Prediction of disease severity in neuromyelitis optica by the levels of IL-6 produced during remission phase – Barros – Clinical & Experimental Immunology – Wiley Online Library

Th17 cytokines have been implicated to neuromyelitis optica (NMO) pathogenesis. Since humanized anti-IL-6R (tocilizumab) IgG has been used as disease modifying therapy for NMO, the objective of our study was to investigate the role of endogenous IL-6 on NMO-derived CD4+T-cell behavior. High production of IL-6, IL-17 and IL-21 by CD4+ T-cells was detected in NMO patients. Further, IL-21 and IL-6 levels were directly related to the level of neurological disabilities. The addition of anti-IL-6R IgG not only reduced directly the production of these cytokines, but also almost abolished the ability of activated autologous monocytes in enhancing IL-6, IL-17 and IL-21 release by CD4+ T-cells. In contrast, in those cell cultures, the production of IL-10 was amplified. Further, anti-IL-6R mAb also potentiated the ability of glucocorticoid in reducing Th17 cytokines. Finally, the in vivo and in vitro IL-6 levels were significantly higher among those patients who experienced clinical relapse during 2-year follow-up. In summary, our results suggest a deleterious role of IL-6 in NMO by, at least in part, favoring the expansion of corticoid-resistant Th17 cells

via Clinical & Experimental Immunology – Wiley Online Library.

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