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In a study of 7 ms patients (small!), all tested positive for peripheral B cell tolerance defect. Two also tested positive for central B cell tolerance defect. Study authors propose those with only peripheral B cell tolerance defect will respond favorably and for a longer term to treatment with rituximab. They surmise the new B cells will be normal in those with peripheral B cell tolerance issues...and B cells will continue to be abnormal in those with central B cell tolerance issues. Might this explain different reactions to rituximab (if inability of rituximab to cross the bbb in adequate amounts can't be to blame)?
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3668812/