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Rituximab increases peripheral natural killer cells in patients with rheumatoid arthritis

1, 2, 3, 4, 5, 6, 7, 8

 

  1. Rheumatology Unit, Department of Medicine, University of Verona, Italy. alessandrogiollo@gmail.com
  2. Rheumatology Unit, Department of Medicine, University of Verona, Italy.
  3. Rheumatology Unit, Department of Medicine, University of Verona, Italy.
  4. Immunology Unit, Department of Pathology, University of Verona, Italy.
  5. Rheumatology Unit, Department of Medicine, University of Verona, Italy.
  6. Rheumatology Unit, Department of Medicine, University of Verona, Italy.
  7. Rheumatology Unit, Department of Medicine, University of Verona, Italy.
  8. Rheumatology Unit, Department of Medicine, University of Verona, Italy.

CER9463
2017 Vol.35, N°2
PI 0241, PF 0246
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PMID: 27908302 [PubMed]

Received: 30/03/2016
Accepted : 02/09/2016
In Press: 27/10/2016
Published: 15/03/2017

Abstract

OBJECTIVES:
The clinical response of rituximab (RTX) is related to the degree of B cell depletion, although other circulating lymphocytes may be affected. We investigated the changes in lymphocyte sub-populations in rheumatoid arthritis (RA) patients treated with RTX and their relationship with the therapeutic response, with attention to natural killer (NK) cells.
METHODS:
In fifty-one RA patients peripheral blood B and T lymphocytes and NK cells subtypes were counted by flow cytometry before and 3, 6 and 12 months after RTX administration. Patients were evaluated for disease activity with DAS28-CRP and EULAR response criteria at each visit.
RESULTS:
RTX significantly increased from baseline values CD56+3- cells (28 %, 19 % and 25 %; p<0.001, p=0.009 and p=0.004 respectively for month 3, 6 and 12) and CD56dimCD16+ cells (41%, 24% and 36%; p<0.001, p=0.001 and p<0.001 respectively for month 3, 6 and 12). CD56bri16- cells were unaffected by RTX treatment. The increase in both CD56+3- and CD56dimCD16+ cells was significantly greater in patients who were re-treated with another course of RTX at month 6 (p=0.046 and p=0.010 respectively). An inverse correlation between disease activity score and increase in NK cells was demonstrated. No significant changes were observed in CD3+, CD4+ and CD8+ cells during the whole observation period.
CONCLUSIONS:
In RA patients, RTX treatment is associated with significant and persistent increase in CD56+3- and CD56dimCD16+ NK cells. A correlation with disease activity is probable, although the association with clinical response remains to be proved.

Rheumatology Article