Rituximab also depletes T cells

AdamS

Senior Member
Messages
336
Likes
1,004
In the OMF Syposium video, Prof Mark Davis presented some incredibly interesting stuff regarding T cells. In particular that there is probably a triggering antigen in ME/CFS and that CD8 clonal expansion, similar to that seen in MS & cancer is present in ME/CFS patients.

I always thought Rituximab was designed to deplete B cells alone, but after a quick Google I found this:

RESULTS: Data on 52 patients were examined. Rituximab induced unexpected and substantial depletion of T cells, mainly CD4+ cells, in most patients...lack of CD4+ cell depletion was associated with no clinical response. Therefore, the mechanism of action of rituximab may depend at least in part on T cells.
CONCLUSION: Rituximab induces substantial T cell depletion, mainly of CD4+ cells, which is associated with the clinical response in RA.
Source: https://www.ncbi.nlm.nih.gov/m/pubmed/23918413/

I'm sure some of you may have been aware of this for a while but I found it interesting/exciting given Mark Davis's findings!
 

AdamS

Senior Member
Messages
336
Likes
1,004
Additionally, it would appear that T-cell activation and proliferation can be modulated by using calcineurin inhibitors (cyclosporine, tacrolimus), mTOR inhibitors (sirolimus), and antiproliferative agents (methotrexate, cyclophosphamide, or mycophenolate). Perhaps this is why we have some anecdotal reports of Sirolimus helping a bit and it could point towards Cyclo having benefit for some patients if T cells are involved/responsible in some way! (Pretty sure Fluge & Mella have a CycloME trial in progress atm, correct me if i'm wrong).

Source: http://www.bloodjournal.org/content/117/23/6061?sso-checked=true
 

Gingergrrl

Senior Member
Messages
13,243
Likes
38,516
I always thought Rituximab was designed to deplete B cells alone, but after a quick Google I found this:
This is interesting and I have done the Lymphocyte subset panel twice (one month apart) after having the initial two Rituximab infusions in mid July and early Aug. I do not have the 2nd test results back yet (hopefully tomorrow) but I believe in the first test that my T cells were normal and unaffected. My B cells were at zero after the first infusion which is the goal of Ritux. Now I intend to look at T cell levels for both sets of tests and am very curious!
 

AdamS

Senior Member
Messages
336
Likes
1,004
Now I intend to look at T cell levels for both sets of tests and am very curious!
Definitely sounds worthwhile, yes it will be interesting to see if T cell levels correpond with clinical response in Ritux or other treatments for ME/CFS.

Also, I hope you're doing okay with your treatment, I don't post as much here anymore but have been following your story!
 

Gingergrrl

Senior Member
Messages
13,243
Likes
38,516
Addendum: I am wrong and some of the other numbers were flagged as low in addition to the B cells but I am not sure what they all mean or how to interpret them. If I posted the numbers, do you know what they mean @AdamS?

Edit: We cross posted at exact same moment and thank you for the good wishes re: following my story!
 

Gingergrrl

Senior Member
Messages
13,243
Likes
38,516
I probably wouldn't unfortunately @Gingergrrl i'm sure others would though :)
No worries! I looked more carefully at the first Lymphocyte Subset Panel that I did after the first infusion of Ritux (but prior to the second one). I did the second LSP more recently but don't have the results back yet.

In the first one, there are a total of 12 items and five were flagged as low but three relate to B-cells so I believe this is '"normal" and the goal of Ritux. I am not sure about the additional two things that were flagged and suspect they relate to T cells. My doctor was not concerned at all at the time so I did not question it any further since I didn't really know what I was looking at (beyond the Absolute CD19 and the %CD19 meaning the B cells being at zero).
 

BurnA

Senior Member
Messages
2,087
Likes
9,783
In the OMF Syposium video, Prof Mark Davis presented some incredibly interesting stuff regarding T cells. In particular that there is probably a triggering antigen in ME/CFS and that CD8 clonal expansion, similar to that seen in MS & cancer is present in ME/CFS patients.

I always thought Rituximab was designed to deplete B cells alone, but after a quick Google I found this:





Source: https://www.ncbi.nlm.nih.gov/m/pubmed/23918413/

I'm sure some of you may have been aware of this for a while but I found it interesting/exciting given Mark Davis's findings!
Discussed here
http://forums.phoenixrising.me/inde...which-rtx-might-be-working.37669/#post-599316