Reduced dosage rituximab in the treatment of anti-N-methyl-d-aspartate receptor encephalitis: An observation study in Chinese patients
The aim of this study was to observe the treatment effect and investigate the possible mechanism of reduced dosage (600 mg) rituximab treatment on anti-N-methyl-d-aspartate receptor (anti-NMDAR) encephalitis. The median modified Rankin Scale of ten enrolled patients decreased from 4 (range 2–4) befo...
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| Veröffentlicht in: | Journal of neuroimmunology 2019-05, Vol.330, p.81-86 |
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| creator | Deng, Bo Yu, Hai Liu, Xiaoni Yu, Xue Zhang, Xiang Li, Xiang Yang, Wenbo Dong, Siqi Qiu, Yue Chen, Xiangjun |
| description | The aim of this study was to observe the treatment effect and investigate the possible mechanism of reduced dosage (600 mg) rituximab treatment on anti-N-methyl-d-aspartate receptor (anti-NMDAR) encephalitis. The median modified Rankin Scale of ten enrolled patients decreased from 4 (range 2–4) before rituximab infusion to 0 (range 0–2) after a mean follow-up time of 24.3 ± 8.7 months. One patient relapsed 9 months after treatment. No severe adverse event was observed. The proportion of total B cells in lymphocytes was depleted from 13.4 ± 6.7% to 0.6 ± 0.8% one day after treatment. B cells started to regeneration at 3 months and reached 9.4 ± 3.7% at 12 months after treatment. At this time point, proportion of regulatory B cells (Breg) in reconstituted B cells was significantly higher than that before treatment (15.3 ± 12.1% vs. 0.5 ± 0.6%, p = 0.006), while proportion of memory B cells (Bmem) was significantly lower than baseline level (8.0 ± 4.5% vs. 30.2 ± 12.6%, p |
| doi_str_mv | 10.1016/j.jneuroim.2019.02.008 |
| format | Article |
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•Reduced dosage rituximab was effective and safe in treating anti-NMDAR encephalitis.•Reduced dosage rituximab could maintain B cells at low level as long as 3 months after treatment.•B cells after rituximab treatment had raised proportion of regulatory B cells while reduced proportion of memory B cells.</description><identifier>ISSN: 0165-5728</identifier><identifier>EISSN: 1872-8421</identifier><identifier>DOI: 10.1016/j.jneuroim.2019.02.008</identifier><identifier>PMID: 30851542</identifier><language>eng</language><publisher>Netherlands: Elsevier B.V</publisher><subject>Anti-N-methyl-d-aspartate receptor encephalitis ; B cell ; Dosage regimen ; Rituximab ; Treatment</subject><ispartof>Journal of neuroimmunology, 2019-05, Vol.330, p.81-86</ispartof><rights>2019 Elsevier B.V.</rights><rights>Copyright © 2019 Elsevier B.V. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c368t-990cface62e6dd1c67648bb966cb0403f71da537739346b189d94c9ee4389b63</citedby><cites>FETCH-LOGICAL-c368t-990cface62e6dd1c67648bb966cb0403f71da537739346b189d94c9ee4389b63</cites><orcidid>0000-0003-1101-4013</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.jneuroim.2019.02.008$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30851542$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Deng, Bo</creatorcontrib><creatorcontrib>Yu, Hai</creatorcontrib><creatorcontrib>Liu, Xiaoni</creatorcontrib><creatorcontrib>Yu, Xue</creatorcontrib><creatorcontrib>Zhang, Xiang</creatorcontrib><creatorcontrib>Li, Xiang</creatorcontrib><creatorcontrib>Yang, Wenbo</creatorcontrib><creatorcontrib>Dong, Siqi</creatorcontrib><creatorcontrib>Qiu, Yue</creatorcontrib><creatorcontrib>Chen, Xiangjun</creatorcontrib><title>Reduced