title: Clinical and immunological follow-up of B-cell depleting therapy in CNS demyelinating diseases.
abstract: The aim of this observational study was to analyze clinical and immunological effects of rituximab treatment in neuromyelitis optica (NMO) and longitudinally extensive transverse myelitis (LETM) patients. We report on four NMO and two recurrent LETM patients who were treated with rituximab. Overall, B-cell depletion resulted in profound clinical stabilization in all patients. Rituximab did not affect titers of antibodies to aquaporin-4 (AQP4-IgG) and myelin oligodendrocyte glycoprotein, immunoglobulin (Ig) isotypes and IgG subtype distribution, even after long-term B-cell depletion. Relapses were not associated with re-emerging B-cells, serum levels of B-cell activating factor (BAFF) or AQP4-IgG titers. BAFF serum levels increased following rituximab treatment.
authors.affiliation: Clinical Department of Neurology, Innsbruck Medical University, Innsbruck, Austria.
authors.forename: Viktoria
authors.initials: V
authors.lastname: Gredler
authors.forename: Simone
authors.initials: S
authors.lastname: Mader
authors.forename: Kathrin
authors.initials: K
authors.lastname: Schanda
authors.forename: Harald
authors.initials: H
authors.lastname: Hegen
authors.forename: Franziska
authors.initials: F
authors.lastname: Di Pauli
authors.forename: Bettina
authors.initials: B
authors.lastname: Kuenz
authors.forename: Florian
authors.initials: F
authors.lastname: Deisenhammer
authors.forename: Thomas
authors.initials: T
authors.lastname: Berger
authors.forename: Markus
authors.initials: M
authors.lastname: Reindl
authors.forename: Andreas
authors.initials: A
authors.lastname: Lutterotti
mesh_terms: D000328:Adult; D058846:Antibodies, Monoclonal, Murine-Derived / Q000627:therapeutic use; D015703:Antigens, CD / Q000378:metabolism; D051401:Aquaporin 4 / Q000276:immunology; D053264:B-Cell Activating Factor / Q000097:blood; D001402:B-Lymphocytes / Q000502:physiology*; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000378:metabolism; D007155:Immunologic Factors / Q000378:metabolism; D008137:Longitudinal Studies; D008212:Lymphocyte Depletion / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009188:Myelitis, Transverse / Q000097:blood / Q000276:immunology* / Q000628:therapy*; D009471:Neuromyelitis Optica / Q000097:blood / Q000276:immunology* / Q000628:therapy*; D019370:Observation; D000069283:Rituximab; D013997:Time Factors; D055815:Young Adult
chemical_list: C496030:AQP4 protein, human; D058846:Antibodies, Monoclonal, Murine-Derived; D015703:Antigens, CD; D051401:Aquaporin 4; D053264:B-Cell Activating Factor; D007074:Immunoglobulin G; D007155:Immunologic Factors; D000069283:Rituximab