The effect of desensitization protocols on human splenic B-cell populations in vivo
The effect of desensitization protocols on human splenic B-cell populations in vivo
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DOI：
10.1111/j.1600-6143.2006.01632.x
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发表时间：
2007-02-01
影响因子：
8.8
通讯作者：
Grande, J. P.
中科院分区：
文献类型：
--
作者：
Ramos, E. J.;Pollinger, H. S.;Grande, J. P.
利妥昔单抗、静脉注射免疫球蛋白 (IVIG) 和兔抗胸腺细胞球蛋白 (rATG) 均被认为对抗体产生细胞有影响，但缺乏支持数据。为了评估这些药物对体内脾 B 细胞群的影响，我们回顾性检查了从接受这些药物治疗的患者身上摘取的 25 个脾脏，作为 ABO 不相容或阳性交叉配型活体肾移植脱敏方案的一部分。将这些脾脏与因外伤而切除的对照（CTL）脾脏进行比较。多次移植前血浆置换（PP）加低剂量 IVIG 后移植时切除的 CTL 和脾脏显示出相似数量的初始 B 细胞（CD20（+）和 CD79（+））、浆细胞（CD138（+））和记忆 B 细胞（CD27（+）细胞）。在该 PP/IVIG 方案中添加利妥昔单抗可减少初始 B 细胞的数量，但对记忆或浆细胞没有影响。联合治疗（PP/IVIG、利妥昔单抗和rATG）显示CD27(+)细胞减少的趋势，但浆细胞同样没有变化。我们得出的结论是，这些方案都不会减少体内脾浆细胞。 PP/低剂量 IVIG 不会改变脾 B 细胞，但添加利妥昔单抗会减少成熟 B 细胞。记忆 B 细胞可能会受到包括 rATG 在内的联合疗法的影响，需要进一步研究。
Rituximab, intravenous immunoglobulin (IVIG) and rabbit antithymocyte globulin (rATG) all have been suggested to have an effect on antibody producing cells, however, supporting data are lacking. To assess the impact of these agents on splenic B-cell populations in vivo, we retrospectively examined 25 spleens removed from patients treated with these agents as part of desensitization protocols in either ABO incompatible or positive crossmatch living donor kidney transplantation. These were compared to control (CTL) spleens removed for trauma. CTLs and spleens removed at transplant after multiple pretransplant plasmaphereses (PP) plus low-dose IVIG showed similar large numbers of naive B cells (CD20(+) and CD79(+)), plasma cells (CD138(+)) and memory B cells (CD27(+) cells). Adding rituximab to this PP/IVIG regimen reduced the number naive B cells, but had no effect on memory or plasma cells. Combination treatment (PP/IVIG, rituximab and rATG) showed a trend toward the reduction of CD27(+) cells, but again plasma cells were unchanged. We conclude that none of these protocols reduces splenic plasma cells in vivo. PP/low-dose IVIG does not alter splenic B cells, but the addition of rituximab decreases mature B cells. Memory B cells may be affected by combination therapy including rATG and requires further study.