RESEARCH - Changes in macrophage function after rituximab treatment in patients with RA

[Guest guest]

Ann Rheum Dis. 2007 Jun;66(6):818-20. Epub 2006 Dec 5.

Changes in macrophage function after rituximab treatment in patients with

rheumatoid arthritis.

Division of Clinical Immunology and Allergy, Bnai Zion Medical Center, P O

Box 4940, Haifa 31048, Israel. elias.toubi@....

OBJECTIVE: To assess changes in macrophage phenotype and function after

rituximab-induced B cell depletion in patients with rheumatoid arthritis

(RA). METHODS: 10 patients with RA were treated with rituximab, achieving

significant B cell depletion 4 months later. Clinical improvement,

rheumatoid factor (RF), anti-cyclic citrullinated peptide (anti-CCP)

antibodies, mRNA of B cell activating factor (BAFF), interleukin (IL) 10 and

CD86 in human monocyte-derived macrophages (HMDMs) and tumour necrosis

factor alpha (TNFalpha) secretion from cultured HMDMs were assessed at

baseline and after the depletion. RESULTS: A clinical response of American

College of Rheumatology (ACR) 50% improvement was noted in six patients, and

another two patients responded with moderate improvement, equivalent to ACR

20-50% improvements. RF and anti-CCP antibodies were positive at baseline in

seven of ten patients. RF disappeared or declined in six patients 4 months

after treatment, correlating with clinical improvement. By contrast,

anti-CCP remained unchanged in six patients. After rituximab treatment, and

in association with clinical improvement, BAFF, IL10 and CD86 mRNA

expression in HMDM were significantly upregulated compared with values at

baseline. A significant decrease in TNFalpha in the supernatant of cultured

HMDM was also noted.

CONCLUSIONS: In addition to B cell depletion and attenuation in some of the

specific autoantibodies, clinical improvement in rituximab-treated patients

with RA occurred in association with changes in macrophage function.

PMID: 17148544

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed & cmd=Retrieve & dopt=Abstra\

ctPlus & list_uids=17148544

Not an MD