Rituximab in myasthenia gravis: a "to be or not to be" inhibitor of T cell function

Mariapaola Marino, Amelia Evoli, Emanuela Bartoccioni, Paolo Emilio Alboini

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

In recent years, rituximab (RTX), a monoclonal antibody that binds the B lymphocyte membrane protein CD20, has been increasingly used for the treatment of autoimmune diseases, with the rationale of destroying pathogenic B lymphocytes and decreasing autoantibody formation. Surprisingly, RTX has also proven effective in predominantly T cell-mediated diseases, raising the question whether additional mechanisms may play roles in determining the therapeutic response. Here, we review the current literature on the effects of RTX in autoimmune diseases, with special emphasis on myasthenia gravis (MG). To elicit a complete and effective immune response, B and T lymphocytes cooperate in a loop in which they affect each other. Disruption of this cross talk has profound effects on the immune system. RTX is likely to affect the whole spectrum of B cell function, including antigen presentation, cytokine production, and T cell stimulation. In addition, as a small subset of T lymphocytes expresses CD20, its direct targeting by RTX may contribute to the therapeutic effect. Owing to its distinctive immune characteristics, MG proved to be a useful model to investigate the multifaceted implications of B cell depletion.
Original languageEnglish
Pages (from-to)41-48
Number of pages8
JournalAnnals of the New York Academy of Sciences
DOIs
Publication statusPublished - 2018

Keywords

  • B cells
  • CD20
  • Myasthenia gravis
  • Rituximab
  • T cells

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