{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,10]],"date-time":"2026-01-10T09:25:06Z","timestamp":1768037106489,"version":"3.49.0"},"reference-count":45,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,2,8]],"date-time":"2021-02-08T00:00:00Z","timestamp":1612742400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001659","name":"Deutsche Forschungsgemeinschaft","doi-asserted-by":"publisher","award":["SFB1192"],"award-info":[{"award-number":["SFB1192"]}],"id":[{"id":"10.13039\/501100001659","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001659","name":"Deutsche Forschungsgemeinschaft","doi-asserted-by":"publisher","award":["Heisenberg Programme"],"award-info":[{"award-number":["Heisenberg Programme"]}],"id":[{"id":"10.13039\/501100001659","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:p>Minimal change disease (MCD) is a common cause of nephrotic syndrome. Treatment with steroids is usually effective, but frequent relapses are therapeutic challenges. The anti-CD20 antibody rituximab has shown promising results for treatment of steroid-sensitive nephrotic syndrome. Since predictive biomarkers for treatment efficacy and the accurate rituximab dosage for effective induction of remission are unknown, measurement of CD19<jats:sup>+<\/jats:sup> B cells in blood is often used as marker of successful B cell depletion and treatment efficacy. A male patient with relapsing MCD was successfully treated with rituximab, but developed relapse of proteinuria 1 year later, although no B cells were detectable in his blood. B and T cell populations in the patient\u2019s blood were analyzed before and after treatment with rituximab using FACS analysis. Rituximab binding to B and T cells were measured using Alexa Fluor 647 conjugated rituximab. We identified a population of CD20<jats:sup>+<\/jats:sup> CD19<jats:sup>\u2212<\/jats:sup> cells in the patient\u2019s blood, which consisted mostly of CD20<jats:sup>+<\/jats:sup> CD3<jats:sup>+<\/jats:sup> T cells. Despite the absence of B cells in the blood, the patient was again treated with rituximab. He developed complete remission of proteinuria and depletion of CD20<jats:sup>+<\/jats:sup> T cells. In a control patient with relapsing MCD initial treatment with rituximab led to depletion of both CD20<jats:sup>+<\/jats:sup> B and T cells. Rituximab induces remission of proteinuria in patients with MCD even if circulating B cells are absent. CD20<jats:sup>+<\/jats:sup> T cells may play a role in the pathogenesis of MCD and might be a promising treatment target in patients with MCD.<\/jats:p>","DOI":"10.3389\/fimmu.2020.586012","type":"journal-article","created":{"date-parts":[[2021,2,8]],"date-time":"2021-02-08T22:03:40Z","timestamp":1612821820000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":10,"title":["Rituximab Induces Complete Remission of Proteinuria in a Patient With Minimal Change Disease and No Detectable B Cells"],"prefix":"10.3389","volume":"11","author":[{"given":"Maximilian","family":"Webend\u00f6rfer","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Linda","family":"Reinhard","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rolf A. 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