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Blood, 15 October 2007, Vol. 110, No. 8, pp. 2924-2930. Prepublished online as a Blood First Edition Paper on June 4, 2007; DOI 10.1182/blood-2007-02-068999. This Article Full Text (PDF) All Versions of this Article: blood-2007-02-068999v1 110/8/2924    most recent Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Stasi, R. Articles by Amadori, S. Search for Related Content PubMed PubMed Citation Articles by Stasi, R. Articles by Amadori, S. Related Collections Related Article in Blood Online Social Bookmarking                   What's this?  Previous Article  |  Next Article  Submitted February 5, 2007 Accepted May 27, 2007 Response to B-cell depleting therapy with rituximab reverts the abnormalities of T cell subsets in patients with idiopathic thrombocytopenic purpura Roberto Stasi*, Giovanni Del Poeta, Elisa Stipa, Maria Laura Evangelista, Margherita M Trawinska, Nichola Cooper, and Sergio Amadori Dept. of Medical Sciences, Ospedale "Regina Apostolorum", Albano Laziale, Italy Dept. of Hematology, "Tor Vergata" University Hospital, Rome, Italy Division of Hematology, Ospedale "S. Eugenio", Rome, Italy Molecular Immunology Unit, Institute of Child Health, London, United Kingdom * Corresponding author; email: roberto.stasi{at}uniroma2.it. Rituximab, an anti-CD20 monoclonal antibody, has been used to treat autoimmune disorders such as idiopathic thrombocytopenic purpura (ITP). However, its mechanisms of action as well as the effects on cellular immunity remain poorly defined. We investigated the changes of different peripheral blood T-cell subsets, the apoptosis profile as well as the changes of T cell receptor (TCR) -variable (VB) region gene usage of CD4+ and CD8+ T-cell subpopulations following rituximab therapy. The study involved 30 patients with chronic ITP who received rituximab, of whom 14 achieved a durable (>6 months) response. Compared with the control group, pre-treatment abnormalities of T-cells in ITP patients included an increase of the Th1/Th2 ratio and of Tc1/Tc2 ratios (P<0.001), increased expression of Fas ligand on Th1 and Th2 cells (P<0.001), increased expression of Bcl-2 mRNA (P=0.003) and decreased expression of Bax mRNA (P=0.025) in Th cells, and expansion of oligoclonal T-cells with no preferential use of any TCR VB subfamily. These abnormalities were reverted in responders at 3 and 6 months after treatment, whereas they remained unchanged in nonresponders. Our findings indicate that in patients with ITP response to B-cell depletion induced by rituximab is associated with significant changes of the T-cell compartment. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? Related Article in Blood Online: Rituximab disciplines T cells, spares platelets John W. Semple Blood 2007 110: 2784-2785. [Full Text] [PDF] This article has been cited by other articles: D. B. Cines, J. B. Bussel, H. A. Liebman, and E. T. Luning Prak The ITP syndrome: pathogenic and clinical diversity Blood, June 25, 2009; 113(26): 6511 - 6521. [Abstract] [Full Text] [PDF] K. R. Carson, A. M. Evens, E. A. Richey, T. M. Habermann, D. Focosi, J. F. Seymour, J. Laubach, S. D. Bawn, L. I. Gordon, J. N. Winter, et al. Progressive multifocal leukoencephalopathy after rituximab therapy in HIV-negative patients: a report of 57 cases from the Research on Adverse Drug Events and Reports project Blood, May 14, 2009; 113(20): 4834 - 4840. [Abstract] [Full Text] [PDF] R. Stasi, A. Sarpatwari, J. B. Segal, J. Osborn, M. L. Evangelista, N. Cooper, D. Provan, A. Newland, S. Amadori, and J. B. Bussel Effects of eradication of Helicobacter pylori infection in patients with immune thrombocytopenic purpura: a systematic review Blood, February 5, 2009; 113(6): 1231 - 1240. [Abstract] [Full Text] [PDF] S. A. Beers, C. H. T. Chan, S. James, R. R. French, K. E. Attfield, C. M. Brennan, A. Ahuja, M. J. Shlomchik, M. S. Cragg, and M. J. Glennie Type II (tositumomab) anti-CD20 monoclonal antibody out performs type I (rituximab-like) reagents in B-cell depletion regardless of complement activation Blood, November 15, 2008; 112(10): 4170 - 4177. [Abstract] [Full Text] [PDF] L. Parmentier, B.-A. Bron, C. Prins, J. Samson, I. Masouye, and L. Borradori Mucocutaneous Lichen Planus With Esophageal Involvement: Successful Treatment With an Anti-CD20 Monoclonal Antibody Arch Dermatol, November 1, 2008; 144(11): 1427 - 1430. [Full Text] [PDF] T. E. Warkentin and D. M. Arnold "Spare-spleen-uximab" for chronic ITP Blood, August 15, 2008; 112(4): 925 - 926. [Full Text] [PDF] J. W. Semple ITP three R's: regulation, routing, rituximab Blood, August 15, 2008; 112(4): 927 - 928. [Full Text] [PDF] B. Godeau, R. Porcher, O. Fain, F. Lefrere, P. Fenaux, S. Cheze, A. Vekhoff, M.-P. Chauveheid, J. Stirnemann, L. Galicier, et al. Rituximab efficacy and safety in adult splenectomy candidates with chronic immune thrombocytopenic purpura: results of a prospective multicenter phase 2 study Blood, August 15, 2008; 112(4): 999 - 1004. [Abstract] [Full Text] [PDF] R. Stasi, N. Cooper, G. Del Poeta, E. Stipa, M. Laura Evangelista, E. Abruzzese, and S. Amadori Analysis of regulatory T-cell changes in patients with idiopathic thrombocytopenic purpura receiving B cell-depleting therapy with rituximab Blood, August 15, 2008; 112(4): 1147 - 1150. [Abstract] [Full Text] [PDF] F. Zaja, M. L. Battista, M. T. Pirrotta, S. Palmieri, M. Montagna, N. Vianelli, L. Marin, M. Cavallin, M. Bocchia, M. Defina, et al. Lower dose rituximab is active in adults patients with idiopathic thrombocytopenic purpura Haematologica, June 1, 2008; 93(6): 930 - 933. [Abstract] [Full Text] [PDF] D. Saadoun, M. Rosenzwajg, D. Landau, J. C. Piette, D. Klatzmann, and P. Cacoub Restoration of peripheral immune homeostasis after rituximab in mixed cryoglobulinemia vasculitis Blood, June 1, 2008; 111(11): 5334 - 5341. [Abstract] [Full Text] [PDF] E. Toffoletti, F. Zaja, A. Chiarvesio, A. Michelutti, M. Battista, and R. Fanin No evidences for B-cell clonality by spectratyping analysis in patients with idiopathic thrombocytopenic purpura undergoing rituximab therapy Haematologica, May 1, 2008; 93(5): 795 - 796. [Full Text] [PDF] R. Stasi and D. Provan Helicobacter pylori and Chronic ITP Hematology, January 1, 2008; 2008(1): 206 - 211. [Abstract] [Full Text] [PDF] J.-D. Bouaziz, K. Yanaba, G. M. Venturi, Y. Wang, R. M. Tisch, J. C. Poe, and T. F. Tedder Therapeutic B cell depletion impairs adaptive and autoreactive CD4+ T cell activation in mice PNAS, December 26, 2007; 104(52): 20878 - 20883. [Abstract] [Full Text] [PDF] S. Berentsen Rituximab for the treatment of autoimmune cytopenias Haematologica, December 1, 2007; 92(12): 1589 - 1596. [Full Text] [PDF]

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