奥比努图库单抗
美罗华
医学
CD20
CD19
B细胞激活因子
B细胞
免疫学
内科学
单克隆
外周血
淋巴瘤
单克隆抗体
抗体
作者
Venkat Reddy,Ruth J. Pepper,Kavina Shah,G Cambridge,Scott Henderson,Christian Klein,Loren Kell,Samuel J. Taylor,David Isenberg,Mark S. Cragg,Maria Leandro
出处
期刊:Rheumatology
[Oxford University Press]
日期:2021-11-11
卷期号:61 (7): 2894-2904
被引量:10
标识
DOI:10.1093/rheumatology/keab827
摘要
Abstract Objectives To investigate key factors that may contribute to the variability of rituximab-mediated peripheral and renal B cell depletion (BCD) in SLE. Methods We analysed: (i) CD19+ B cell counts in patients with SLE before and 1, 2, 3 and 6 months after treatment with rituximab, comparing them with RA patients; (ii) the presence of B cells in renal biopsies after rituximab therapy; (iii) whether the duration of BCD correlated with patient demographics and B cell expression of CD20 and FcγRIIb; and (iv) the effect of B cell activation factor (BAFF) on the efficiency of rituximab and obinutuzumab at inducing BCD in whole blood assays, in vitro. Results In SLE (n = 71), the duration of BCD was shorter compared with RA (n = 27). B cells were detectable in renal biopsy samples (n = 6) after treatment with rituximab in all patients with poor response while peripheral blood B cells remained low or undetectable in the same patients. There were no significant relationships between peripheral BCD and patient age, disease duration, serum C3 levels or the level of expression of B cell surface proteins CD20 and FcγRIIb. Obinutuzumab was more efficient than rituximab at inducing BCD in whole blood assays, regardless of excess BAFF. Conclusions BCD in SLE is less efficient than in RA. Renal B cell presence following rituximab treatment was associated with poor outcomes. No significant relationships between any measured B cell related, clinical or laboratory parameters and the efficiency of BCD by rituximab was found. Obinutuzumab was superior to rituximab at inducing BCD.
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