Tuesday, June 21, 2011

Professor Mella: Major clinical response after Rituximab treatment in ME/CFS patients

Professor Mella and Dr. Fluge, Haukeland University Hospital, Publication Date: 06/16/2011

In conclusion, a major clinical response after Rituximab treatment in three out of three pilot patients, in two these with a repeated clinical responses also after a second Rituximab treatment, has been observed.

The third had a limited improvement in CFS symptoms from 6 weeks after the Rituximab infusion. However, from 6 to 10½ months after the infusion she had a major clinical response on all CFS related symptoms lasting until now (10½ months after infusion). Then she had a gradual relapse, and she has now received new Rituximab treatment (two infusions, i.e. at weeks 47 and 49 after her first Rituximab treatment).

All five treatments of the three patients resulted in marked to moderate main symptom improvement. For these three patients, the kinetics in symptom improvement has been very similar, but with in addition a major late and long-lasting response in patient 3, as shown in FIG. 1.

The interval is compatible with the known degradation and half-time of certain proteins that can be produced by B-lymphocytes. The reappearance of symptoms after Rituximab treatment is compatible with the maturing of pre-plasma cell B-lymphocytes from stem cells after the CD20 antigen directed B-cell lysis, which is mediated through complement-directed cytotoxicity (CDC) and by antibody dependent cellular cytotoxicity (ADCC). These immature B-cells have been shown to be capable of protein production, among them the production of antibodies.
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