Journal
JOURNAL OF CLINICAL NEUROSCIENCE
Volume 18, Issue 7, Pages 997-998Publisher
ELSEVIER SCI LTD
DOI: 10.1016/j.jocn.2010.12.011
Keywords
Anti-aquaporin 4 antibody; B-cell activating factor belonging to the TNF family; Neuromyelitis optica; Rituximab
Categories
Funding
- Ministry of Education, Culture, Sports, Science and Technology (MEXT) of Japan [19209032, 20390241]
- Ministry of Health, Labor and Welfare of Japan
- NINDS [K-23 NS0-48869]
- Grants-in-Aid for Scientific Research [19209032, 20390241] Funding Source: KAKEN
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Rituximab is increasingly used for prevention of relapses of neuromyelitis optica (NMO), a condition that is highly associated with serum anti-aquaporin-4 (AQP4) antibodies. However, B-cell depletion also induces systemic B-cell activating factor (BAFF), which may promote antibody production. We collected serial serum samples from a total of seven patients with NMO prior to, and following, treatment with rituximab. The samples were analyzed for anti-AQP4 antibody titer using a cell-based assay and serum BAFF levels were measured on available samples by standard enzyme-linked immunosorbent assay. Anti-AQP4 antibody levels decreased after 4 weeks to 12 weeks from the first injection of rituximab, but they increased transiently in several patients at 2 weeks after the first injection, in association with a parallel increase in serum BAFF levels. Although anti-AQP4 antibodies appear to decrease overall following rituximab treatment, our findings raise concern over the potential for an early BAFF-mediated worsening of patients with NMO receiving rituximab. (C) 2011 Elsevier Ltd. All rights reserved.
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