The effects of in vivo B-cell depleting therapy on ex-vivo cytokine production.
Smeekens S P, van den Hoogen MW, et alTransplant Immunology 2013; pii: S0966-3274(13)00033-6.
Aims
To investigate whether in-vivo B-cell depletion decreases ex-vivo IL-17 production in cells from renal transplant patients.
Interventions
Patients were treated with either a single intra-operative dose of rituximab (375mg/m²) or placebo, added to immunosuppressive therapy which consisted of tacrolimus, mycophenolate mofetil and prednisone.
Participants
20 living-donor renal transplant recipients.
Outcomes
The outcomes for this study included B-cell depletion, biopsy proven rejection, graft loss, ex-vivo cytokine production, flow cytometry of IL-17+cells and B-cells and cytokine assays.
Follow-up
1 year.
CET Conclusions
This manuscript reports data from a small subset of living donor transplants in an ongoing trial of rituximab induction in renal transplantation. The authors hypothesised that B-cell depletion by rituximab may reduce IL-17 production by T-helper cells, thus reducing the post-transplant T-cell response. Use of rituximab did not affect ex-vivo IL-17 (or other cytokine production) in this small subset of living donor transplants. It will be interesting to see if this lack of immunological effect translates to clinical outcome when the main results of the trial are reported.
Data analysis
Per protocol analysis
Trial registration
ClinicalTrials.gov – NCT00565331.