Peripheral B cell depletion and central proinflammatory cytokine reduction following repeated intrathecal administration of rituximab in progressive Multiple Sclerosis

J Neuroimmunol. 2014 Nov 15;276(1-2):229-31. doi: 10.1016/j.jneuroim.2014.08.617. Epub 2014 Aug 19.

Abstract

B cells and/or the enhanced inflammatory milieu in the subarachnoid space are supposed to have a role in cortical pathology of progressive multiple sclerosis (PMS). The efficacy of intravenous rituximab to deplete circulating B cells is remarkable in MS, and its intrathecal delivery could target compartmentalized inflammation in PMS. We describe the central and peripheral effects of repeated intrathecal rituximab administrations in a patient with severe PMS. Peripheral CD20+ B cells were reduced, while oligoclonal bands were unaffected. Several central proinflammatory cytokines, and markers of neurodegeneration were markedly reduced. Central B cells modulation should be investigated in PMS.

Keywords: B lymphocytes; CD20; Neurodegeneration.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Antibodies, Monoclonal, Murine-Derived / administration & dosage*
  • B-Lymphocytes / drug effects*
  • Cytokines / metabolism*
  • Female
  • Humans
  • Immunologic Factors / administration & dosage*
  • Injections, Spinal
  • Multiple Sclerosis / cerebrospinal fluid
  • Multiple Sclerosis / drug therapy*
  • Rituximab

Substances

  • Antibodies, Monoclonal, Murine-Derived
  • Cytokines
  • Immunologic Factors
  • Rituximab