B cells reappear less mature and more activated after their anti-CD20–mediated depletion in multiple sclerosis

B cell depletion via anti-CD20 antibodies is a highly effective treatment for multiple sclerosis (MS). However, little is known about the maturation/activation stage of the returning B cell population after treatment cessation and the wider effects on other immune cells. In the present study, 15 rel...

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Bibliographic Details
Published in:	Proceedings of the National Academy of Sciences - PNAS 2020-10, Vol.117 (41), p.25690-25699
Main Authors:	Nissimov, Nitzan, Hajiyeva, Zivar, Torke, Sebastian, Grondey, Katja, Brück, Wolfgang, Häusser-Kinzel, Silke, Weber, Martin S.
Format:	Article
Language:	eng
Subjects:	Adult Antibodies Antibodies - administration & dosage Antigens, CD - genetics Antigens, CD - immunology Antigens, CD20 - genetics Antigens, CD20 - immunology Antigens, Differentiation, T-Lymphocyte - genetics Antigens, Differentiation, T-Lymphocyte - immunology B-Lymphocytes - cytology B-Lymphocytes - immunology B7-2 Antigen - genetics B7-2 Antigen - immunology Biological Sciences CD20 antigen CD25 antigen CD4 antigen CD40 antigen CD69 antigen CD8 antigen CD86 antigen Depletion Female Humans Immune system Immunologic Memory Immunological memory Lectins, C-Type - genetics Lectins, C-Type - immunology Lymphocytes Lymphocytes B Lymphocytes T Male Memory cells Middle Aged Monoclonal antibodies Multiple sclerosis Multiple Sclerosis, Relapsing-Remitting - drug therapy Multiple Sclerosis, Relapsing-Remitting - genetics Multiple Sclerosis, Relapsing-Remitting - immunology Myeloid cells Phenotypes Rituximab T-Lymphocytes - cytology T-Lymphocytes - immunology
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Summary:	B cell depletion via anti-CD20 antibodies is a highly effective treatment for multiple sclerosis (MS). However, little is known about the maturation/activation stage of the returning B cell population after treatment cessation and the wider effects on other immune cells. In the present study, 15 relapsing-remitting MS patients receiving 1,000 mg of rituximab were included. B, T, and myeloid cells were analyzed before anti-CD20 administration and in different time intervals thereafter over a period of 24 mo. In comparison to the phenotype before anti-CD20 treatment, the reappearing B cell pool revealed a less mature and more activated phenotype: 1) reappearing B cells were significantly enriched in transitional (before: 10.1 ± 1.9%, after: 58.8 ± 5.2%) and mature naive phenotypes (before: 45.5 ± 3.1%, after: 25.1 ± 3.5%); 2) the frequency of memory B cells was reduced (before: 36.7 ± 3.1%, after: 8.9 ± 1.7%); and 3) reappearing B cells showed an enhanced expression of activation markers CD25 (before: 2.1 ± 0.4%, after: 9.3 ± 2.1%) and CD69 (before: 5.9 ± 1.0%, after: 21.4 ± 3.0%), and expressed significantly higher levels of costimulatory CD40 and CD86. T cells showed 1) a persistent increase in naive (CD4⁺: before: 11.8 ± 1.3%, after: 18.4 ± 3.4%; CD8⁺: before: 12.5 ± 1.4%, after: 16.5 ± 2.3%) and 2) a decrease in terminally differentiated subsets (CD4⁺: before: 47.3 ± 3.2%, after: 34.4 ± 3.7%; CD8⁺: before: 53.7 ± 2.1%, after: 49.1 ± 2.7%).
ISSN:	0027-8424 1091-6490