title: Treatment with rituximab affects both the cellular and the humoral arm of the immune system in patients with SLE.
abstract: Herein we investigated how rituximab-induced B cell depletion affected leukocyte subpopulations and antibody titers in SLE patients. We focused our analysis on time points related to absence and return of B cells after depletion. A correlation was found between the baseline frequency and time to repopulation; the fewer B cells initially, the longer to their return. While the few B cells remaining after treatment were of memory, double-negative (IgD-CD27-), and CD5+ phenotype, the returning B cells were mainly naïve, indicating de novo production of B cells. Serum levels of IgG and antibodies against Ro52, Ro60, La44, measles and tetanus remained unchanged, while decreases in IgM, IgE, anti-dsDNA and anti-C1q antibodies were observed. Additionally, a significant increase in activated CD4+ and CD8+ T cells, as well as CD25bright FOXP3+ regulatory T cells was observed. In conclusion, both the humoral and the cellular immune systems were affected by treatment with rituximab.
authors.affiliation: Rheumatology Unit, Department of Medicine, Karolinska Institutet, Karolinska University Hospital, Solna, Sweden. therese.wallerskog@ki.se
authors.forename: Therese
authors.initials: T
authors.lastname: Vallerskog
authors.forename: Iva
authors.initials: I
authors.lastname: Gunnarsson
authors.forename: Mona
authors.initials: M
authors.lastname: Widhe
authors.forename: Anke
authors.initials: A
authors.lastname: Risselada
authors.forename: Lars
authors.initials: L
authors.lastname: Klareskog
authors.forename: Ronald
authors.initials: R
authors.lastname: van Vollenhoven
authors.forename: Vivianne
authors.initials: V
authors.lastname: Malmström
authors.forename: Christina
authors.initials: C
authors.lastname: Trollmo
mesh_terms: D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D058846:Antibodies, Monoclonal, Murine-Derived; D000917:Antibody Formation / Q000187:drug effects*; D001323:Autoantibodies / Q000097:blood; D001402:B-Lymphocytes / Q000187:drug effects* / Q000276:immunology; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D007111:Immunity, Cellular / Q000187:drug effects*; D007136:Immunoglobulins / Q000097:blood / Q000187:drug effects; D007155:Immunologic Factors / Q000627:therapeutic use*; D008180:Lupus Erythematosus, Systemic / Q000188:drug therapy* / Q000276:immunology; D008212:Lymphocyte Depletion; D000069283:Rituximab; D013601:T-Lymphocytes / Q000187:drug effects
chemical_list: D000911:Antibodies, Monoclonal; D058846:Antibodies, Monoclonal, Murine-Derived; D001323:Autoantibodies; D007136:Immunoglobulins; D007155:Immunologic Factors; D000069283:Rituximab