Evidence map›Paper›PMID 21775681›Full record

Trial reportJournal of immunology (Baltimore, Md. : 1950)2011

Increased T cell proliferative responses to islet antigens identify clinical responders to anti-CD20 monoclonal antibody (rituximab) therapy in type 1 diabetes.

Kevan C Herold, Mark D Pescovitz, Paula McGee, Heidi Krause-Steinrauf, Lisa M Spain, Kasia Bourcier, Adam Asare, Zhugong Liu, John M Lachin, H Michael Dosch and 1 more

Open access · bronzeAbstract readComparative StudyRandomized Controlled Trial
In one paragraph

Trial report in Journal of immunology (Baltimore, Md. : 1950), 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 58 papers.

0numbers the graph read from it
0cells of the map it votes in
58citing papers in PubMed
5.8field-weighted citation impact, top 4% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

58 citing papers in PubMed, 83 citations in OpenAlex.

  1. Trial
  2. Frontiers in endocrinology · 2023
    Trial
  3. Trial
  4. Trial
  5. Trial
  6. Trial
  7. Trial
  8. Reactivation of latent viruses in individuals receiving rituximab for new onset type 1 diabetes.Journal of clinical virology : the official publication of the Pan American Society for Clinical Virology · 2013
    Trial
  9. Article
  10. New and emerging therapies in type 1 diabetes mellitus.The Journal of clinical investigation · 2026
    Review
  11. Are We Ready With Prevention for Type 1 Diabetes?Diabetes/metabolism research and reviews · 2025
    Review
  12. Article
  13. Review
  14. Article
  15. Review
  16. Article
  17. Article
  18. The immunology of type 1 diabetes.Nature reviews. Immunology · 2024
    Review
  19. Review
  20. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 6 institutions in 2 countries.

Kevan C HeroldDepartment of Immunobiology, Yale University, New Haven, CT 06511, USA. kevan.herold@yale.edu
Mark D Pescovitz
Paula McGee
Heidi Krause-Steinrauf
Lisa M Spain
Kasia Bourcier
Adam Asare
Zhugong Liu
John M Lachin
H Michael Dosch
Type 1 Diabetes TrialNet Anti-CD20 Study Group
George Washington University · USImmune Tolerance Network · USIndiana University – Purdue University Indianapolis · USNational Institute of Diabetes and Digestive and Kidney Diseases · USUniversity of Toronto · CAYale University · US

Funding

Yale Diabetes Research CenterP30DK045735 · NIDDK · YALE UNIVERSITY · PI Kevan C Herold, GERALD I SHULMAN · 1993 to 2026
$44.0M
Northwest Clinical Center for Type 1 Diabetes - TrialNetU01DK061034 · NIDDK · BENAROYA RESEARCH INST AT VIRGINIA MASON · PI GREENBAUM, CARLA J · 2001 to 2018
$10.3M
Type 1 Diabetes TrialNet: Clinical Center at Yale University (U01)U01DK085466 · NIDDK · YALE UNIVERSITY · PI HEROLD, KEVAN C · 2009 to 2018
$3.3M
NIDDK NIH HHS P30 DK045735NIDDK NIH HHS U01 DK061034NIDDK NIH HHS U01 DK085466NIDDK NIH HHS U01DK085466
6 · The paper itself

Abstract

Type 1 diabetes mellitus is believed to be due to the autoimmune destruction of β-cells by T lymphocytes, but a single course of rituximab, a monoclonal anti-CD20 B lymphocyte Ab, can attenuate C-peptide loss over the first year of disease. The effects of B cell depletion on disease-associated T cell responses have not been studied. We compare changes in lymphocyte subsets, T cell proliferative responses to disease-associated target Ags, and C-peptide levels of participants who did (responders) or did not (nonresponders) show signs of β-cell preservation 1 y after rituximab therapy in a placebo-controlled TrialNet trial. Rituximab decreased B lymphocyte levels after four weekly doses of mAb. T cell proliferative responses to diabetes-associated Ags were present at baseline in 75% of anti-CD20- and 82% of placebo-treated subjects and were not different over time. However, in rituximab-treated subjects with significant C-peptide preservation at 6 mo (58%), the proliferative responses to diabetes-associated total (p = 0.032), islet-specific (p = 0.048), and neuronal autoantigens (p = 0.005) increased over the 12-mo observation period. This relationship was not seen in placebo-treated patients. We conclude that in patients with type 1 diabetes mellitus, anti-B cell mAb causes increased proliferative responses to diabetes Ags and attenuated β-cell loss. The way in which these responses affect the disease course remains unknown.

Indexed as

AdolescentAdultAntibodies, Monoclonal, Murine-DerivedAutoantigensCell ProliferationChildC-PeptideDiabetes Mellitus, Type 1FemaleHumansImmunologic FactorsInsulin-Secreting CellsMaleRituximabTime FactorsT-Lymphocyte SubsetsAntibodies, Monoclonal, Murine-DerivedAutoantigensC-PeptideImmunologic FactorsRituximab

Identifiers

PMID21775681
PMCPMC3150302
OpenAlexW2114603595

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.