Rheumatoid arthritis is often classified as a T-cell-mediated autoimmune disease, where disease symptoms are caused by chronic inflammation in the joints. Yet approximately 50% of rheumatoid arthritis patients that were treated with a B-cell depleting antibody (rituximab, anti-CD20 antibody) showed significant improvement in their disease symptoms. This improvement following rituximab treatment is due to:

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Quizplus · Accepted Answer

Rituximab specifically targets and eliminates B cells, including autoreactive B cells that produce antibodies against joint tissue. These antibodies, called rheumatoid factor and anti-cyclic citrullinated peptide (anti-CCP) antibodies, contribute to joint inflammation and damage in rheumatoid arthritis. By eliminating these autoreactive B cells and antibodies, rituximab reduces inflammation and improves symptoms in many patients. The improvement is not due to off-target effects on T cells, loss of T cell function, or elimination of epitope spreading. Furthermore, the diagnosis of rheumatoid arthritis is typically based on the presence of antibodies and other markers in the blood, imaging studies, and clinical symptoms, so misdiagnosis is unlikely in most cases.

Rheumatoid Arthritis Is Often Classified as a T-Cell-Mediated Autoimmune Disease