Effects of rituximab therapy on B cell differentiation and depletion.

Abstract:

:Rituximab is a human/murine chimeric anti-CD20 monoclonal antibody. It is largely used to treat B cell malignancies and has become standard in the management of B cell‑mediated diseases such as rheumatoid arthritis and granulomatosis with polyangitis. The effects of rituximab need to be monitored by B cell phenotyping. Evaluate possible surface markers for monitoring B cell development in response to rituximab treatment. This review discusses the literature on the B cell surface markers analysed by flow cytometry in patients treated with rituximab. A panel of biomarkers of response to treatment to monitor by flow cytometry is also suggested. B cell phenotyping is useful to predict clinical relapses after rituximab treatment. The proposed panel of biomarkers includes CD38++CD24++IgD+/- immature B cells and IgD-CD38+/- memory B cells. In responders, Th1/Th2 balance and tolerance cells (CD4+CD25+CD127-/low Treg cells and CD19+CD24hiCD38hi Breg cells) tend to be restored after rituximab therapy. Furthermore, in responder patients, indirect depletion of CD19+/-CD27++CD38++ preplasma cells can be proposed as a predictor of response. Flow cytometric analysis of samples from patients treated with rituximab is a useful strategy to stratify patients according to response to treatment. Identification of B cell differentiation stages by means of a specific flow cytometry panel could improve monitoring of rituximab effects and enable non-responders to be distinguished from good responders.

journal_name

Clin Rheumatol

journal_title

Clinical rheumatology

authors

Bergantini L,d'Alessandro M,Cameli P,Vietri L,Vagaggini C,Perrone A,Sestini P,Frediani B,Bargagli E

doi

10.1007/s10067-020-04996-7

subject

Has Abstract

pub_date

2020-05-01 00:00:00

pages

1415-1421

issue

5

eissn

0770-3198

issn

1434-9949

pii

10.1007/s10067-020-04996-7

journal_volume

39

pub_type

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