title: The value of blocking IL-6 outside of rheumatoid arthritis: current perspective.
abstract: OBJECTIVE
  Interleukin-6 (IL-6) is a multifunctional cytokine that regulates immune response and induces acute phase response. Despite the important physiological activities of IL-6, dysregulated overproduction of IL-6 is pathologically involved in various immune-mediated inflammatory diseases (IMIDs) including rheumatoid arthritis (RA). A series of clinical studies of tocilizumab, a humanized anti-IL-6 receptor (IL-6R) antibody, for patients with RA refractory to conventional therapy or anti-tumor necrosis factor therapy have demonstrated the clinical benefit of IL-6 blockade in RA. On the other hand, there is now accumulating evidence that tocilizumab is therapeutically effective for patients with a number of IMIDs other than RA. This review focuses on the perspective of IL-6 blockade therapy for such IL-6-related IMIDs outside of RA.
  
  
  RESULTS
  A considerable number of case reports and preclinical studies have shown the benefit of IL-6 blockade therapy in various IMIDs such as systemic lupus erythematosus, adult-onset Still disease, Takayasu arthritis, polyarteritis nodosa, systemic sclerosis, reactive arthritis, dermatomyositis, and polymyositis.
  
  
  CONCLUSIONS
  Blocking IL-6 with tocilizumab can be a therapeutic option for patients with various IMIDs in which overproduction of IL-6 plays a pathological role. Future clinical studies investigating the safety and efficacy will elucidate the clinical benefits of IL-6 blockade therapy for such diseases.
authors.affiliation: Laboratory of Immune Regulation, Wakayama Medical University, Wakayama City, Wakayama, Japan.
authors.forename: Miho
authors.initials: M
authors.lastname: Murakami
authors.forename: Norihiro
authors.initials: N
authors.lastname: Nishimoto
mesh_terms: D000328:Adult; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized; D016918:Arthritis, Reactive / Q000276:immunology / Q000628:therapy; D001172:Arthritis, Rheumatoid / Q000276:immunology / Q000628:therapy*; D002986:Clinical Trials as Topic; D003882:Dermatomyositis / Q000276:immunology / Q000628:therapy; D006801:Humans; D007154:Immune System Diseases / Q000276:immunology / Q000628:therapy*; D007249:Inflammation / Q000276:immunology / Q000628:therapy*; D008180:Lupus Erythematosus, Systemic / Q000276:immunology / Q000628:therapy; D019947:Receptors, Interleukin-6 / Q000037:antagonists & inhibitors*; D012595:Scleroderma, Systemic / Q000276:immunology / Q000628:therapy; D016706:Still's Disease, Adult-Onset / Q000276:immunology / Q000628:therapy; D013625:Takayasu Arteritis / Q000276:immunology / Q000628:therapy; D000093242:Interleukin-6 Inhibitors; D015850:Interleukin-6
chemical_list: D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D019947:Receptors, Interleukin-6; D000093242:Interleukin-6 Inhibitors; C508600:IL6 protein, human; D015850:Interleukin-6; C502936:tocilizumab