. Results–Treatment with rituximab induced a dramatic and sustained improvement …
Objective – To study the time course of immunoglobulin, B and plasma cells in the blood and cerebrospinal fluid (CSF) before and during rituximab treatment in a patient with severe relapsing–remitting multiple sclerosis (MS) in relation to clinical and MRI findings.
Methods – Immunoglobulins in the CSF were measured by nephelometry and detected by isoelectrical focussing. CSF and blood cell subtypes from seven time points were analysed by flow cytometry.
Results – Treatment with rituximab induced a dramatic and sustained improvement in clinical and MRI findings over a follow‐up period of 20 months. By contrast, the initially completely suppressed B and plasma cells in both the blood and CSF reappeared after 5 and 10 months, CSF cells being the first to reappear. Interestingly, intrathecal IgG synthesis persisted throughout the study period.
Discussion – Although highly effective in this case, the clinical effect in larger series and the mechanism of rituximab in MS deserves further evaluation.
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