Only Follow-Up of Memory B Cells Helps Monitor Rituximab Administration to Patients with Neuromyelitis Optica Spectrum Disorders.

Autor: Lebrun C; Centre de Ressources et Compétences sclérose en plaques, Neurologie, Université Nice Côte d'Azur, CHU Pasteur 2, Nice, France. Lebrun.c@chu-nice.fr., Cohen M; Centre de Ressources et Compétences sclérose en plaques, Neurologie, Université Nice Côte d'Azur, CHU Pasteur 2, Nice, France., Rosenthal-Allieri MA; Laboratoire d'Immunologie, CHU Archet 1, Nice, France., Bresch S; Centre de Ressources et Compétences sclérose en plaques, Neurologie, Université Nice Côte d'Azur, CHU Pasteur 2, Nice, France., Benzaken S; Laboratoire d'Immunologie, CHU Archet 1, Nice, France., Marignier R; Sclérose en plaques, pathologies de la myéline et neuro-inflammation, Hospices Civils de Lyon, Lyon, France.; France-Centre de Recherche en Neurosciences de Lyon, Inserm U1028 CNRS UMR5292, FLUID team, Faculté de Médecine Laennec, Lyon, France., Seitz-Polski B; Laboratoire d'Immunologie, CHU Archet 1, Nice, France., Ticchioni M; Laboratoire d'Immunologie, CHU Archet 1, Nice, France.; Centre Méditerranéen de Médecine Moléculaire, INSERM U1065, Nice, France.
Jazyk: angličtina
Zdroj: Neurology and therapy [Neurol Ther] 2018 Dec; Vol. 7 (2), pp. 373-383. Date of Electronic Publication: 2018 Jun 07.
DOI: 10.1007/s40120-018-0101-4
Abstrakt: Introduction: Neuromyelitis optica spectrum disorders (NMOSD) are identified as a spectrum of inflammatory demyelinating disorders involving the brain, spinal cord and optic nerves. These disorders require early diagnosis and highly active immunosuppressive treatment. Rituximab (RTX) has demonstrated efficacy in limiting relapse in NMOSD when using several administration schedules. We questioned if the CD19+ CD27+ memory B cell count was a more reliable marker to monitor RTX administration than the RTX plasma level and CD19+ B cell count.
Methods: We analyzed 125 blood samples from 17 NMOSD patients treated with RTX and also measured the level of anti-aquaporine-4 antibodies (anti-AQP-4 Abs), human anti-chimeric antibodies to the murine fragment of RTX (HACA-RTX Abs), and the RTX concentration.
Results: The mean follow-up time of the cohort was 7.4 (2-16) years. All patients improved with a mean EDSS going from 4 (1-8.5) to 2.7 (1-5.5). The mean interval between RTX infusions was 9.6 months with identification of prolonged responders. Total CD19+ B cell detection with the routine technique did not correlate to re-emergence of CD19+ CD27+ memory B cells. The RTX residual concentration did not correlate with the CD19+ CD27+ memory B cell count or with anti-RTX antibody production.
Conclusion: In contrast to total CD19+ cell, detected with the routine technique, CD19+ CD27+ memory B cells are a reliable marker for biological relapse and allow a decrease in the frequency of infusions.
Databáze: MEDLINE
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