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The mechanism of anti-CD20–mediated B cell depletion revealed by intravital imaging
Fabricio Montalvao, Zacarias Garcia, Susanna Celli, Béatrice Breart, Jacques Deguine, Nico Van Rooijen, Philippe Bousso
Fabricio Montalvao, Zacarias Garcia, Susanna Celli, Béatrice Breart, Jacques Deguine, Nico Van Rooijen, Philippe Bousso
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Brief Report Immunology

The mechanism of anti-CD20–mediated B cell depletion revealed by intravital imaging

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Abstract

Anti-CD20 Ab therapy has proven successful for treating B cell malignancies and a number of autoimmune diseases. However, how anti-CD20 Abs operate in vivo to mediate B cell depletion is not fully understood. In particular, the anatomical location, the type of effector cells, and the mechanism underlying anti-CD20 therapy remain uncertain. Here, we found that the liver is a major site for B cell depletion and that recirculation accounts for the decrease in B cell numbers observed in secondary lymphoid organs. Using intravital imaging, we established that, upon anti-CD20 treatment, Kupffer cells (KCs) mediate the abrupt arrest and subsequent engulfment of B cells circulating in the liver sinusoids. KCs were also effective in depleting malignant B cells in a model of spontaneous lymphoma. Our results identify Ab-dependent cellular phagocytosis by KCs as a primary mechanism of anti-CD20 therapy and provide an experimental framework for optimizing the efficacy of therapeutic Abs.

Authors

Fabricio Montalvao, Zacarias Garcia, Susanna Celli, Béatrice Breart, Jacques Deguine, Nico Van Rooijen, Philippe Bousso

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Figure 3

KCs mediate the arrest and engulfment of normal and malignant B cells during anti-CD20 therapy.

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KCs mediate the arrest and engulfment of normal and malignant B cells du...
(A–D) Rag2–/– MAFIA mice were adoptively transferred with dye-labeled B cells and subjected to intravital imaging of the liver. (A) Representative time-lapse images recorded before or immediately after anti-CD20 injection. B cells are indicated by white circles. (B) B cell behavior and contact with KCs before or after anti-CD20 injection. Each line represents an individual B cell, red squares represent the time period during which B cells are present in the imaging field without contacting KCs, and green squares indicate the time period during which B cells are associated with a KC. (C) Impaired B cell arrest in FcRγ–/– mice treated with anti-CD20. Rag2–/–FcRγ–/– mice were transferred with dye-labeled B cells and injected with anti-CD20. (D) Rag2–/– MAFIA mice were injected with a YFP-expressing B cell tumor line. Representative time-lapse images show that tumor cells were rapidly engulfed by KCs upon anti-CD20 injection. Engulfed B cell tumors are indicated by white circles. (E and F) KCs are effectors of anti-CD20 therapy in a model of spontaneously developing B cell lymphoma. Csfr1gfp/+Cd19cre/+Rosa26RFP/+Eμ-myc+/– mice were subjected to intravital imaging of the liver following anti-CD20 injection. (E) Representative time-lapse images showing the engulfment and subsequent digestion of RFP-expressing lymphoma cells by KCs. (F) Quantification of B cell engulfment by KCs following anti-CD20 therapy. Scale bar: 10 μm.

Copyright © 2026 American Society for Clinical Investigation
ISSN: 0021-9738 (print), 1558-8238 (online)

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