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Ocrelizumab Depletes CD20+ T Cells in Multiple Sclerosis Patients

Department of Neurology, Hannover Medical School, D-30625 Hannover, Germany
Department of Clinical Immunology & Rheumatology, Hannover Medical School, D-30625 Hannover, Germany
Author to whom correspondence should be addressed.
These authors contributed equally to this work.
Cells 2019, 8(1), 12;
Received: 10 December 2018 / Revised: 21 December 2018 / Accepted: 26 December 2018 / Published: 28 December 2018
(This article belongs to the Special Issue The Molecular and Cellular Basis for Multiple Sclerosis)
PDF [1001 KB, uploaded 28 December 2018]


Ocrelizumab, a humanized monoclonal anti-CD20 antibody, has shown pronounced effects in reduction of disease activity in multiple sclerosis (MS) patients and has recently been approved for the treatment of patients with relapsing MS (RMS) and primary progressive MS (PPMS). CD20 is mainly expressed by B cells, but a subset of T cells (CD3+CD20+ T cells) also expresses CD20, and these CD20+ T cells are known to be a highly activated cell population. The blood of MS patients was analyzed with multicolor flow cytometry before and two weeks after treatment with ocrelizumab regarding the phenotype of peripheral blood mononuclear cells. CD20-expressing CD3+ T cells were found in blood samples of all MS patients, accounted for 2.4% of CD45+ lymphocytes, and constituted a significant proportion (18.4%) of all CD20+ cells. CD3+CD20+ T cells and CD19+CD20+ B cells were effectively depleted two weeks after a single administration of 300 mg ocrelizumab. Our results demonstrate that treatment with ocrelizumab does not exclusively target B cells, but also CD20+ T cells, which account for a substantial amount of CD20-expressing cells. Thus, we speculate that the efficacy of ocrelizumab might also be mediated by the depletion of CD20-expressing T cells. View Full-Text
Keywords: Ocrelizumab; CD3+CD20+; CD20; T cells; B cells; multiple sclerosis; RMS; PPMS Ocrelizumab; CD3+CD20+; CD20; T cells; B cells; multiple sclerosis; RMS; PPMS

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This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited (CC BY 4.0).

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Gingele, S.; Jacobus, T.L.; Konen, F.F.; Hümmert, M.W.; Sühs, K.-W.; Schwenkenbecher, P.; Ahlbrecht, J.; Möhn, N.; Müschen, L.H.; Bönig, L.; Alvermann, S.; Schmidt, R.E.; Stangel, M.; Jacobs, R.; Skripuletz, T. Ocrelizumab Depletes CD20+ T Cells in Multiple Sclerosis Patients. Cells 2019, 8, 12.

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