title: The immune balance between memory and regulatory B cells in NMO and the changes of the balance after methylprednisolone or rituximab therapy.
abstract: We aim to explore the impacts of high dose methylprednisolone therapy (HDMT) and rituximab on circulating B cells in NMO patients. Twenty-two NMO patients in the acute relapse phase were treated with HDMT and 9 patients in the remission stage were treated with rituximab. The frequencies of circulating CD19(+)CD27(+) memory B cell (Bmem), CD19(+)CD24(high)CD38(high) regulatory B cell (Breg) and the B cell production of interleukin (IL)-10 and interferon (IFN)-γ were monitored by flow cytometry before and after the treatment. The frequencies of circulating Bregs and the B cell IL-10 production were significantly lower in NMO patients before HDMT compared to healthy controls. Two weeks' HDMT further reduced the frequencies of Bregs while increased the frequencies of Bmems, which steered the numerical balance between Bmem and Breg in favor of Bmem. Meanwhile, HDMT significantly inhibited the B cell IFN-γ expression. Rituximab exerted its effect through B cell elimination and subsequent B cell repopulation which was characterized by the predominance of Bregs, restored the numerical balance between Breg and Bmem back to an advantageous "Breg>Bmem" status. Therefore, HDMT and rituximab had basically different impacts on B cells in NMO.
authors.affiliation: Department of Neurology, Huashan Hospital, Shanghai Medical College, Fudan University, China.
authors.forename: Chao
authors.initials: C
authors.lastname: Quan
authors.affiliation: Department of Neurology, Huashan Hospital, Shanghai Medical College, Fudan University, China.
authors.forename: Jingzi
authors.initials: J
authors.lastname: ZhangBao
authors.affiliation: Department of Neurology, Huashan Hospital, Shanghai Medical College, Fudan University, China.
authors.forename: Jiahong
authors.initials: J
authors.lastname: Lu
authors.affiliation: Department of Neurology, Huashan Hospital, Shanghai Medical College, Fudan University, China; Department of Neurology, Jing'an District Centre Hospital of Shanghai, China.
authors.forename: Chongbo
authors.initials: C
authors.lastname: Zhao
authors.affiliation: Department of Neurology, Jing'an District Centre Hospital of Shanghai, China.
authors.forename: Tongjia
authors.initials: T
authors.lastname: Cai
authors.affiliation: Department of Neurology, Jing'an District Centre Hospital of Shanghai, China.
authors.forename: Bei
authors.initials: B
authors.lastname: Wang
authors.affiliation: Department of Neurology, Huashan Hospital, Shanghai Medical College, Fudan University, China.
authors.forename: Hai
authors.initials: H
authors.lastname: Yu
authors.affiliation: Institute of Neurology, Huashan Hospital, Shanghai Medical College, Fudan University, China.
authors.forename: Jian
authors.initials: J
authors.lastname: Qiao
authors.affiliation: Department and Institute of Neurology, Huashan Hospital, Shanghai Medical College, Fudan University, China. Electronic address: chuanzhenlu@163.com.
authors.forename: Chuanzhen
authors.initials: C
authors.lastname: Lu
mesh_terms: D000293:Adolescent; D000328:Adult; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D058846:Antibodies, Monoclonal, Murine-Derived / Q000627:therapeutic use*; D015703:Antigens, CD / Q000378:metabolism; D051401:Aquaporin 4 / Q000378:metabolism; D016175:B-Lymphocyte Subsets / Q000187:drug effects* / Q000276:immunology; D016207:Cytokines / Q000378:metabolism; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D008297:Male; D008775:Methylprednisolone / Q000627:therapeutic use*; D008875:Middle Aged; D009471:Neuromyelitis Optica / Q000188:drug therapy / Q000276:immunology / Q000473:pathology; D000069283:Rituximab; D013997:Time Factors; D055815:Young Adult
chemical_list: C496030:AQP4 protein, human; D000893:Anti-Inflammatory Agents; D058846:Antibodies, Monoclonal, Murine-Derived; D015703:Antigens, CD; D051401:Aquaporin 4; D016207:Cytokines; D000069283:Rituximab; D008775:Methylprednisolone
keywords: Memory B cells; Methylprednisolone; Neuromyelitis optica; Regulatory B cells; Rituximab