Blockade of interleukin-6 as a possible therapeutic target for AA amyloidosis.

Autor:	Almenara Tejederas M; Servicio de Nefrología, Hospital Universitario Virgen Macarena, Sevilla, España. Electronic address: marinaalmenara@hotmail.com., Alonso García F; Servicio de Nefrología, Hospital Universitario Virgen Macarena, Sevilla, España., Aguilera Morales WA; Servicio de Nefrología, Hospital Universitario Virgen Macarena, Sevilla, España., de la Prada Álvarez F; Servicio de Nefrología, Hospital Universitario Virgen Macarena, Sevilla, España., Salgueira Lazo M; Servicio de Nefrología, Hospital Universitario Virgen Macarena, Sevilla, España.
Jazyk:	English; Spanish; Castilian
Zdroj:	Nefrologia [Nefrologia (Engl Ed)] 2021 Jun 14. Date of Electronic Publication: 2021 Jun 14.
DOI:	10.1016/j.nefro.2021.01.006
Abstrakt:	Introduction: AA (secondary) amyloidosis is a severe complication of chronic inflammatory disorders. It is characterized by the systemic deposition of an abnormal protein called amyloid, affecting mainly renal function. IL-6 is a cytokine with a relevant role in this disease development. Interleukin-receptor antagonists, like Tocilizumab (TCZ), have become possible treatment choice for AA amyloidosis. In published reports, TCZ has shown good efficacy for AA amyloidosis, being associated with regression of renal amyloid deposits. Methods: Retrospective review that included patients with histological diagnosis of AA renal amyloidosis under treatment with TCZ during the years 2018-2019 in our center. We have registered clinical and demographic variables. Renal function was measured by means of CKD-EPI equation to estimate the glomerular filtration rate (FG) and protein/creatinine ratio (IPC) at 3, 6 and 12 months. We define renal response as a decrease by at least 30% of proteinuria and/or stabilization or improvement of FG. We consider that an anti-inflammatory response is a decrease of more than 50% in serum amyloid protein (PSA) and/or C-reactive protein (CRP). Results: We collected 3 cases of patients with histologically proven AA amyloidosis treated with TCZ (2 men; 1 woman; aged 55, 74 and 75 years). The follow-up was 13, 14 and 75 months. FG was stabilized in two patients. The third patient remained on hemodialysis during follow-up, although with excellent control of her underlying inflammatory disease. In all three cases, reduced PSA and CRP were observed. There have been no adverse events. Conclusions: The TCZ may be an effective and safe option in treatment of AA amyloidosis with renal involvement. Our results position it as an interesting therapeutic option to consider in these cases, although prospective studies would be necessary to evaluate the global role of TCZ in AA amyloidosis. (Copyright © 2021 Sociedad Española de Nefrología. Published by Elsevier España, S.L.U. All rights reserved.)
Databáze:	MEDLINE
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