Immunophenotyping of B- and T-cell alterations in patients with autoimmune premature ovarian insufficiency following rituximab treatment

The study examined immune system changes in six patients with autoimmune premature ovarian insufficiency (POI), a condition affecting female fertility. Four patients had antibodies against enzymes that produce steroid hormones. Patients received rituximab treatment, which depletes B-cells, and blood samples were collected at various time points up to 12 months. At baseline, patients with steroid autoantibodies showed increased frequency of specific B-cells and Th1-type T-cells compared to patients without autoantibodies. After rituximab treatment, expected B-cell depletion occurred followed by repopulation. At 8 months, changes in T-cells were observed with reduced Th1 and Tfh cell frequencies. The results indicate that autoimmune POI is associated with alterations in B- and T-cell subsets, suggesting a Th1-driven autoimmune process.