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

Blood. 2009 May 7;113(19):4521-4. doi: 10.1182/blood-2008-12-197053. Epub 2009 Feb 17.

Abstract

Recent data highlight the importance of inflammatory markers during human immunodeficiency virus type 1 (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-CD20 monoclonal antibody rituximab induces clinical remissions. Before and during successful rituximab therapy, 15 plasma cytokines were measured as were adaptive (CD4, CD8, CD19) and innate (CD16/56) immune cell populations and HIV-1 viral loads. A significant reduction from baseline of the CD19 B-cell count, consistent with rituximab's mechanism of action, was observed. Markedly elevated cytokine levels were observed before rituximab therapy, and a reduction from baseline values with rituximab therapy was observed for interleukin (IL)-5, IL-6, and IL-10. 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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antibodies, Monoclonal / therapeutic use*
  • Antibodies, Monoclonal, Murine-Derived
  • Antigens, CD20 / immunology
  • Antineoplastic Agents / therapeutic use*
  • Castleman Disease / blood*
  • Castleman Disease / drug therapy*
  • Castleman Disease / virology
  • Cytokines / blood*
  • HIV Infections / blood
  • HIV Infections / complications*
  • HIV Infections / virology
  • HIV-1 / pathogenicity*
  • Humans
  • Prognosis
  • Rituximab
  • Viral Load

Substances

  • Antibodies, Monoclonal
  • Antibodies, Monoclonal, Murine-Derived
  • Antigens, CD20
  • Antineoplastic Agents
  • Cytokines
  • Rituximab