Suppression of bone turnover by B-cell depletion in patients with rheumatoid arthritis

• Published in: Osteoporosis international 2011-12, Vol.22 (12), p.3067-3072
• Main Authors: Wheater, G., Hogan, V. E., Teng, Y. K. O., Tekstra, J., Lafeber, F. P., Huizinga, T. W. J., Bijlsma, J. W. J., Francis, R. M., Tuck, S. P., Datta, H. K., van Laar, J. M.
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Antibodies, Monoclonal, Murine-Derived - adverse effects; Antirheumatic Agents - adverse effects; Arthritis, Rheumatoid - blood; Arthritis, Rheumatoid - drug therapy; B-Lymphocytes - metabolism; Biological and medical sciences; biomarkers; Bisphosphonates; Bone density; Bone Regeneration - drug effects; Bone Remodeling - drug effects; Bone resorption; Bone turnover; Cellular biology; Collagen; Collagen Type I - blood; Diseases of the osteoarticular system; Endocrinology; Female; Fundamental and applied biological sciences. Psychology; Humans; Inflammation; Inflammatory diseases; Inflammatory joint diseases; Joint diseases; Lymphocytes B; Male; Medical sciences; Medicine; Medicine & Public Health; Middle Aged; Monoclonal antibodies; Original Article; Orthopedics; Osteoblasts; Osteocalcin; Osteogenesis; Osteoporosis; Osteoporosis. Osteomalacia. Paget disease; Osteoprotegerin; Osteoprotegerin - blood; Peptide Fragments - blood; Peptides - blood; Prednisolone; procollagen; Procollagen - blood; Rheumatoid arthritis; Rheumatology; Rituximab; Skeleton and joints; Vertebrates: osteoarticular system, musculoskeletal system
• ISSN: 0937-941X; 1433-2965
• DOI: 10.1007/s00198-011-1607-0

Summary The role of B cells in inflammatory bone formation and resorption is controversial. We investigated this in patients with rheumatoid arthritis (RA) treated with rituximab, a B-cell depleting antibody. We found a significant suppression in bone turnover, possibly a direct effect or as a consequence of a reduction in inflammation and disease activity. Introduction RA is the most prevalent inflammatory joint disease, in which B cells play an important role. However, the role of B cells in bone turnover is controversial and RA subjects treated with rituximab, a B-cell depleting monoclonal antibody, provide an ideal model for determining the role of B cells in inflammatory bone resorption. Methods Serum from 46 RA patients, collected pre- and post-rituximab therapy, was analysed for biomarkers of bone turnover (procollagen type I amino-terminal propeptide [P1NP], osteocalcin, β-isomerised carboxy-terminal telopeptide of type 1 collagen [βCTX] and osteoprotegerin [OPG]). Results A significant decrease in bone resorption was observed 6 months after rituximab (median change βCTX −50 ng/L, 95%CI −136, −8 p