Genberg Helena, Hansson Anneli, Wernerson Annika, Wennberg Lars, Tydén Gunnar
Department of Transplantation Surgery, Karolinska University Hospital, Huddinge, Sweden.
Transplantation. 2007 Dec 27;84(12 Suppl):S33-6. doi: 10.1097/01.tp.0000296122.19026.0f.
The B-cell depleting anti-CD20 antibody rituximab has become a therapeutic alternative in renal transplantation. However, understanding of the pharmacodynamics is limited. We have therefore studied the effect of single-dose rituximab, in combination with conventional triple immunosuppressive therapy, on the B-cell population in peripheral blood as well as in tissues, in kidney transplant recipients. Forty-nine kidney recipients received single-dose rituximab. The prevalence of B cells was assessed in peripheral blood, kidney transplant tissue, and in lymph nodes. In 88%, complete depletion of B cells in peripheral blood was observed and, 15 months after treatment, B cells were still undetectable in the majority of patients. In kidney tissue, B cells were also completely eliminated. In contrast, the B cells were not eliminated in lymph nodes, although a reduction was observed. In conclusion, single-dose rituximab in kidney transplant recipients evokes a long-term elimination of B-cells in peripheral blood as well as within the kidney transplant.
B细胞耗竭性抗CD20抗体利妥昔单抗已成为肾移植中的一种治疗选择。然而，对其药效学的了解有限。因此，我们研究了单剂量利妥昔单抗联合传统三联免疫抑制疗法对肾移植受者外周血以及组织中B细胞群体的影响。49名肾移植受者接受了单剂量利妥昔单抗治疗。评估了外周血、肾移植组织和淋巴结中B细胞的患病率。在88%的患者中，观察到外周血B细胞完全耗竭，治疗15个月后，大多数患者的B细胞仍检测不到。在肾组织中，B细胞也被完全清除。相比之下，淋巴结中的B细胞虽有减少，但未被清除。总之，肾移植受者使用单剂量利妥昔单抗可对外周血以及肾移植内的B细胞产生长期清除作用。
