title: Rituximab ameliorates anti-N-methyl-D-aspartate receptor encephalitis by removal of short-lived plasmablasts.
abstract: We measured anti-N-methyl-D-aspartate receptor (NMDAR) autoantibody levels and assessed B cell subsets using multicolor flow cytometry of peripheral blood mononuclear cells (PBMCs) from a recurrent anti-NMDAR encephalitis case to evaluate the effectiveness of rituximab treatment. Rituximab depleted CD20(+) fractions of naïve and memory B cell subsets and reduced the number of CD20(-) plasmablasts. This study suggests that short-lived plasmablasts are removed by rituximab-induced depletion of the CD20(+) B cell population. Increased numbers of plasmablasts in PBMCs may be a candidate predictive factor for unfavorable prognosis of anti-NMDAR encephalitis and an indication of when to commence second-line immunotherapy.
authors.affiliation: Department of Neuropediatrics, Tokyo Metropolitan Neurological Hospital, 2-6-1 Musashidai, Fuchu, Tokyo 183-0042, Japan. Electronic address: yasuo_hachiya@tmhp.jp.
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Hachiya
authors.forename: Akinori
authors.initials: A
authors.lastname: Uruha
authors.forename: Emi
authors.initials: E
authors.lastname: Kasai-Yoshida
authors.forename: Konomi
authors.initials: K
authors.lastname: Shimoda
authors.forename: Ikuko
authors.initials: I
authors.lastname: Satoh-Shirai
authors.forename: Satoko
authors.initials: S
authors.lastname: Kumada
authors.forename: Eiji
authors.initials: E
authors.lastname: Kurihara
authors.forename: Kotoko
authors.initials: K
authors.lastname: Suzuki
authors.forename: Atsuko
authors.initials: A
authors.lastname: Ohba
authors.forename: Shin-ichiro
authors.initials: S
authors.lastname: Hamano
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Sakuma
mesh_terms: D060426:Anti-N-Methyl-D-Aspartate Receptor Encephalitis / Q000134:cerebrospinal fluid / Q000188:drug therapy*; D058846:Antibodies, Monoclonal, Murine-Derived / Q000627:therapeutic use*; D015703:Antigens, CD / Q000378:metabolism; D001323:Autoantibodies / Q000097:blood; D002675:Child, Preschool; D005434:Flow Cytometry; D006801:Humans; D007155:Immunologic Factors / Q000627:therapeutic use*; D007963:Leukocytes, Mononuclear / Q000187:drug effects; D008297:Male; D010950:Plasma Cells / Q000187:drug effects*; D000069283:Rituximab
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; D015703:Antigens, CD; D001323:Autoantibodies; D007155:Immunologic Factors; D000069283:Rituximab
keywords: Anti-NMDAR encephalitis; Central nervous system; Flow cytometric analysis; Rituximab