Adult Still's disease reflects a Th2 rather than a Th1 cytokine profile

Saiki, Osamu; Uda, Hiroshi; Nishimoto, N.; Miwa, Takashi; Mima, Toru; Ogawara, Tomoharu; Azuma, Naoto; Katada, Yoshinori; Sawaki, Junko; Tsutsui, Hiroko; Maeda, Akira; Nakanishi, Kenji

doi:10.1016/j.clim.2004.03.023

Cited by 33 publications

(23 citation statements)

References 27 publications

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“…4 In addition, recent studies have indicated that Th1/Th2 cytokines may play a critical role in the pathogenesis of ASD. 4,10,12,13 Chen et al demonstrated that IFNγ-producing Th cells in the peripheral blood of patients with ASD, but not IL-4-producing Th cells, were increased more than in the healthy controls. 12 Whereas the importance of Th1/Th2 imbalance in ASD remains unclear, including in our case, some previous studies also indicated that the suppression of Th cell is useful in the treatment of active ASD.…”

Section: Discussionmentioning

confidence: 96%

“…The favorable effects of TNF inhibitors such as infl iximab and etanercept have been also noticed in patients with refractory ASD, [7][8][9] whereas the serum tumor necrosis factor α (TNFα) levels appeared not to correlate with ASD activity. 4, 10 We experienced a Japanese patient with intractable ASD, in whom tacrolimus concomitant with corticosteroids, but not a high dose of methotrexate (MTX) and/or TNF inhibitors, were effective. Our case indicates that tacrolimus may have a favorable effect for patients with refractory ASD.…”

Section: Introductionmentioning

confidence: 99%

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Successful treatment of a patient with refractory adult Still's disease by tacrolimus

et al. 2007

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Adult Still's disease (ASD) is a systemic rheumatic disease characterized by high spiking fever, erythema, polyarthritis, and increased levels of C-reactive protein, ferritin, and interleukin (IL)-18. Recently, biological agents targeting proinflammatory cytokines such as tumor necrosis factor (TNF) alpha, IL-1, and IL-6 have been described as effective treatments for refractory ASD. Herein, we present a patient with ASD, who was successfully treated by tacrolimus concomitant with corticosteroid, while infliximab and etanercept were not effective. Tacrolimus may be one of the drugs for the ASD patients refractory to the conventional treatments including TNF inhibitors.

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Section: Discussionmentioning

confidence: 96%

Section: Introductionmentioning

confidence: 99%

Successful treatment of a patient with refractory adult Still's disease by tacrolimus

et al. 2007

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“…IL-18 has been reported to be elevated in patients with AOSD [13]. In addition to inducing IL-6, IL-18 promotes TNF and IL-1 production via the nuclear factor-kB (NF-kB) pathway [14][15][16].…”

Section: Discussionmentioning

confidence: 99%

A case report of a patient with refractory adult-onset Still’s disease who was successfully treated with tocilizumab over 6 years

Nakahara¹,

Mima²,

Yoshio-Hoshino³

et al. 2008

Mod Rheumatol

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Interleukin-6 overproduction is pathologically involved in adult onset Still's disease (AOSD). We successfully treated a man with refractory AOSD utilizing tocilizumab. Tocilizumab was discontinued after 15 doses due to intestinal bleeding, but the efficacy was sustained over 21 months. Tocilizumab was readministered safely upon recurrence and showed similar efficacy over 6 years. Corticosteroid and NSAIDs could be discontinued and intestinal bleeding was no more observed. Tocilizumab can be a therapeutic option for AOSD.

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“…In erythematösen Hautlä-sionen und der Synovia betroffener Gelenke werden IFN-γ-mRNA-Transkripte überexprimiert [2]. In einer anderen Studien wurden bei Patienten mit aktivem adulten M. Still neben erhöhten IL-18-Serumspiegeln auch erhöhte Th2-Typ-IL-4-und -IL-13-und -IL-6-Spiegel beschrieben [21]. logicals dar.…”

Section: Pathophysiologieunclassified

Adulter Morbus Still, Schnitzler-Syndrom und autoinflammatorische Syndrome im Erwachsenenalter

Lamprecht

2009

Z. Rheumatol.

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Adult-onset Still's disease (AoSD), Schnitzler syndrome, and cases of adult-onset autoinflammatory syndromes [10-15% of cases of familial Mediterranean fever (FMF) and tumor necrosis factor (TNF) receptor-associated periodic syndrome (TRAPS)] are characterized by a genetic predisposition, with increased interleukin (IL)-1beta and IL-18 production and TNF-alpha signaling, respectively. As a result, periodic fever and inflammation at barrier tissues (synovial tissues, serous membranes, and the skin) are encountered in such patients. Pathophysiological insights into these diseases have renewed interest in research on IL-1beta in rheumatic diseases and have opened new therapeutic avenues. Recently published studies have shown that patients with Schnitzler syndrome, methotrexate-refractory AoSD, and colchicine-refractory FMF or contraindications to colchicines in FMF respond well to treatment with the soluble IL-1 receptor antagonist anakinra. For TRAPS patients, the p75 TNF-alpha receptor/Fc-IgG1 fusion protein etanercept is the treatment of first choice.

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Adult Still's disease reflects a Th2 rather than a Th1 cytokine profile

Cited by 33 publications

References 27 publications

Successful treatment of a patient with refractory adult Still's disease by tacrolimus

Successful treatment of a patient with refractory adult Still's disease by tacrolimus

A case report of a patient with refractory adult-onset Still’s disease who was successfully treated with tocilizumab over 6 years

Adulter Morbus Still, Schnitzler-Syndrom und autoinflammatorische Syndrome im Erwachsenenalter

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