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Cerebral rituximab uptake in multiple sclerosis: A 89Zr-immunoPET pilot study
Marloes Hj Hagens1, Joep Killestein1, Maqsood M Yaqub2
1Department of Neurology, VU University Medical Center, Amsterdam, The Netherlands/MS Center Amsterdam, VU University Medical Center, Amsterdam, The Netherlands.
Multiple Sclerosis (Houndmills, Basingstoke, England)
|April 27, 2017
Summary
Rituximab rapidly reduces multiple sclerosis activity, but this study found no evidence of the drug entering the brain. Further research is needed to understand rituximab's rapid therapeutic effects in multiple sclerosis.
Area of Science:
- Neuroimmunology
- Pharmacokinetics
- Radiochemistry
Background:
- Rituximab, a monoclonal antibody, effectively treats relapsing-remitting multiple sclerosis (MS).
- Its rapid clinical and radiological benefits occur within weeks of administration.
- The precise mechanisms behind rituximab's swift therapeutic action in MS remain unclear.
Purpose of the Study:
- To investigate whether central nervous system (CNS) penetration of rituximab explains its rapid effect in MS.
- To utilize positron emission tomography (PET) with zirconium-89-labeled rituximab ([89Zr]rituximab) for assessing CNS entry.
Main Methods:
- Positron emission tomography (PET) imaging was employed.
- Zirconium-89-labeled rituximab ([89Zr]rituximab) was administered to assess brain penetration.
- Quantification of radiotracer uptake in the CNS was performed.
Main Results:
- No evidence of cerebral penetration of [89Zr]rituximab was detected.
- The study did not find that rituximab crosses the blood-brain barrier to a significant extent.
Conclusions:
- Central nervous system penetration of rituximab is unlikely to be the mechanism behind its rapid therapeutic effects in multiple sclerosis.
- Alternative explanations for rituximab's prompt efficacy in MS require further investigation.
