Cytokine changes during rituximab therapy in HTV-associated multicentric Castleman disease

摘要

Recent data highlight the importance of inflammatory markers during human immunodeficiency virus type (HIV) infection. HIV-associated multicentric Castleman disease (HIV-MCD) presents with systemic symptoms attributed to cytokine disarray, and we have previously shown that the use of the anti-CD0 monoclonal antibody rituximab induces clinical remissions. Before and during suc-cessful rituximab therapy, 5 plasma cytokines were measured as were adaptive (CD, CD8, CD9) and innate (CD6/ 56) immune cell populations and HIV-viral loads. A significant reduction from baseline of the CD9 B-cell count, consistent with rituximab's mechanism of action, was observed. Markedly elevated cytokine levels were observed before rituximab therapy, and a reduction frombaseline values with rituximab therapy was observed for interleukin (IL)-5, IL-6, and IL-0. Therapies that reduce the inflammatory cytokine response are likely to be successful in a range of diseases, including HIV-MCD, and in the future may be used to guide therapeutic strategies.