Prolonged Impairment of Immunological Memory After Anti-CD20 Treatment in Pediatric Idiopathic Nephrotic Syndrome

Frontiers in Immunology
Manuela ColucciMarina Vivarelli

Abstract

Anti-CD20 therapy is effective in idiopathic nephrotic syndrome (INS). However, transient or sustained hypogammaglobulinemia predisposing to an increased risk of infectious diseases can follow treatment in some patients. We analyzed the long-term effects of anti-CD20 therapy on immunological memory in 27 frequently-relapsing/steroid-dependent INS pediatric patients after more than 4 years from the first and at least 2 years from the last anti-CD20 infusion. Twenty-one INS children, never treated with anti-CD20 and under an intense oral immunosuppression with prednisone, mycophenolate mofetil, and calcineurin inhibitors were also included as control group. Levels of circulating B-cell subpopulations, total serum immunoglobulins and IgG and memory B cells directed against hepatitis B virus (HBV) and tetanus were determined and correlated with clinical characteristics. Nine patients never relapsed after more than 2 years from the last anti-CD20 administration (5 after the first, 3 after the second, and 1 after the fifth infusion). At last follow-up, most patients showed a complete recovery and normalization of total (27/27), transitional (27/27), and mature-naïve B cells (25/27). However, a sustained and significant reduction of t...Continue Reading

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Citations

Jul 7, 2020·Frontiers in Pharmacology·Francesco GuzziPaola Romagnani
Jun 25, 2020·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Eugene Yu-Hin Chan, Kjell Tullus
Oct 1, 2020·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Mika OkutsuKenji Ishikura
Nov 27, 2020·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Julie OniszczukVincent Audard
Oct 30, 2020·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Claire DossierGeorges Deschênes
Mar 6, 2021·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Federica ZottaFrancesco Emma
Mar 30, 2021·Frontiers in Immunology·Manuela ColucciMarina Vivarelli
Jun 12, 2021·Archives of Disease in Childhood·Rajiv SinhaStephen D Marks
Aug 13, 2021·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Marina VivarelliFrancesco Emma
Apr 8, 2021·Pediatrics International : Official Journal of the Japan Pediatric Society·Toshiyuki TakahashiTadashi Ariga

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Methods Mentioned

BETA
density-gradient centrifugation
flow cytometry
Biopsy

Software Mentioned

SPSS
GraphPad Prism

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