Rituxan,Methotrexate, or Similar?

I've read more and more about Rituxan (or something similar-not a typical cidp med) for cidp patients. Are any of you taking it? Do you take it in conjunction with ivig or plasmapharesis? What are the pros & Cons? Do you feel it has helped you?

Rituximab, or Mabthera are what are called monoclonal antibodies. I have had a Rituxin treatment about 5 weeks ago and am hoping it might start to show some results soon. I am still on IVIG.

Monoclonal Antibodies.
One way the immune system attacks foreign substances in the body is by making large numbers of antibodies. An antibody is a protein that sticks to a specific protein called an antigen. Antibodies circulate in the body until they find and attach to the antigen. Once attached, they can recruit other parts of the immune system to destroy the cells containing the antigen.
Researchers have learned how to design antibodies that specifically target a certain antigen, such as one that is found on cancer cells. They can then make many copies of that antibody in the lab. These are known as monoclonal antibodies (mAbs or moAbs).
They are activated B-cells quietly trolling the blood, collecting and digesting molecules called antigens that appear to be suspicious. Once they are digested bits of the proteins are placed onto MHC molecules on their cell surface for T-cells to inspect. If the T-cells decide those molecules came from a pathogen, they turn the B-cells on – transforming them into antibody producing machines (‘plasma cells’) that can generate from 100’s to thousands of antibodies per second.

These antibodies or immunoglobulins are specifically manufactured to lock onto a portion of a pathogen or a cell. This accomplishes several things. In order to get into a cell, viruses, fit, like a key into a lock, onto receptors on a cell – a process that antibodies disrupt. Attaching themselves to a pathogen is also a red flag for macrophages to come gobble the pathogen up. Antibodies also turn on the complement system – which can destroy pathogens as well.

B-cells also produce powerful inflammatory cytokines that trigger the immune response and the activation of other immune cells. They are key players in the immune response and overactive B-cell activity has been implicated in auto-immune disorders.

Monoclonal Antibodies are identical antibodies that target one specific protein on a cell. Their ability to do this has lead to their use in diagnosing pathogens, guiding medications to specific cells in cancer cells, etc.

B-cell Depleting Antibodies – target and attach to B-cells. Rituximab (Mabthera) is a monoclonal antibody that targets the CD 20 receptor and kills B-cells that have this receptor. It depletes the body of B-cells. The CD 20 receptor shows up on the surface of mature B-cells and appears to play some role in turning B-cells into plasma or antibody producing cells.

Like so many other drugs, researchers do not know exactly how Rituximab depletes the body of B-cells but they have some ideas. They believe that Rituximab binding to B-cells may signal natural killer cells, macrophages and moncytes or the complement system to kill the B-cells. Rituximab binding could also simply tell the cells themselves to commit suicide. It may be that in different diseases different pathways come into play.

Thank you Mceagle, -so interesting. I am guessing that everyone, very healthy people included, have antigens. Even ones that would make a different person sick. I wonder if autoimmune disease is a single point of infliction, like a virus, or a gradual culmination of different antigens where at some point overwhelming the immune system and goes into a kind of frenzy.

There is a neurobiologist working on technology to identify the specific antigens, which may be unique to each of us, that are causing all the trouble. It will change the way they can be targeted.

http://www.klinikum.uni-muenchen.de/Institut-fuer-Klinische-Neuroimmunologie/en/forschung/ag_dornmair/publikationen/index.html

Good luck to you both



mabes said:

Thank you Mceagle, -so interesting. I am guessing that everyone, very healthy people included, have antigens. Even ones that would make a different person sick. I wonder if autoimmune disease is a single point of infliction, like a virus, or a gradual culmination of different antigens where at some point overwhelming the immune system and goes into a kind of frenzy.

There is a neurobiologist working on technology to identify the specific antigens, which may be unique to each of us, that are causing all the trouble. It will change the way they can be targeted.

http://www.klinikum.uni-muenchen.de/Institut-fuer-Klinische-Neuroim...

Good luck to you both

Oops, that's cumulative...

i just did the IV injection . it will be up to twelve months to

see if works