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rituximab plus rifampicin--sphingolipids

Discussion in 'Rituximab: News and Research' started by jaybee00, Nov 1, 2016.

  1. jaybee00

    jaybee00

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    Hello,

    In this paper "Membrane microdomain sphingolipids are required for anti-CD20-induced death of chronic lymphocytic leukemia B cells" https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3269491/ The antibiotic rifampicin was used in conjunction with a CD20-specific monoclonal antibody tositumomab (B1) (similar to Rituximab)

    They found that ".....rifampicin, an inducer of P-glycoprotein, improved the activity of this transmembrane efflux pump, normalized the quantity of sphingomyelin within the membrane, and thereby restored the efficacy of the B1 monoclonal antibody in the formerly B1-resistant cases of chronic lymphocytic leukemia."

    Has rifampicin been used by any CFS patients receiving rituximab to potentially aid response/increase efficacy?

    Thanks,
    JB
     
    Hutan, Hip, aaron_c and 2 others like this.
  2. jaybee00

    jaybee00

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    Anybody?
     
  3. Hip

    Hip Senior Member

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    Sphingolipids are low in ME/CFS, according to the metabolomic study by Robert Naviaux et al. I don't know if that might have any bearing for why rituximab fails to work in some ME/CFS patients.

    This paper says that rituximab not only binds to CD20 on B cells, but may also bind to sphingomyelin phosphodiesterase acid-like 3b protein (SMPDL-3b). Sphingomyelin is a type of sphingolipid. However, I have no idea of what this means!

    But the study you quoted says rifampicin increases the level of sphingomyelin.



    Probably no relation to this tositumomab / rituximab research, but Dr Chia sometimes uses rifampicin (also called rifampin) in conjunction with oxymatrine, as he finds it sometimes boosts the immunomodulatory effects of oxymatrine. Rifampicin is known to have some antiviral properties.
     
    Last edited: Nov 29, 2016
    BlackJackBen likes this.
  4. Jonathan Edwards

    Jonathan Edwards Senior Member

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    I don't think there is any need to add anything in to rituximab for ME/CFS at this stage. Rituximab depletes B cells very well in patients. The chronic lymphatic leukaemia case is an unusual one. The first thing is to make sure rituximab does actually have an effect in ME/CFS. We still do not know that.
     

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