Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Aug 10;9(10):3079-3080.
doi: 10.1016/j.ekir.2024.08.008. eCollection 2024 Oct.

Extremely Long-Lasting B-cell Depletion and BAFFling Effects Following Obinutuzumab-Based Regimen in Lupus Nephritis

Dario Roccatello  1 , Savino Sciascia  1 , Emanuele De Simone  1 , Thomas Schindler  2 , Elsa Martins  2 , Huiyan Ashley Mao  2 , Daniela Rossi  1 , Roberta Fenoglio  1
Affiliations

Extremely Long-Lasting B-cell Depletion and BAFFling Effects Following Obinutuzumab-Based Regimen in Lupus Nephritis

Dario Roccatello et al. Kidney Int Rep. .
No abstract available

PubMed Disclaimer

Figures

Figure 1
Figure 1
Clinical and laboratory response to obinutuzumab as monitored by SLEDAI-2K, anti-DNA antibodies and proteinuria levels. B-cell activating factor (BAFF) levels were monitored and increased during the follow-up. Obinutuzumab was administered as an i.v. infusion of 1000 mg on day 1 and weeks 2, 24, and 26, after premedication for prophylaxis against infusion-related reactions. B-cell depletion has been shown to distort BAFF homeostasis in patients with systemic lupus erythematosus, and an association between BAFF levels and disease exacerbation has been suggested. The loss of B cells following treatment with anti-CD20 agents reduces BAFF consumption by the major “users” of BAFF, thereby raising the steady state serum BAFF levels. This mechanism, as well as a potential compensatory, increased production of BAFF as a major cytokine regulating B-cell survival, maturation, and differentiation of B cells, could contribute to the increased levels of BAFF observed in patients who relapse after rituximab therapy compared with both those in remission and those who experience flare before B-cell depletion. Nevertheless, these observations do not apply to our patient, who experienced a progressive increase in circulating BAFF after obinutuzumab treatment while clinically in remission with persistent B-cell depletion, possibly pointing to a bystander effect instead of a causal relationship between increases in BAFF levels upon B-cell depletion and disease recurrence.
See this image and copyright information in PMC

References

    1. Mössner E., Brünker P., Moser S., et al. Increasing the efficacy of CD20 antibody therapy through the engineering of a new type II anti-CD20 antibody with enhanced direct and immune effector cell-mediated B-cell cytotoxicity. Blood. 2010;115:4393–4402. doi: 10.1182/blood-2009-06-225979. - DOI - PMC - PubMed
    1. Furie R.A., Aroca G., Cascino M.D., et al. B-cell depletion with obinutuzumab for the treatment of proliferative lupus nephritis: a randomised, double-blind, placebo-controlled trial. Ann Rheum Dis. 2022;81:100–107. doi: 10.1136/annrheumdis-2021-220920. - DOI - PMC - PubMed
    1. Carter L.M., Isenberg D.A., Ehrenstein M.R. Elevated serum BAFF levels are associated with rising anti-double-stranded DNA antibody levels and disease flare following B cell depletion therapy in systemic lupus erythematosus. Arthritis Rheum. 2013;65:2672–2679. doi: 10.1002/art.38074. - DOI - PubMed
    1. Scholz J.L., Cancro M.P. Resolve, revise, and relax: the 3 Rs of B cell repertoire adjustment. Immunol Lett. 2012;143:2–8. doi: 10.1016/j.imlet.2012.01.014. - DOI - PMC - PubMed
    1. Furie R.A., Aroca G., Cascino M.D., et al. B-cell depletion with obinutuzumab for the treatment of proliferative lupus nephritis: a randomised, double-blind, placebo-controlled trial. Annals of the Rheumatic Diseases. 2021;81:100–107. doi: 10.1136/annrheumdis-2021-220920. - DOI - PMC - PubMed

LinkOut - more resources