Immunological response after SARS-CoV-2 infection and mRNA vaccines in patients with myasthenia gravis treated with Rituximab

Damato, Valentina; Spagni, Gregorio; Monte, Gabriele; Scandiffio, Letizia; Cavalcante, Paola; Zampetti, Nicole; Fossati, Marco; Falso, Silvia; Mantegazza, Renato; Battaglia, Alessandra; Fattorossi, Andrea; Evoli, Amelia

doi:10.1016/j.nmd.2023.02.005

Cited by 4 publications

(1 citation statement)

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“…Accumulated evidence suggests that B-cell depletion therapy has a regulatory effect on T cell subsets. The immunomodulatory effect of rituximab on T cells in patients with MG has been repeatedly reported (30,54). Furthermore, rituximab or ofatumumab also plays an immunomodulatory role on T cells in other autoimmune diseases, such as MS and rheumatoid arthritis (44, 55, 56).…”

Section: Discussionmentioning

confidence: 96%

Therapeutic effect of ofatumumab in patients with myasthenia gravis: immunoregulation of follicular T helper cells and T helper type 17 cells

Li,

Zhang,

Liu

2023

Front. Neurol.

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IntroductionThis study aimed to study the therapeutic effects of ofatumumab in patients with myasthenia gravis (MG) in addition to the immunomodulatory effects on peripheral follicular T helper (Tfh) cells and T helper type 17 (Th17) cells.MethodsThirty-one patients with anti-acetylcholine receptor (AChR) antibody-positive MG were included in this study. At weeks 0, 1, 2, and 4, an initial dose of 20 mg of ofatumumab was injected subcutaneously, with a 2-month follow-up after completing this first cycle. At baseline, 1 month, and 3 months, we assessed the Quantitative MG (QMG), 15-item MG-Quality of Life (MG-QOL15), and MG-Activities of Daily Living (MG-ADL) scales and measured the frequencies of Tfh, Th17, and B cells and the levels of anti-AChR antibody, IL-6, IL-21, and IL-17 in the peripheral blood.ResultsAt 1 month and 3 months, the QMG, MG-QOL15, and MG-ADL scores were all significantly reduced. At 3 months, doses of prednisone were reduced by an average of 37%. Decreased frequencies of Tfh and Th17 cells, depletion of B cells, and reduced levels of IL-6, IL-21, and IL-17 were all observed at 1 month or 3 months.DiscussionTherefore, the therapeutic effect of ofatumumab could be detected after one cycle of treatment, which was maintained for 2 months. The immunomodulatory effect of ofatumumab during the observation period may involve depletion of B cells, reduction of Tfh and Th17 cells frequencies, and reduced levels of IL-6, IL-21, and IL-17. The findings provide novel data for the potential application of ofatumumab in MG.

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Section: Discussionmentioning

confidence: 96%