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Small proteins secreted by white blood cells are called “cytokines.”
“Inflammatory cytokines” and “anti-inflammatory cytokines” keep each other in balance, regulating the body’s functions.
Among inflammatory cytokines, interleukin-6 (IL-6) was discovered in the 1980s by Dr. Tadamitsu Kishimoto of Osaka University.
https://chugai-pharm.jp/contents/zb/013/01/
IL-6, which we have long considered in connection with eye disease, is now leading to a possible treatment for pneumonia from the novel coronavirus.
Cytokine (IL-6) Biologics May Work Against Coronavirus Infection
When we examined cytokines in vitreous fluid obtained during surgery inside the eye (retinal and vitreous surgery), we found that IL-6 accumulates inside the eye in most diseases (retinal detachment, diabetic retinopathy, retinal vein occlusion).
Comprehensive Analysis of Inflammatory Immune Mediators in Vitreoretinal Diseases1
We showed the potential of treating uveitis by suppressing IL-6 with an antibody drug (2009).
Involvement of Th17 cells and the effect of anti-IL-6 therapy in autoimmune uveitis2
In that paper, we wrote that IL-6 is the “root of all evil” that increases “Th17,” a group of white blood cells that worsens inflammation.
Google scholarshows that it is still widely cited around the world today.
Antibody against the IL-6 receptor: tocilizumab (Actemra®）、
This was joint research with Dr. Yoshiyuki Ohsugi of Chugai Pharmaceutical and Dr. Nobuyuki Ohguro of Osaka University.
Actemra®is a biologic (antibody drug) actually used to treat rheumatoid arthritis.
In addition, it is used for active polyarticularjuvenile idiopathic arthritis,、systemic juvenile idiopathic arthritis,、adult Still’s disease,、Castleman disease,
and cytokine release syndrome associated with tumor-specific T-cell infusion therapy.
* Biologics used in ophthalmology are, for uveitis, Remicade®• Humira®, and for age-related macular degeneration and macular edema, Lucentis®• Eylea®.
In severe novel coronavirus pneumonia, the body is said to be in a state of “cytokine storm” (cytokine release syndrome).
COVID-19: consider cytokine storm syndromes and immunosuppression3
A “runaway immune system”: inflammatory cytokines are suddenly produced in large amounts and destroy tissues throughout the body.
Tocilizumab (Actemra®) has attracted attention for working against cytokine storm and preventing COVID-19 (novel coronavirus pneumonia) from becoming severe.
Effective treatment of severe COVID-19 patients with tocilizumab4
(References)
1. Yoshimura, T., Sonoda, K.-H., Sugahara, M., Mochizuki, Y., Enaida, H., Oshima, Y., Ueno, A., Hata, Y., Yoshida, H., Ishibashi, T., 2009. Comprehensive Analysis of Inflammatory Immune Mediators in Vitreoretinal Diseases. PLoS ONE 4, e8158. https://doi.org/10.1371/journal.pone.0008158
2. Yoshimura, T., Sonoda, K.-H., Ohguro, N., Ohsugi, Y., Ishibashi, T., Cua, D.J., Kobayashi, T., Yoshida, H., Yoshimura, A., 2009. Involvement of Th17 cells and the effect of anti-IL-6 therapy in autoimmune uveitis. Rheumatology 48, 347–354. https://doi.org/10.1093/rheumatology/ken489
3. Mehta, P., McAuley, D.F., Brown, M., Sanchez, E., Tattersall, R.S., Manson, J.J., 2020. COVID-19: consider cytokine storm syndromes and immunosuppression. The Lancet 395, 1033–1034. https://doi.org/10.1016/S0140-6736(20)30628-0
4. Xu, X., Han, M., Li, T., Sun, W., Wang, D., Fu, B., Zhou, Y., Zheng, X., Yang, Y., Li, X., Zhang, X., Pan, A., Wei, H., 2020. Effective treatment of severe COVID-19 patients with tocilizumab. Proc Natl Acad Sci USA 202005615. https://doi.org/10.1073/pnas.2005615117
A book that explains immunology in an easy-to-understand way:
