Skip to main content
Top
Published in: Modern Rheumatology 4/2013

Open Access 01-07-2013 | Case Report

Clinical improvement in a patient with neuromyelitis optica following therapy with the anti-IL-6 receptor monoclonal antibody tocilizumab

Authors: Manabu Araki, Toshimasa Aranami, Takako Matsuoka, Masakazu Nakamura, Sachiko Miyake, Takashi Yamamura

Published in: Modern Rheumatology | Issue 4/2013

Login to get access

Abstract

Neuromyelitis optica (NMO) is a disabling autoimmune disease associated with an elevation of anti-aquaporin 4 (AQP4) autoantibodies. Here, we present a case with NMO who responded to monthly administration of the anti-IL-6 receptor antibody tocilizumab. The treatment rapidly reduced the elevated numbers of plasmablasts and anti-AQP4 autoantibodies in the patient. Furthermore, neuropathic pain and disability scores gradually improved. Tocilizumab may be considered as a therapeutic option for NMO.
Literature
1.
go back to reference Lennon VA, Wingerchuk DM, Kryzer TJ, Pittock SJ, Lucchinetti CF, Fujihara K, et al. A serum autoantibody marker of neuromyelitis optica: distinction from multiple sclerosis. Lancet. 2004;364:2106–12.PubMedCrossRef Lennon VA, Wingerchuk DM, Kryzer TJ, Pittock SJ, Lucchinetti CF, Fujihara K, et al. A serum autoantibody marker of neuromyelitis optica: distinction from multiple sclerosis. Lancet. 2004;364:2106–12.PubMedCrossRef
2.
go back to reference Lennon VA, Kryzer TJ, Pittock SJ, Verkman AS, and Hinson SR. IgG marker of optic-spinal multiple sclerosis binds to the aquaporin-4 water channel. J Exp Med 2005;202:473–7. Lennon VA, Kryzer TJ, Pittock SJ, Verkman AS, and Hinson SR. IgG marker of optic-spinal multiple sclerosis binds to the aquaporin-4 water channel. J Exp Med 2005;202:473–7.
3.
go back to reference Lucchinetti CF, Mandler RN, McGavern D, Bruck W, Gleich G, Ransohoff RM. A role for humoral mechanisms in the pathogenesis of Devic’s neuromyelitis optica. Brain. 2002;125:1450–61.PubMedCrossRef Lucchinetti CF, Mandler RN, McGavern D, Bruck W, Gleich G, Ransohoff RM. A role for humoral mechanisms in the pathogenesis of Devic’s neuromyelitis optica. Brain. 2002;125:1450–61.PubMedCrossRef
4.
go back to reference Saadoun S, Waters P, Bell BA, Vincent A, Verkman AS, Papadopoulos MS. Intra-cerebral injection of neuromyelitis optica immunoglobulin G and human complement produces neuromyelitis optica lesions in mice. Brain. 2010;133:349–611.PubMedCrossRef Saadoun S, Waters P, Bell BA, Vincent A, Verkman AS, Papadopoulos MS. Intra-cerebral injection of neuromyelitis optica immunoglobulin G and human complement produces neuromyelitis optica lesions in mice. Brain. 2010;133:349–611.PubMedCrossRef
5.
go back to reference Bradl M, Misu T, Takahashi T, Watanabe M, Mader S, Reindl M, et al. Neuromyelitis optica: pathogenicity of patients immunoglobulin in vivo. Ann Neurol. 2009;66:630–43.PubMedCrossRef Bradl M, Misu T, Takahashi T, Watanabe M, Mader S, Reindl M, et al. Neuromyelitis optica: pathogenicity of patients immunoglobulin in vivo. Ann Neurol. 2009;66:630–43.PubMedCrossRef
6.
go back to reference Okamoto T, Ogawa M, Lin Y, Murata M, Miyake S, Yamamura T. Review: treatment of neuromyelitis optica: current debate. Ther Adv Neurol Dis. 2008;1:43–52.CrossRef Okamoto T, Ogawa M, Lin Y, Murata M, Miyake S, Yamamura T. Review: treatment of neuromyelitis optica: current debate. Ther Adv Neurol Dis. 2008;1:43–52.CrossRef
7.
go back to reference Shimizu J, Hatanaka Y, Hasegawa M, Iwata A, Sugimoto I, Date H, et al. IFNβ-1b may severely exacerbate Japanese optic-spinal MS in neuromyelitis optica spectrum. Neurology. 2010;75:1423–7.PubMedCrossRef Shimizu J, Hatanaka Y, Hasegawa M, Iwata A, Sugimoto I, Date H, et al. IFNβ-1b may severely exacerbate Japanese optic-spinal MS in neuromyelitis optica spectrum. Neurology. 2010;75:1423–7.PubMedCrossRef
8.
go back to reference Kleiter I, Hellwig K, Berthele A, Kumpfel T, Linker RA, Harting H-P, et al. Failure of natalizumab to prevent relapses in neuromyelitis optica. Arch Neurol. 2012;69:239–45.PubMedCrossRef Kleiter I, Hellwig K, Berthele A, Kumpfel T, Linker RA, Harting H-P, et al. Failure of natalizumab to prevent relapses in neuromyelitis optica. Arch Neurol. 2012;69:239–45.PubMedCrossRef
9.
