Low-dose rituximab lowers serum Exosomal miR-150-5p in AChR-positive refractory myasthenia gravis patients

J Neuroimmunol. 2020 Nov 15:348:577383. doi: 10.1016/j.jneuroim.2020.577383. Epub 2020 Sep 15.

Abstract

Two potentially related microRNAs (miRNAs; miR-150-5p and miR-146a-5p) were examined after low-dose rituximab (RTX) treatment in patients with acetylcholine receptor antibody (AChR)-positive refractory myasthenia gravis (MG). In this prospective, open-label, and self-controlled pilot trial, 12 AChR-positive refractory MG patients were administrated a single, low dose of RTX and followed up at six months. Results showed that RTX decreased the serum exosomal miR-150-5p, scores on three clinical indices (MGFA, MMT, ADL), and patients' prednisolone requirement. Additionally, CD19+ and CD27+ B cells decreased, showing a strong correlation with miR-150-5p. In conclusion, low-dose RTX is effective for AChR-positive refractory MG treatment. Furthermore, our data support the role of miR-150-5p as a potential biomarker for MG.

Keywords: Exosome; Myasthenia gravis; Rituximab; microRNA.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Autoantibodies / immunology
  • Autoantigens / immunology
  • Child
  • Exosomes / drug effects*
  • Female
  • Humans
  • Immunologic Factors / therapeutic use*
  • Male
  • MicroRNAs / blood*
  • MicroRNAs / drug effects
  • Middle Aged
  • Myasthenia Gravis / blood
  • Myasthenia Gravis / drug therapy*
  • Pilot Projects
  • Receptors, Cholinergic / immunology
  • Rituximab / therapeutic use*
  • Young Adult

Substances

  • Autoantibodies
  • Autoantigens
  • Immunologic Factors
  • MIRN150 microRNA, human
  • MicroRNAs
  • Receptors, Cholinergic
  • Rituximab