Frequency of Regulatory T Cells is Not Affected by Transient B Cell Depletion Using Anti-CD20 Antibodies in Rheumatoid Arthritis

Martin Feuchtenberger*, 1, Sabine Müller1, Petra Roll1, Anne Waschbisch2, Arne Schäfer1, Christian Kneitz1, Heinz Wiendl2, Hans-Peter Tony1
1 University of Würzburg, Department of Medicine II, Rheumatology and Clinical Immunology, Germany
2 University of Würzburg, Department of Neurology, Germany

Article Metrics

CrossRef Citations:
Total Statistics:

Full-Text HTML Views: 3886
Abstract HTML Views: 2384
PDF Downloads: 556
Total Views/Downloads: 6832
Unique Statistics:

Full-Text HTML Views: 1253
Abstract HTML Views: 1254
PDF Downloads: 406
Total Views/Downloads: 2918

Creative Commons License
© Feuchtenberger et al.; Licensee Bentham Open

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestrictive use, distribution, and reproduction in any medium, provided the original work is properly cited.

* Address correspondence to this author at the University of Würzburg, Dept of Medicine II, Rheumatology and Clinical Immunology Klinikstraße 6, D-97070 Würzburg, Germany; Tel: +49-(0)931/201-0; Fax: +49-(0)931/201-70421; E-mail:



Transient B cell depletion with the monoclonal anti-CD20 antibody rituximab has shown favourable clinical responses in patients with rheumatoid arthritis (RA). Recently a characteristic regeneration pattern of B cell subpopulations has been reported. However, little is known about the impact of B-cell depletion on peripheral T cells in particular regulatory T cells.

Materials and Methodology

17 patients with RA having failed anti-TNF were treated with rituximab. Four colour staining was performed using CD19, CD3, CD4, CD8, CD16, CD56, CD25, HLA-DR, HLA-G and intracellular Foxp3 at five time points spanning up to 12 months after rituximab. In addition, quantification of the soluble form of the HLA class I molecule HLA-G by ELISA has been performed.


Peripheral B cell depletion lasted 6 to 9 months. The absolute number of CD3+, CD4+ and CD8+ lymphocytes showed no significant changes up to 1 year after B-cell depletion compared to before therapy. Only the relative frequency for CD3 and CD4 showed a significant increase (p < 0.05). In particular, CD4+CD25++ and Foxp3 positive regulatory T cells remained constant. The percentage of HLA-G positive cells in the CD4+ or CD8+ population did not change significantly either. The amount of sHLA-G remained without significant changes.


Absolute T cell counts showed no significant changes after rituximab compared to the time point before therapy.In particular, the frequency of regulatory T cells with a CD4+CD25++ phenotype as well as positive Foxp3 expression were numerically stable. Additionally, HLA-G positive regulatory T cells and soluble levels of HLA-G showed no significant changes.