Journal of Clinical Immunology

, Volume 30, Issue 1, pp 99–105

B-Cell Reconstitution and BAFF After Alemtuzumab (Campath-1H) Treatment of Multiple Sclerosis

  • Sara A. J. Thompson
  • Joanne L. Jones
  • Amanda L. Cox
  • D. Alastair S. Compston
  • Alasdair J. Coles
Article

DOI: 10.1007/s10875-009-9327-3

Cite this article as:
Thompson, S.A.J., Jones, J.L., Cox, A.L. et al. J Clin Immunol (2010) 30: 99. doi:10.1007/s10875-009-9327-3

Abstract

Introduction

Treatment with alemtuzumab is highly effective in relapsing–remitting multiple sclerosis; however, 30% of patients develop autoimmunity. Alemtuzumab (previously called Campath 1-H) induces a prolonged T-cell lymphopenia with memory cells dominating the reconstituting T-cell pool for at least 3 months.

Results

Here we show that B-cell recovery is rapid, returning to baseline by 3 months and rising to 165% of baseline by 12 months after treatment. Immature transitional 1 B cells are the predominant cell type 1 month after treatment. This coincides with a surge in serum B-cell activating factor (BAFF), which remains elevated by 33% for at least 12 months after alemtuzumab. BAFF is critical for transition to the mature naive B-cell phenotype, which dominates from 3 months after alemtuzumab. Differentiation to memory B cells is slow so there are radical and prolonged alterations to the B-cell pool after alemtuzumab.

Keywords

BAFF: B-cell activating factor B cells autoimmunity reconstitution T1 B cell: transitional type I B cell 

Copyright information

© Springer Science+Business Media, LLC 2009

Authors and Affiliations

  • Sara A. J. Thompson
    • 1
  • Joanne L. Jones
    • 1
  • Amanda L. Cox
    • 1
  • D. Alastair S. Compston
    • 1
  • Alasdair J. Coles
    • 1
  1. 1.Department of Clinical NeurosciencesUniversity of CambridgeCambridgeUK

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