Abstract | BACKGROUND: OBJECTIVES: To study clinical and paraclinical effects of tocilizumab in a patient with NMO. DESIGN: Case report. SETTING: Academic neurology department. PATIENT: MAIN OUTCOME MEASURES: Clinical disability, magnetic resonance imaging, cytokines and transcription factors levels in the cerebrospinal fluid, and peripheral blood mononuclear cells. RESULTS: A patient who continued to accumulate neurological disability and magnetic resonance imaging activity while receiving numerous immunoactive therapies stabilized, and eventually improved clinically and on magnetic resonance metrics after treatment initiation with tocilizumab. Treatment and clinical response correlated with a significant reduction of IL-6 levels in the CSF as well as a diminished expression of signal transducer and activator of transcription 3. CONCLUSIONS:
Tocilizumab might be effective in NMO, here in a patient not responding to leukocyte depletion. Our findings further support data that implicate IL-6 as a critical molecule in the immunopathogenesis of NMO, and a critical role for T cells in the pathogenesis of this disorder.
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Authors | Bernd C Kieseier, Olaf Stüve, Thomas Dehmel, Norbert Goebels, Verena I Leussink, Anne K Mausberg, Marius Ringelstein, Bernd Turowski, Orhan Aktas, Gerald Antoch, Hans-Peter Hartung |
Journal | JAMA neurology
(JAMA Neurol)
Vol. 70
Issue 3
Pg. 390-3
(Mar 01 2013)
ISSN: 2168-6157 [Electronic] United States |
PMID | 23599943
(Publication Type: Case Reports, Journal Article, Research Support, Non-U.S. Gov't)
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Chemical References |
- Antibodies, Monoclonal, Humanized
- tocilizumab
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Topics |
- Adult
- Antibodies, Monoclonal, Humanized
(therapeutic use)
- Female
- Humans
- Immunity, Cellular
(drug effects, immunology)
- Neuromyelitis Optica
(diagnosis, drug therapy, immunology)
- Treatment Outcome
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