针对自身免疫性脑炎进行个性化Ofatumumab治疗:四名患者的病例系列
Qiong Long1, Jiahui Xie1, Zhenyu Yang1
1College of Clinical Medicine, Hunan University of Chinese Medicine, Changsha, Hunan 410007, China; Department of Neurology, The Second People's Hospital of Hunan Province (Brain Hospital of Hunan Province), Changsha, Hunan 410007, China.
Journal of neuroimmunology
|December 13, 2025
概括
以B细胞监测为指导的个性化ofatumumab疗法在耐火性自身免疫脑炎方面显示出有前途. 这种方法改善了患者的治疗结果,并在一系列小病例中证明了有利的安全性.
科学领域:
- 神经免疫学 神经免疫学
- 免疫治疗是一种免疫疗法.
- B细胞生物学B细胞生物学
背景情况:
- 自身免疫性脑炎 (AE) 是一种重要的神经免疫学疾病.
- 目前的免疫疗法选择对于耐火性疾病患者是有限的.
- 确定新的治疗策略对于改善AE患者的治疗结果至关重要.
研究的目的:
- 为了评估个性化ofatumumab (OFA) 治疗方案的疗效和安全性.
- 调查监测CD27+CD19+记忆B细胞的实用性,以指导耐火AE的OFA治疗.
主要方法:
- 对三个抗N-甲基-d-酸盐受体 (抗NMDAR) 脑炎病例和一个抗体阴性AE (NA-AE) 病例的回顾性分析.
- 对皮质类固醇和IVIG耐药的患者在0日和7日接受了OFA (20毫克皮下注射)
- 随后的OFA剂量基于周围血液CD27+CD19+记忆B细胞计数超过PBMCs的0.05%.
主要成果:
- 所有患者在平均10个月的随访后都出现了临床改善.
- 修改后的兰金尺度 (mRS) 和CASE分数有显著的减少.
- 一名患者在SARS-CoV-2感染后复发;其他患者没有复发,没有不良事件.
结论:
- 以CD27+CD19+记忆B细胞监测为指导的个性化ofatumumab疗法为耐火AE提供了一个潜在的新策略.
- 这种方法可以为具有挑战性的AE病例提供有效和安全的治疗选择.
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