Treatment of Graves' disease with rituximab specifically reduces the production of thyroid stimulating autoantibodies
Research output: Contribution to journal › Journal article › Research › peer-review
Treatment of Graves' disease (GD) with the B-lymphocyte depleting agent rituximab in addition to standard methimazole-therapy prolongs remission. Paradoxically, it does not mediate a reduction in thyrotropin receptor antibody (TRAb) levels over that of methimazole monotherapy. Using a bioassay involving Chinese hamster ovary cells transfected with the human thyrotropin receptor, we found that the stimulatory capacity of TRAbs was reduced markedly, by 66+/-22%, upon treatment with rituximab and methimazole for 21 days (p<0.0001), compared to an increase by 33% on average (NS) in patients receiving methimazole alone (p=0.04 between groups). The overall levels of TRAbs decreased by around 15% in both groups. Within one year of follow-up, rituximab therapy mediated specific decreases in thyroid-peroxidase antibody- and IgM levels, whereas IgG levels were unaffected. The data indicate that rituximab therapy has differential effects on pathogenic and non-pathogenic autoantibodies, even when directed against the same antigen. The possible mechanisms underlying this hitherto unappreciated phenomenon are discussed.
Original language | English |
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Journal | Clinical Immunology |
Volume | 130 |
Issue number | 3 |
Pages (from-to) | 252-8 |
Number of pages | 7 |
ISSN | 1521-6616 |
DOIs | |
Publication status | Published - 2008 |
Bibliographical note
Keywords: Animals; Antibodies, Monoclonal; Antibody Formation; Autoantibodies; CHO Cells; Cricetinae; Cricetulus; Cyclic AMP; Graves Disease; Humans; Immunoglobulins, Thyroid-Stimulating; Immunologic Factors
ID: 20194928