Department of Neuropediatrics, Tokyo Metropolitan Neurological Hospital, 2-6-1 Musashidai, Fuchu, Tokyo 183-0042, Japan.
J Neuroimmunol. 2013 Dec 15;265(1-2):128-30. doi: 10.1016/j.jneuroim.2013.09.017. Epub 2013 Sep 28.
We measured anti-N-methyl-D-aspartate receptor (NMDAR) autoantibody levels and assessed B cell subsets using multicolor flow cytometry of peripheral blood mononuclear cells (PBMCs) from a recurrent anti-NMDAR encephalitis case to evaluate the effectiveness of rituximab treatment. Rituximab depleted CD20(+) fractions of naïve and memory B cell subsets and reduced the number of CD20(-) plasmablasts. This study suggests that short-lived plasmablasts are removed by rituximab-induced depletion of the CD20(+) B cell population. Increased numbers of plasmablasts in PBMCs may be a candidate predictive factor for unfavorable prognosis of anti-NMDAR encephalitis and an indication of when to commence second-line immunotherapy.
我们测量了复发性抗 N-甲基-D-天冬氨酸受体（NMDAR）脑炎病例外周血单个核细胞（PBMC）中抗 NMDAR 自身抗体水平，并使用多色流式细胞术评估 B 细胞亚群，以评估利妥昔单抗治疗的效果。利妥昔单抗耗尽了幼稚和记忆 B 细胞亚群的 CD20(+) 部分，并减少了 CD20(-) 浆母细胞的数量。本研究表明，利妥昔单抗诱导的 CD20(+) B 细胞群耗竭可清除短暂存在的浆母细胞。PBMC 中浆母细胞数量的增加可能是抗 NMDAR 脑炎不良预后的候选预测因素，也是开始二线免疫治疗的指征。
