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

Nancy L Monson, Petra D. Cravens, Elliot Frohman, Kathleen Hawker, Michael K. Racke

Research output: Contribution to journalArticlepeer-review

190 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)258-264
Number of pages7
JournalArchives of neurology
Volume62
Issue number2
DOIs
StatePublished - Feb 2005

ASJC Scopus subject areas

  • Arts and Humanities (miscellaneous)
  • Clinical Neurology

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