EVALUATING THE EFFICACY OF RITUXIMAB AND CYCLOSPORIN A IN MANAGING B CELL ABNORMALITIES IN ATHLETES WITH CHRONIC GRAFT-VERSUS-HOST DISEASE

Abstract

Objective: This study investigates the efficacy of rituximab (RTX) combined with cyclosporin A (CsA) in managing B cell abnormalities in athletes suffering from chronic graft-versus-host disease (cGVHD), a common complication following allogenic hematopoietic stem cell transplantation. The goal is to provide a theoretical foundation for the treatment and prognostic evaluation of cGVHD in this unique population. Methods: cGVHD mouse models were developed using total body irradiation followed by transplantation of a mixed suspension of bone marrow cells and splenocytes from donor mice. Starting on the second day post-transplantation, recipient mice received subcutaneous injections of RTX and CsA until day 29. Observations included changes in body weight, clinical scores of cGVHD, survival rates, and serum levels of B cell activating factor (BAFF) and pro-inflammatory cytokines, measured via ELISA. The proportion of regulatory B cells (Bregs) in the blood was assessed using flow cytometry. Results: Mice with cGVHD exhibited significant weight loss, increased clinical scores of cGVHD, and more severe symptoms compared to controls. However, all mice survived until the experiment's conclusion. Elevated serum BAFF levels and a reduced ratio of Bregs highlighted B cell dysregulation in cGVHD mice. Treatment with RTX and CsA mitigated these abnormalities, significantly lowering serum pro-inflammatory factors and stabilizing B cell function. Conclusion: The combination of rituximab and cyclosporin A effectively managed B cell abnormalities in cGVHD, demonstrating potential for reducing cGVHD incidence and improving recovery outcomes in athletes. This research underscores the importance of tailored therapeutic strategies that consider the specific health needs and recovery goals of athletes undergoing complex medical treatments, contributing significantly to sports medicine and the management of athlete health post-transplantation.