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Pearls & Oy-sters: Recurrent Lyme Neuroborreliosis With Seroreversion in a Patient With Multiple Sclerosis on a B-Cell Depleting Therapy.
Neurology
February 2025
Clinic of Neurology and Neurophysiology, Medical Center, Faculty of Medicine, University of Freiburg, Germany; and.
True seronegativity is extremely rare in Lyme neuroborreliosis (LNB) with reports only in patients with hematological malignancies or under treatment with chemotherapy and B-cell depleting therapies. In these instances, diagnosing LNB can be challenging. We report the case of a 63-year-old patient with 2 independent episodes of LNB.
View Article and Find Full Text PDFAlterations in Gut Microbiome-Host Relationships After Immune Perturbation in Patients With Multiple Sclerosis.
Neurol Neuroimmunol Neuroinflamm
March 2025
Yale School of Medicine Department of Neurology, New Haven, CT.
Background And Objectives: Gut microbial symbionts have been shown to influence the development of autoimmunity in multiple sclerosis (MS). Emerging research points to an important relationship between the microbial-IgA interface and MS pathophysiology. IgA-secreting B cells are observed in the MS brain, and shifts in gut bacteria-IgA binding have been described in some patients with MS.
View Article and Find Full Text PDFProlonged SARS-CoV-2 Viremia in an Immunocompromised Patient.
J Med Cases
January 2025
Department of Clinical Sciences, Malmo, Lund University, Malmo, Sweden.
Immunocompromised patients, especially those receiving B-cell depleting therapies, are at risk for developing atypical presentation with regard to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, with the potential for diagnostic delay and adverse outcomes if such delay occurs. A 66-year-old female with history of granulomatosis with polyangiitis (GPA) with previous pulmonary involvement, treated with rituximab and low-dose prednisolone, presented with prolonged fever and cough after having been treated at home for a mild SARS-CoV-2 infection in early July 2023. The patient had a prolonged course over several months with constitutional symptoms such as fever, cough and malaise.
View Article and Find Full Text PDFSequelae of B-Cell Depleting Therapy: An Immunologist's Perspective.
BioDrugs
January 2025
Department of Allergy and Clinical Immunology, St James' University Hospital, Leeds, UK.
B-cell depleting therapy (BCDT) has revolutionised the treatment of B-cell malignancies and autoimmune diseases by targeting specific B-cell surface antigens, receptors, ligands, and signalling pathways. This narrative review explores the mechanisms, applications, and complications of BCDT, focusing on the therapeutic advancements since the introduction of rituximab in 1997. Various monoclonal antibodies and kinase inhibitors are examined for their roles in depleting B cells through antibody-dependent and independent mechanisms.
View Article and Find Full Text PDFElevated frequencies of activated memory B cells in multiple sclerosis are reset to healthy control levels after B cell depletion with Ocrelizumab.
J Neuroimmunol
December 2024
Versiti Blood Research Institute, Milwaukee, WI, USA; Department of Microbiology and Immunology, Medical College of Wisconsin, Milwaukee, WI, USA. Electronic address:
In multiple sclerosis (MS) the B cell depleting drug ocrelizumab has shown high efficacy in reducing inflammatory activity. Its mechanism of action is unclear due to B cell subset complexity and unknown roles in pathogenesis. Here, we comprehensively phenotyped and quantitated peripheral blood B cell subsets before and after ocrelizumab infusion to gain insight into the fate of B cell subsets with pathogenic potential.
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