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Arch Neurol. 2005 Feb;62(2):258-64.

Effect of rituximab on the peripheral blood and cerebrospinal fluid B cells in patients with primary progressive multiple sclerosis.

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  • 1Department of Neurology and Center for Immunology, The University of Texas Southwestern Medical Center, Dallas 75390, USA. nancy.monson@utsouthwestern.edu

Abstract

BACKGROUND:

Rituximab, an anti-CD20 monoclonal antibody that depletes CD20(+) B cells, has demonstrated efficacy in peripheral neurological diseases. Whether this efficacy can be translated to neurological diseases of the central nervous system with possible autoimmune B-cell involvement remains unknown.

OBJECTIVE:

To determine the effect of rituximab on cerebrospinal fluid B cells in patients with multiple sclerosis.

DESIGN:

Four patients with primary progressive multiple sclerosis were treated with rituximab. Cerebrospinal fluid and peripheral blood B-cell subsets were identified by flow cytometry from each patient before and after rituximab treatment.

RESULTS:

The B cells in cerebrospinal fluid were not as effectively depleted as their peripheral blood counterparts. Rituximab treatment temporarily suppressed the activation state of B cells in cerebrospinal fluid. The residual B cells underwent expansion after rituximab treatment.

CONCLUSION:

The effect(s) of rituximab on the cerebrospinal fluid B-cell compartment is limited in comparison with the effect(s) on the B cells in the periphery, but this finding will need to be confirmed in a larger group of MS patients.

Comment in

PMID:
15710854
[PubMed - indexed for MEDLINE]
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