Rituximab, which depletes B cells, preserves β-cell function in patients with type 1 diabetes mellitus, but how this affect is achieved is not known. A new study has shown that rituximab does not alter the frequencies of autoreactive and polyreactive B cells in patients with type 1 diabetes mellitus 52 weeks after treatment. The researchers suggest that rituximab temporarily dampens autoimmune processes by depleting B cells, but that newly generated B cells replace those that are lost (rather than B cells that were not destroyed repopulating the periphery). This observation could explain why many patients relapse after anti-B-cell therapy.
References
Chamberlain, N. et al. Rituximab does not reset defective early B cell tolerance checkpoints. J. Clin. Invest. http://dx.doi.org/10.1172/JCI83840
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Greenhill, C. Effects of anti-B-cell therapy. Nat Rev Endocrinol 12, 64 (2016). https://doi.org/10.1038/nrendo.2015.234
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DOI: https://doi.org/10.1038/nrendo.2015.234