Monday, April 15, 2013

IL-6 and Some New Aspects of Tocilizumab

Recently I had the honour and pleasure to attend to a lecture by Professor Tadamitsu Kishimoto of Osaka University, the immunologist behind the development of tocilizumab. In his talk he pointed to some unusual aspects of tocilizumab. It seems that we don't know the whole story yet.

Professor Kishimoto told a story that even made the New York Times. A nearly 7 year old girl was battling leukaemia. She fell fatally ill with high fever not reacting to the usual drugs. A thousand fold increase in IL-6 had been found among other lab results. So it has been decided to use tocilizumab and from fatally ill she stabilized and could be weaned from artificial ventilation within a week.

He talked on other findings as well. The role of tocilizumab in treating relapsing polychondritis, in Takayasu vasculitis, adult onset Still's disease, and ... polymyalgia rheumatica.

For me, more interesting were findings in amyloidosis. There have been case reports on amyloid vanishing from the guts and skin under tocilizumab. The results of an ongoing study on renal amyloidosis will be presented later this year. I'm looking forward to see these results.

The interesting ideas on the aryl hydrocarbon receptor might yield other uses of tocilizumab as an imbalance of arid5a and regnase might amplify IL-6 production. Maybe we'll see a new use of tocilizumab in dioxin intoxication.

I hope that patients with unusual forms of sarcoidosis will also benefit from tocilizumab. And I'm eager to hear more on tocilizumab and relapsing polychondritis.

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