title: Kinetic analysis of changes in T- and B-lymphocytes after anti-CD20 treatment in renal pathology.
abstract: The main objective of this study is to describe qualitatively and quantitatively the different immune lymphocyte phenotypes of patients with renal disease after treatment with anti-CD20.
  
  
  
  Two cohorts of transplanted and autoimmune kidney patients were compared: (1) Those who began treatment with Rituximab, matched (for sex, age and general clinical parameters) with (2) Non-treated control kidney patients. Different analyses were performed: (A) B-lymphocyte subpopulations; (B) T-cell subpopulations; (C) serum levels of BAFF, APRIL, Rituximab and anti-Rituximab; (D) rs396991 polymorphism of CD16a and at different time points for each type of analysis: (i) at baseline, (ii) day 15, (iii) at three and (iv) six months post-antiCD20.
  
  
  
  (A) A depletion of all B cell subsets analysed was observed preferentially decreasing the CD40+memory B-cells, switched memory cells and plasmablasts. (B) A significant decreased percentage of CD4+T-lymphocytes was observed. A significant decrease of the percentage of memory T-cells and an increase in naïve T-cells was also observed. (C) A significant increase for APRIL was observed, as well as a positive correlation between the APRIL levels, and the differential of B-cells. (D) The presence of CD16a Valine-variant induced greater changes in the variations of total T-cell and T-naïve subpopulations.
  
  
  
  Our results highlight that the treatment of renal disease with Rituximab affects T-cells, particularly naïve/memory balance, while APRIL could be also a secondary marker of this treatment. The sequential analysis of phenotypic alterations of B- and T-cells could help patient management, although further studies to identify periods of remission or clinical relapse are warranted.
authors.affiliation: Nephrology and Renal Transplantation Service, Hospital Clínic, Universitat de Barcelona, 08036, Barcelona, Spain.
authors.forename: Alexis
authors.initials: A
authors.lastname: Sentís
authors.affiliation: Nephrology and Renal Transplantation Service, Hospital Clínic, Universitat de Barcelona, 08036, Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIPABS), Barcelona, Spain; Facultat de Medicina, Universitat de Barcelona, 08036, Barcelona, Spain.
authors.forename: Fritz
authors.initials: F
authors.lastname: Diekmann
authors.affiliation: Immunology Service, Hospital Clínic, Universitat de Barcelona, 08036, Barcelona, Spain.
authors.forename: Arturo
authors.initials: A
authors.lastname: Llobell
authors.affiliation: Immunology Service, Hospital Clínic, Universitat de Barcelona, 08036, Barcelona, Spain.
authors.forename: Noemí
authors.initials: N
authors.lastname: de Moner
authors.affiliation: Autoimmune Diseases Service, Hospital Clínic, Universitat de Barcelona, 08036, Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIPABS), Barcelona, Spain; Facultat de Medicina, Universitat de Barcelona, 08036, Barcelona, Spain.
authors.forename: Gerard
authors.initials: G
authors.lastname: Espinosa
authors.affiliation: Immunology Service, Hospital Clínic, Universitat de Barcelona, 08036, Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIPABS), Barcelona, Spain; Facultat de Medicina, Universitat de Barcelona, 08036, Barcelona, Spain.
authors.forename: Jordi
authors.initials: J
authors.lastname: Yagüe
authors.affiliation: Nephrology and Renal Transplantation Service, Hospital Clínic, Universitat de Barcelona, 08036, Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIPABS), Barcelona, Spain; Facultat de Medicina, Universitat de Barcelona, 08036, Barcelona, Spain.
authors.forename: Josep Maria
authors.initials: JM
authors.lastname: Campistol
authors.affiliation: Nephrology and Renal Transplantation Service, Hospital Clínic, Universitat de Barcelona, 08036, Barcelona, Spain.
authors.forename: Eduard
authors.initials: E
authors.lastname: Mirapeix
authors.affiliation: Immunology Service, Hospital Clínic, Universitat de Barcelona, 08036, Barcelona, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIPABS), Barcelona, Spain; Facultat de Medicina, Universitat de Barcelona, 08036, Barcelona, Spain. Electronic address: mjuan@clinic.cat.
authors.forename: Manel
authors.initials: M
authors.lastname: Juan
mesh_terms: D000483:Alleles; D001327:Autoimmune Diseases / Q000175:diagnosis / Q000276:immunology / Q000378:metabolism / Q000628:therapy; D016175:B-Lymphocyte Subsets / Q000187:drug effects / Q000276:immunology* / Q000378:metabolism*; D015415:Biomarkers; D005260:Female; D005500:Follow-Up Studies; D005838:Genotype; D006801:Humans; D007155:Immunologic Factors / Q000494:pharmacology* / Q000627:therapeutic use; D016130:Immunophenotyping; D007674:Kidney Diseases / Q000175:diagnosis / Q000276:immunology* / Q000378:metabolism* / Q000628:therapy; D016030:Kidney Transplantation; D018655:Lymphocyte Count; D008297:Male; D010641:Phenotype; D011110:Polymorphism, Genetic; D017452:Receptors, IgG / Q000235:genetics; D000069283:Rituximab / Q000494:pharmacology* / Q000627:therapeutic use; D016176:T-Lymphocyte Subsets / Q000187:drug effects / Q000276:immunology* / Q000378:metabolism*
chemical_list: D015415:Biomarkers; C496124:FCGR3A protein, human; D007155:Immunologic Factors; D017452:Receptors, IgG; D000069283:Rituximab
keywords: AntiCD20 treatment; Autoimmune renal disease; Immune phenotype; Kidney transplant; Rituximab