dosage rituximab in the treatment of anti-N-methyl-d-aspartate receptor encephalitis: An observation study in Chinese patients</title><title>Journal of neuroimmunology</title><addtitle>J Neuroimmunol</addtitle><description>The aim of this study was to observe the treatment effect and investigate the possible mechanism of reduced dosage (600 mg) rituximab treatment on anti-N-methyl-d-aspartate receptor (anti-NMDAR) encephalitis. The median modified Rankin Scale of ten enrolled patients decreased from 4 (range 2–4) before rituximab infusion to 0 (range 0–2) after a mean follow-up time of 24.3 ± 8.7 months. One patient relapsed 9 months after treatment. No severe adverse event was observed. The proportion of total B cells in lymphocytes was depleted from 13.4 ± 6.7% to 0.6 ± 0.8% one day after treatment. B cells started to regeneration at 3 months and reached 9.4 ± 3.7% at 12 months after treatment. At this time point, proportion of regulatory B cells (Breg) in reconstituted B cells was significantly higher than that before treatment (15.3 ± 12.1% vs. 0.5 ± 0.6%, p = 0.006), while proportion of memory B cells (Bmem) was significantly lower than baseline level (8.0 ± 4.5% vs. 30.2 ± 12.6%, p < 0.001). Our results supported that reduced dosage rituximab was effective and safe in treating anti-NMDAR encephalitis. B cell depletion and rebalance of Breg and Bmem might be involved in the treatment mechanism of this therapy.
[Display omitted]
•Reduced dosage rituximab was effective and safe in treating anti-NMDAR encephalitis.•Reduced dosage rituximab could maintain B cells at low level as long as 3 months after treatment.•B cells after rituximab treatment had raised proportion of regulatory B cells while reduced proportion of memory B cells.</description><subject>Anti-N-methyl-d-aspartate receptor encephalitis</subject><subject>B cell</subject><subject>Dosage regimen</subject><subject>Rituximab</subject><subject>Treatment</subject><issn>0165-5728</issn><issn>1872-8421</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><recordid>eNqFkcFu1DAURS0EokPLL1ResnGwY8eJWVGNKCBVIFXdW479wniUxMF2KuYH-O46mpYtq2c93XuffC5C14xWjDL58VgdZ1hj8FNVU6YqWleUdq_QjnVtTTpRs9doV4QNadq6u0DvUjpSyhou1Ft0wWnXsEbUO_T3HtxqwWEXkvkFOPq8_vGT6bGfcT4AzhFMnmDOOAzYzNmTH2SCfDiNxBGTFhOzycUHFpYcIoa5PA5m9NmnT_hmxqFPEB9N9mHGKa_utCXvD36GBHgp-5KdrtCbwYwJ3j_PS_Rw--Vh_43c_fz6fX9zRyyXXSZKUTsYC7IG6RyzspWi63slpe2poHxomTMNb1uuuJA965RTwioAwTvVS36JPpxjlxh-r5CynnyyMI5mhrAmXRdHIwq2TSrPUhtDShEGvcTCJZ40o3qrQB_1SwV6q0DTWpcKivH6-cbaT-D-2V6YF8HnswDKRx89RJ2s37A5Xyhm7YL_340n1uCeAA</recordid><startdate>20190515</startdate><enddate>20190515</enddate><creator>Deng, Bo</creator><creator>Yu, Hai</creator><creator>Liu, Xiaoni</creator><creator>Yu, Xue</creator><creator>Zhang, Xiang</creator><creator>Li, Xiang</creator><creator>Yang, Wenbo</creator><creator>Dong, Siqi</creator><creator>Qiu, Yue</creator><creator>Chen, Xiangjun</creator><general>Elsevier B.V</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-1101-4013</orcidid></search><sort><creationdate>20190515</creationdate><title>Reduced dosage rituximab in the treatment of anti-N-methyl-d-aspartate receptor encephalitis: An observation study in Chinese patients</title><author>Deng, Bo ; Yu, Hai ; Liu, Xiaoni ; Yu, Xue ; Zhang, Xiang ; Li, Xiang ; Yang, Wenbo ; Dong, Siqi ; Qiu, Yue ; Chen, Xiangjun</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c368t-990cface62e6dd1c67648bb966cb0403f71da537739346b189d94c9ee4389b63</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Anti-N-methyl-d-aspartate