go back to reference Min JH, Kim BJ, Lee KH. Development of extensive brain lesions following fingolimod (FTY720) treatment in a patient with neuromyelitis optica spectrum disorder. Mult Scler. 2012;18:113–5.PubMedCrossRef Min JH, Kim BJ, Lee KH. Development of extensive brain lesions following fingolimod (FTY720) treatment in a patient with neuromyelitis optica spectrum disorder. Mult Scler. 2012;18:113–5.PubMedCrossRef
10.
go back to reference Cree BA, Lamb S, Morgan K, et al. An open label study of the effects of rituximab in neuromyelitis optica. Neurology 2005; 1270–2. Cree BA, Lamb S, Morgan K, et al. An open label study of the effects of rituximab in neuromyelitis optica. Neurology 2005; 1270–2.
11.
go back to reference Chihara N, Aranami T, Sato W, Miyazaki Y, Miyake S, Okamoto T, et al. Interleukin 6 signaling promotes anti-aquaporin 4 autoantibody production from plasmablasts in neuromyelitis optica. Proc Natl Acad Sci USA. 2011;108:3701–6. Chihara N, Aranami T, Sato W, Miyazaki Y, Miyake S, Okamoto T, et al. Interleukin 6 signaling promotes anti-aquaporin 4 autoantibody production from plasmablasts in neuromyelitis optica. Proc Natl Acad Sci USA. 2011;108:3701–6.
12.
go back to reference Yoshizaki K, Nakagawa T, Kaieda T, Muraguchi A, Yamamura Y, Kishimoto T. Induction of proliferation and Ig production in human B leukemic cells by anti-immunoglobulins and T cell factors. J Immunol. 1982;128:1296–301.PubMed Yoshizaki K, Nakagawa T, Kaieda T, Muraguchi A, Yamamura Y, Kishimoto T. Induction of proliferation and Ig production in human B leukemic cells by anti-immunoglobulins and T cell factors. J Immunol. 1982;128:1296–301.PubMed
13.
go back to reference Tanaka T, Narazaki M, Kishimoto T. Therapeutic targeting of the interleukin-6 receptor. Annu Rev Pharmacol Toxicol. 2012;52:199–219.PubMedCrossRef Tanaka T, Narazaki M, Kishimoto T. Therapeutic targeting of the interleukin-6 receptor. Annu Rev Pharmacol Toxicol. 2012;52:199–219.PubMedCrossRef
14.
go back to reference Wingerchuk DM, Lennon VA, Pittock SJ, Lucchinetti CF, Weinshenker BG. Revised diagnostic criteria for neuromyelitis optica. Neurology. 2006;66:1485–9.PubMedCrossRef Wingerchuk DM, Lennon VA, Pittock SJ, Lucchinetti CF, Weinshenker BG. Revised diagnostic criteria for neuromyelitis optica. Neurology. 2006;66:1485–9.PubMedCrossRef
15.
go back to reference Kurtzke JF. Rating neurologic impairment in multiple sclerosis: an expanded disability status scale (EDSS). Neurology. 1983;33:1444–52.PubMedCrossRef Kurtzke JF. Rating neurologic impairment in multiple sclerosis: an expanded disability status scale (EDSS). Neurology. 1983;33:1444–52.PubMedCrossRef
16.
go back to reference McCaffery M, Beebe A, editors. Pain: clinical manual for nursing practice. Baltimore: Mosby; 1993. McCaffery M, Beebe A, editors. Pain: clinical manual for nursing practice. Baltimore: Mosby; 1993.
17.
go back to reference Imura T, Takaso M, Nakazawa T, Naruse K, Takahira N, Itoman M. Correlation between inflammatory cytokines in the spinal fluid and spinal disorders. J Lumber Spine Disord. 2008;14:134–9.CrossRef Imura T, Takaso M, Nakazawa T, Naruse K, Takahira N, Itoman M. Correlation between inflammatory cytokines in the spinal fluid and spinal disorders. J Lumber Spine Disord. 2008;14:134–9.CrossRef
18.
go back to reference Nishimoto N, Terao K, Mima T, Nakahara H, Takagi N, Kakehi T. Mechanisms and pathogenic significances in increase in serum interleukin-6 (IL-6) and soluble IL-6 receptor after administration of an anti-IL-6 receptor antibody, tocilizumab, in patients with rheumatoid arthritis and Castleman disease. Blood. 2008;112:3959–64.PubMedCrossRef Nishimoto N, Terao K, Mima T, Nakahara H, Takagi N, Kakehi T. Mechanisms and pathogenic significances in increase in serum interleukin-6 (IL-6) and soluble IL-6 receptor after administration of an anti-IL-6 receptor antibody, tocilizumab, in patients with rheumatoid arthritis and Castleman disease. Blood. 2008;112:3959–64.PubMedCrossRef
Metadata
Title
Clinical improvement in a patient with neuromyelitis optica following therapy with the anti-IL-6 receptor monoclonal antibody tocilizumab
Authors
Manabu Araki
Toshimasa Aranami
Takako Matsuoka
Masakazu Nakamura
Sachiko Miyake
Takashi Yamamura
Publication date
01-07-2013
Publisher
Springer Japan
Published in
Modern Rheumatology / Issue 4/2013
Print ISSN: 1439-7595
Electronic ISSN: 1439-7609
DOI
https://doi.org/10.1007/s10165-012-0715-9

Other articles of this Issue 4/2013

Modern Rheumatology 4/2013 Go to the issue
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine