Medizinische Universität Graz - Research portal
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SHR Neuro Cancer Cardio Lipid Metab Microb
Venhoff, N; Niessen, L; Kreuzaler, M; Rolink, AG; Hässler, F; Rizzi, M; Voll, RE; Thiel, J.
Reconstitution of the peripheral B lymphocyte compartment in patients with ANCA-associated vasculitides treated with rituximab for relapsing or refractory disease.
AUTOIMMUNITY. 2014; 47(6): 401-8.
Doi: 10.3109/08916934.2014.914174
Web of Science
PubMed
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- Leading authors Med Uni Graz
- Thiel Jens
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- Abstract:
- While in patients with rheumatoid arthritis B-cell repopulation starts within 9 months after rituximab (RTX) therapy, a delayed B-cell repopulation was reported in some RTX-treated patients with ANCA-associated vasculitides (AAV). To date, the frequency of AAV patients with impaired peripheral B-cell regeneration and the mechanisms leading to the constricted regenerative capacity are unknown. We analyzed the B-cell repopulation kinetic in 37 AAV patients treated with RTX followed by maintenance immunosuppressants. We report on serum concentrations of the B-cell-activating factor BAFF, immunoglobulins and B-cell subpopulations in patients that relapsed after RTX. B-cells were re-detectable in only one patient within 9 months after RTX. In 14 patients (41%), B-cell repopulation started later, after a mean observation time of 21 months. Only seven of these patients had detectable B-cells within the first year after RTX. Twenty patients (59%) had no B-cell reconstitution within the observation period. BAFF was increased in RTX-treated AAV patients compared to healthy controls and correlated inversely with peripheral B-cell numbers, IgG- and IgA concentrations. Immunoglobulin concentrations declined significantly after RTX and the IgG concentration correlated with B-cell numbers. Thirteen patients relapsed after RTX. Relapses occurred exclusively either after B-cell reconstitution had started or were accompanied by rising ANCA titres. In relapsed patients, the B-lymphocyte compartment consisted mainly of switched memory B-cells. Our data indicate that RTX treatment can induce secondary immunodeficiency in AAV, with hypogammaglobulinemia and long-lasting B-lymphopenia. Further studies are needed to define the pathophysiology of the impaired B-cell development in RTX-treated AAV patients.
- Find related publications in this database (using NLM MeSH Indexing)
- Agammaglobulinemia - etiology, immunology
- Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis - immunology, physiopathology, therapy
- Antibodies, Monoclonal, Murine-Derived - adverse effects, therapeutic use
- Antirheumatic Agents - adverse effects, therapeutic use
- B-Lymphocytes - immunology, pathology
- Cell Count - administration & dosage
- Humans - administration & dosage
- Immunologic Memory - administration & dosage
- Lymphopenia - etiology, immunology
- Recurrence - administration & dosage
- Rituximab - administration & dosage
- Find related publications in this database (Keywords)
- Antineutrophil cytoplasmic antibody
- B lymphocytes
- granulomatosis with polyangiitis (GPA, Wegener's)
- rituximab