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March 2020; 7 (2) ArticleOpen Access

Alemtuzumab therapy changes immunoglobulin levels in peripheral blood and CSF

Nora Möhn, Steffen Pfeuffer, Tobias Ruck, Catharina C. Gross, Thomas Skripuletz, Luisa Klotz, Heinz Wiendl, Martin Stangel, Sven G. Meuth
First published December 11, 2019, DOI: https://doi.org/10.1212/NXI.0000000000000654
Nora Möhn
From the Department of Neurology and Clinical Neuroimmunology and Neurochemistry (N.M., T.S., M.S.), Hannover Medical School, Hannover, Germany; and Neurology Clinic with Institute of Translational Neurology (S.P., T.R., C.C.G., L.K., H.W., S.G.M.), University of Münster, Münster, Germany.
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Steffen Pfeuffer
From the Department of Neurology and Clinical Neuroimmunology and Neurochemistry (N.M., T.S., M.S.), Hannover Medical School, Hannover, Germany; and Neurology Clinic with Institute of Translational Neurology (S.P., T.R., C.C.G., L.K., H.W., S.G.M.), University of Münster, Münster, Germany.
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Tobias Ruck
From the Department of Neurology and Clinical Neuroimmunology and Neurochemistry (N.M., T.S., M.S.), Hannover Medical School, Hannover, Germany; and Neurology Clinic with Institute of Translational Neurology (S.P., T.R., C.C.G., L.K., H.W., S.G.M.), University of Münster, Münster, Germany.
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Catharina C. Gross
From the Department of Neurology and Clinical Neuroimmunology and Neurochemistry (N.M., T.S., M.S.), Hannover Medical School, Hannover, Germany; and Neurology Clinic with Institute of Translational Neurology (S.P., T.R., C.C.G., L.K., H.W., S.G.M.), University of Münster, Münster, Germany.
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Thomas Skripuletz
From the Department of Neurology and Clinical Neuroimmunology and Neurochemistry (N.M., T.S., M.S.), Hannover Medical School, Hannover, Germany; and Neurology Clinic with Institute of Translational Neurology (S.P., T.R., C.C.G., L.K., H.W., S.G.M.), University of Münster, Münster, Germany.
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Luisa Klotz
From the Department of Neurology and Clinical Neuroimmunology and Neurochemistry (N.M., T.S., M.S.), Hannover Medical School, Hannover, Germany; and Neurology Clinic with Institute of Translational Neurology (S.P., T.R., C.C.G., L.K., H.W., S.G.M.), University of Münster, Münster, Germany.
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Heinz Wiendl
From the Department of Neurology and Clinical Neuroimmunology and Neurochemistry (N.M., T.S., M.S.), Hannover Medical School, Hannover, Germany; and Neurology Clinic with Institute of Translational Neurology (S.P., T.R., C.C.G., L.K., H.W., S.G.M.), University of Münster, Münster, Germany.
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Martin Stangel
From the Department of Neurology and Clinical Neuroimmunology and Neurochemistry (N.M., T.S., M.S.), Hannover Medical School, Hannover, Germany; and Neurology Clinic with Institute of Translational Neurology (S.P., T.R., C.C.G., L.K., H.W., S.G.M.), University of Münster, Münster, Germany.
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Sven G. Meuth
From the Department of Neurology and Clinical Neuroimmunology and Neurochemistry (N.M., T.S., M.S.), Hannover Medical School, Hannover, Germany; and Neurology Clinic with Institute of Translational Neurology (S.P., T.R., C.C.G., L.K., H.W., S.G.M.), University of Münster, Münster, Germany.
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Citation
Alemtuzumab therapy changes immunoglobulin levels in peripheral blood and CSF
Nora Möhn, Steffen Pfeuffer, Tobias Ruck, Catharina C. Gross, Thomas Skripuletz, Luisa Klotz, Heinz Wiendl, Martin Stangel, Sven G. Meuth
Neurol Neuroimmunol Neuroinflamm Mar 2020, 7 (2) e654; DOI: 10.1212/NXI.0000000000000654

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    Figure 1 Measurement of serum immunoglobulin (IgG, IgA, and IgM) levels in alemtuzumab-treated patients

    Serum IgG (A), IgM (B), and IgA (C) levels (in g/L) were analyzed before the first alemtuzumab course and at 12 and 24 months. Stars represent levels of significance (**p < 0.01; ***p < 0.001).

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    Figure 2 Measurement of CSF immunoglobulin (IgG, IgA, and IgM) levels in alemtuzumab-treated patients

    CSF IgG (A), IgM (B), and IgA (C) concentrations (in mg/L) were analyzed before the first alemtuzumab course and at 12 and 24 months. In addition, quantitative fraction of intrathecal IgG synthesis over time is shown (D). Stars represent levels of significance (**p < 0.01; ***p < 0.001). OCB = oligoclonal band.

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    Figure 3 Serum immunoglobulin levels of patients with third alemtuzumab course compared with controls and treatment-naive patients with MS

    Samples were collected 36 months after initiation of therapy; serum IgG (A), IgM (B), and IgA (C) levels (in g/L) were measured. Controls had received 2 courses of alemtuzumab treatment and were matched to third-course patients. Samples taken from third-course patients and treatment-naive patients with MS were analyzed after thawing. Stars represent levels of significance (**p < 0.01 vs control).

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