We also detected anti-KIR4.1 antibodies in the cerebrospinal liquid of 19 of 30 sufferers with multiple sclerosis whose cerebrospinal liquid was tested for anti-KIR4.1 reactivity. We observed evidence for intrathecal antibody synthesis in 2 of the 19 individuals . Mapping the KIR4.1 Epitope Evaluation of the membrane topology of the KIR4.1 protein has predicted two extracellular loops . We synthesized peptides representing the extracellular loops of KIR4.1 and the adjacent intramembrane areas , tagged them with biotin, and layered them onto streptavidin-coated ELISA plates. We noticed serum reactivity to KIR4.1128-148 in 4 percent of the persons with multiple sclerosis however in non-e of the healthy donors or persons with other neurologic illnesses .It really is conceivable that the neutropenia reported in additional trials was caused by therapeutic agents that patients received together with the rituximab.31 The lack of an increase in rituximab-associated infections inside our study is in keeping with the findings in other studies that avoided the usage of both immunosuppressive agents and corticosteroids.30 However, our sample was too small to detect rare infections, such as PML, and other uncommon adverse events. Careful attention, larger studies, and longer periods of follow-up shall be needed to obtain better estimates of the dangers of adverse events. The reduction in IgM levels, which is consistent with the findings in previous research of rituximab where IgM levels were measured,30,32 shows that rituximab works more effectively in reducing the B-lymphocyte population than in reducing the amount of cells that secrete IgG.