receptor encephalitis</topic><topic>B cell</topic><topic>Dosage regimen</topic><topic>Rituximab</topic><topic>Treatment</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Deng, Bo</creatorcontrib><creatorcontrib>Yu, Hai</creatorcontrib><creatorcontrib>Liu, Xiaoni</creatorcontrib><creatorcontrib>Yu, Xue</creatorcontrib><creatorcontrib>Zhang, Xiang</creatorcontrib><creatorcontrib>Li, Xiang</creatorcontrib><creatorcontrib>Yang, Wenbo</creatorcontrib><creatorcontrib>Dong, Siqi</creatorcontrib><creatorcontrib>Qiu, Yue</creatorcontrib><creatorcontrib>Chen, Xiangjun</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of neuroimmunology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Deng, Bo</au><au>Yu, Hai</au><au>Liu, Xiaoni</au><au>Yu, Xue</au><au>Zhang, Xiang</au><au>Li, Xiang</au><au>Yang, Wenbo</au><au>Dong, Siqi</au><au>Qiu, Yue</au><au>Chen, Xiangjun</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Reduced dosage rituximab in the treatment of anti-N-methyl-d-aspartate receptor encephalitis: An observation study in Chinese patients</atitle><jtitle>Journal of neuroimmunology</jtitle><addtitle>J Neuroimmunol</addtitle><date>2019-05-15</date><risdate>2019</risdate><volume>330</volume><spage>81</spage><epage>86</epage><pages>81-86</pages><issn>0165-5728</issn><eissn>1872-8421</eissn><abstract>The aim of this study was to observe the treatment effect and investigate the possible mechanism of reduced dosage (600 mg) rituximab treatment on anti-N-methyl-d-aspartate receptor (anti-NMDAR) encephalitis. The median modified Rankin Scale of ten enrolled patients decreased from 4 (range 2–4) before rituximab infusion to 0 (range 0–2) after a mean follow-up time of 24.3 ± 8.7 months. One patient relapsed 9 months after treatment. No severe adverse event was observed. The proportion of total B cells in lymphocytes was depleted from 13.4 ± 6.7% to 0.6 ± 0.8% one day after treatment. B cells started to regeneration at 3 months and reached 9.4 ± 3.7% at 12 months after treatment. At this time point, proportion of regulatory B cells (Breg) in reconstituted B cells was significantly higher than that before treatment (15.3 ± 12.1% vs. 0.5 ± 0.6%, p = 0.006), while proportion of memory B cells (Bmem) was significantly lower than baseline level (8.0 ± 4.5% vs. 30.2 ± 12.6%, p < 0.001). Our results supported that reduced dosage rituximab was effective and safe in treating anti-NMDAR encephalitis. B cell depletion and rebalance of Breg and Bmem might be involved in the treatment mechanism of this therapy.
[Display omitted]
•Reduced dosage rituximab was effective and safe in treating anti-NMDAR encephalitis.•Reduced dosage rituximab could maintain B cells at low level as long as 3 months after treatment.•B cells after rituximab treatment had raised proportion of regulatory B cells while reduced proportion of memory B cells.</abstract><cop>Netherlands</cop><pub>Elsevier B.V</pub><pmid>30851542</pmid><doi>10.1016/j.jneuroim.2019.02.008</doi><tpages>6</tpages><orcidid>https://orcid.org/0000-0003-1101-4013</orcidid></addata></record> |
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| subjects | Anti-N-methyl-d-aspartate receptor encephalitis B cell Dosage regimen Rituximab Treatment |
| title | Reduced dosage rituximab in the treatment of anti-N-methyl-d-aspartate receptor encephalitis: An observation study in Chinese patients |
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