Effect of infliximab in progressive Neuro-Behçet's syndrome

Kikuchi, Hirotoshi; Aramaki, Kaori; Hirohata, Shunsei

doi:10.1016/j.jns.2008.05.002

Cited by 101 publications

(57 citation statements)

References 24 publications

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“…Interestingly, it has been reported that patients with chronic progressive NB refractory to methotrexate respond to treatment with infliximab (27). More importantly, administration of infliximab decreases the CSF IL-6 levels without affecting the TNF-α levels in these patients (27). This suggests that the mechanisms underlying decreases in the levels of CSF IL-6 might not be accounted for by neutralization of TNF-α.…”

Section: Discussionmentioning

confidence: 99%

“…However, it should be pointed out that there were a fraction of patients who did not adequately respond to methotrexate and who deteriorated with persistent elevations of CSF IL-6. Interestingly, it has been reported that patients with chronic progressive NB refractory to methotrexate respond to treatment with infliximab (27). More importantly, administration of infliximab decreases the CSF IL-6 levels without affecting the TNF-α levels in these patients (27).…”

Section: Discussionmentioning

confidence: 99%

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Changes in Biomarkers Focused on Differences in Disease Course or Treatment in Patients with Neuro-Behçet's Disease

Hirohata

Kikuchi

2012

Intern. Med.

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Objective Neurological manifestations of Behçet's disease (NB) are serious complications. However, their pathogenesis remains unclear. The current study examined the levels of proinflammatory cytokines, including IL-1β, IL-6, IL-8 and TNF-α, in cerebrospinal fluid (CSF). Methods CSF cytokines were measured using an enzyme-linked immunosorbent assay. CSF was obtained from 17 patients with acute NB, 19 patients with chronic progressive NB and 20 patients with noninflammatory neurological diseases, including cerebrovascular disease, cervical spondylosis and degenerative diseases. Results CSF total cell counts and polymorph nuclear leukocyte counts were significantly lower in the patients with chronic progressive NB than in those with acute NB. The CSF levels of IL-6 and IL-8 were markedly elevated in the NB patients compared with those measured in the control patients. There were no significant differences in the CSF levels of IL-6 and IL-8 between the patients with acute NB and those with chronic progressive NB. In contrast, there were no significant differences in the CSF levels of IL-1β and TNF-α among the control, acute NB and chronic progressive NB patients. Consistently, the CSF levels of IL-6 and IL-8 were significantly decreased following successful treatment in both acute NB and chronic progressive NB patients, whereas the CSF levels of IL-1β and TNF-α were not changed significantly. Of note, the CSF levels of IL-6 were significantly correlated with the CSF levels of IL-8 in the patients with acute NB (r =0.7647, p =0.0003) but not in the patients with chronic progressive NB (r =0.1343, p =0.5835). Conclusion These results indicate that CSF IL-6 and IL-8 play important roles in the pathogenesis of NB. However, the data also suggest that the mechanisms underlying the elevation of CSF IL-6 and IL-8 might be different in patients with acute NB and those with chronic progressive NB.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Changes in Biomarkers Focused on Differences in Disease Course or Treatment in Patients with Neuro-Behçet's Disease

Hirohata

Kikuchi

2012

Intern. Med.

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“…This fact, in addition to the severe course in the reported Albanian patients, could indicate that ABD is still 'unknown' in the country or that less severe cases could be misdiagnosed. Further, neuro-ABD is a rarely diagnosed manifestation but it could be underestimated, if cerebral radiological imaging is [3,24,25,45] . Last, this case emphasizes the unpredictability of ABD even with combined immunosuppression (development of an ocular involvement despite therapy) and corroborates the evidence of efficacy and a favourable safety profile of TNF-␣ inhibitors in the treatment of ABD refractory to conventional immunosuppressive drugs, as already reported by other authors.…”

Section: Case Reportmentioning

confidence: 99%

Infliximab for the Treatment of Refractory Adamantiades-Behçet Disease with Articular, Intestinal, Cerebral and Ocular Involvement

Donghi¹,

Mainetti²

2010

Dermatology

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“…No safety problems were reported. Other series (Kikuchi et al, 2008) also showed good results with infliximab 5mg/kg in 5 patients with progressive neuro-Behçet's disease refractory to glucocorticoids and methotrexate. Infliximab was added to former treatment scheme.…”

Section: Central Nervous System Diseasementioning

confidence: 84%