title: Cytokine changes during rituximab therapy in HIV-associated multicentric Castleman disease.
abstract: Recent data highlight the importance of inflammatory markers during human immunodeficiency virus type 1 (HIV) infection. HIV-associated multicentric Castleman disease (HIV-MCD) presents with systemic symptoms attributed to cytokine disarray, and we have previously shown that the use of the anti-CD20 monoclonal antibody rituximab induces clinical remissions. Before and during successful rituximab therapy, 15 plasma cytokines were measured as were adaptive (CD4, CD8, CD19) and innate (CD16/56) immune cell populations and HIV-1 viral loads. A significant reduction from baseline of the CD19 B-cell count, consistent with rituximab's mechanism of action, was observed. Markedly elevated cytokine levels were observed before rituximab therapy, and a reduction from baseline values with rituximab therapy was observed for interleukin (IL)-5, IL-6, and IL-10. Therapies that reduce the inflammatory cytokine response are likely to be successful in a range of diseases, including HIV-MCD, and in the future may be used to guide therapeutic strategies.
authors.affiliation: Department of Oncology, HIV Medicine and Immunology, Imperial College School of Medicine, Chelsea and Westminster Hospital, London, United Kingdom. m.bower@imperial.ac.uk
authors.forename: Mark
authors.initials: M
authors.lastname: Bower
authors.forename: Ophelia
authors.initials: O
authors.lastname: Veraitch
authors.forename: Richard
authors.initials: R
authors.lastname: Szydlo
authors.forename: Peter
authors.initials: P
authors.lastname: Charles
authors.forename: Peter
authors.initials: P
authors.lastname: Kelleher
authors.forename: Brian
authors.initials: B
authors.lastname: Gazzard
authors.forename: Mark
authors.initials: M
authors.lastname: Nelson
authors.forename: Justin
authors.initials: J
authors.lastname: Stebbing
mesh_terms: D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D058846:Antibodies, Monoclonal, Murine-Derived; D018951:Antigens, CD20 / Q000276:immunology; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D005871:Castleman Disease / Q000097:blood* / Q000188:drug therapy* / Q000821:virology; D016207:Cytokines / Q000097:blood*; D015658:HIV Infections / Q000097:blood / Q000150:complications* / Q000821:virology; D015497:HIV-1 / Q000472:pathogenicity*; D006801:Humans; D011379:Prognosis; D000069283:Rituximab; D019562:Viral Load
chemical_list: D000911:Antibodies, Monoclonal; D058846:Antibodies, Monoclonal, Murine-Derived; D018951:Antigens, CD20; D000970:Antineoplastic Agents; D016207:Cytokines; D000069283:Rituximab