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MR Vol.14 No.1 indexに戻る
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MODERN RHEUMATOLOGY
Vol.14 No.1 |
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Inflammatory cytokines and systemic-onset
juvenile idiopathic arthritis
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| Shumpei Yokota1 , Takako Miyamae1, Tomoyuki
Imagawa1, Naomi Iwata1, 2, Shigeki Katakura1 and Masaaki Mori1 |
(1) Department of Pediatrics, Yokohama City
University School of Medicines, 3-9 Fukuura, Kanazawa-ku, Yokohama,
236-0004, Japan
(2) Department of Rheumatic Diseases, Aichi Childrens Health and Medical Center,
Obu, Japan |
Received: 22 April 2003 Accepted: 07 August 2003 |
| Abstract |
| Abstract Systemic-onset juvenile idiopathic arthritis
(JIA) is a severe and steroid-dependent disease, which sometimes
progresses to the fatal disease macrophage activation syndrome. An
investigation of inflammatory cytokine levels revealed increases
in IL-6 in serum of systemic-onset disease patients. Continuously
elevated levels of IL-6 in serum may play a important role in manifesting
the clinical symptoms and signs of systemic-onset JIA, including
spiking fever, rash, arthritis, and serositis. The characteristic
fever spikes parallel IL-6 levels. Long-term exposure to high levels
of IL-6 in children results in severe growth impairment, which was
strongly suggested by the recent establishment of IL-6 transgenic
mice. To avoid disease progression to macrophage activation syndrome
and the adverse effects of high-dose corticosteroids, it might be
reasonable to inhibit the formation of IL-6/IL-6R complex in order
to block the binding to gp130 receptor, a biologically active receptor
for IL-6. This review will provide evidence of the relationship between
IL-6 homeostasis and systemic-onset JIA, and our recent trials of
anti-IL-6R antibody (MRA) for children with acute systemic disease
intractable to long-term and high-dose corticosteroid therapy. MRA
could be a therapeutic modality for children with systemic-onset
JIA intractable to high-dose corticosteroids. |
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| Key words |
| Key words Antirheumatic drug - Cytokine - Cytokine-inducible proteins
- Inflammation - Juvenile idiopathic arthritis (JIA) |
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