Rituximab levels in cerebrospinal fluid of patients with neurological autoimmune disorders.
BACKGROUND
Rituximab, a monoclonal antibody against the B-cell-specific surface protein CD20, is being evaluated for treatment of multiple sclerosis and neuromyelitis optica. Both diseases are restricted to the brain and cerebrospinal fluid (CSF). Whereas the ability of rituximab to deplete B cells in peripheral blood and tissue is well known, little information is available about the ability of rituximab to penetrate the barriers separating brain and CSF from the serum compartment.


OBJECTIVE
To measure rituximab levels in serum and CSF of rituximab-treated patients and correlate them with CSF and response markers.


METHODS
Fourteen paired serum/CSF samples of patients with autoimmune nervous system disorder were analyzed for up to 43 weeks after rituximab application.


RESULTS
Rituximab remains detectable within the CSF after i.v. application for up to 24 weeks. Furthermore, levels of rituximab in CSF correlate significantly with the integrity of the blood CSF barrier.
Petereit
H F
HF
Department of Neurology, Heilig Geist-Krankenhaus, Köln, Germany. petereit@hgk-koeln.de
Rubbert-Roth
A
A
D000368:Aged; D000911:Antibodies, Monoclonal / Q000008:administration & dosage / Q000134:cerebrospinal fluid / Q000493:pharmacokinetics*; D058846:Antibodies, Monoclonal, Murine-Derived; D001402:B-Lymphocytes / Q000166:cytology / Q000187:drug effects; D001812:Blood-Brain Barrier; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D007155:Immunologic Factors / Q000008:administration & dosage / Q000134:cerebrospinal fluid / Q000493:pharmacokinetics*; D007275:Injections, Intravenous; D018655:Lymphocyte Count; D008297:Male; D009103:Multiple Sclerosis / Q000134:cerebrospinal fluid / Q000188:drug therapy* / Q000276:immunology; D009471:Neuromyelitis Optica / Q000134:cerebrospinal fluid / Q000188:drug therapy* / Q000276:immunology; D000069283:Rituximab; D055815:Young Adult
D000911:Antibodies, Monoclonal; D058846:Antibodies, Monoclonal, Murine-Derived; D007155:Immunologic Factors; D000069283:Rituximab