在多发性硬化症中进行反复的IV抗CD20治疗:对外周免疫细胞子集的长期影响
Julia Feige1, Tobias Moser1, Katja Akgün2
1Department of Neurology, Christian Doppler University Hospital, Paracelsus Medical University, Salzburg, Austria.
Annals of clinical and translational neurology
|January 11, 2024
概括
抗CD20消耗单克隆抗体有效减少多发性硬化症 (MS) 患者的B细胞. 免疫细胞的变化,特别是T细胞的转移,发生在两次治疗周期后,rituximab和ocrelizumab之间没有区别.
科学领域:
- 免疫学 免疫学 免疫学
- 神经学 神经学
- 药理学 药理学是指药理学的学科.
背景情况:
- 多发性硬化症 (MS) 是一种慢性自身免疫性疾病,影响中枢神经系统.
- 抗CD20单克隆抗体,如rituximab (RTX) 和ocrelizumab (OCR),是MS的有效治疗方法.
- 了解免疫细胞枯竭的动力学对于优化多发性硬化症治疗至关重要.
研究的目的:
- 在MS患者接受RTX或OCR治疗后,研究外周免疫细胞子集的耗尽动力学.
- 为了比较RTX和OCR对B和T细胞群的免疫效应.
主要方法:
- 对15名多发性硬化患者 (7 RTX,8 OCR) 接受新型抗CD20疗法的前性研究.
- 使用多参数光细胞测量对外围血液免疫细胞的免疫类型鉴定.
- 在基线和每12周,长达15个月的时间内进行血样和血样分析.
主要成果:
- 在第一次输液后发生了显著和持续的CD19+B细胞枯竭.
- 在第二个周期后,不成熟和天真B细胞以及记忆T辅助细胞的比例增加被观察到.
- 调节性T细胞数量下降,B细胞依赖TH17.1细胞在第二个周期后下降.
- 在RTX和OCR之间没有发现枯竭动态的显著差异.
结论:
- 重复的抗CD20疗法诱导B细胞迅速枯竭和延迟T细胞子集的比例变化.
- 两次治疗周期后免疫细胞子集的变化需要进一步调查它们在多发性硬化症中的病原学意义.
- 里图西马布和奥克雷利祖马布在MS患者中表现出类似的免疫衰竭动力学.
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