Rapid alteration of serum interleukin-6 levels may predict the reactivity of i.v. cyclophosphamide pulse therapy in systemic sclerosis-associated interstitial lung disease

J Dermatol. 2018 Oct;45(10):1221-1224. doi: 10.1111/1346-8138.14580. Epub 2018 Jul 27.

Abstract

Systemic sclerosis (SSc) is an autoimmune disorder characterized by excessive extracellular matrix deposition. Although SSc-associated interstitial lung disease (ILD) is one of the most important complications as a cause of death in SSc, prediction factors of treatment reactivity in SSc-ILD are still unclear. To assess relationships between interleukin (IL)-6 and reactivity to treatment, we measured serum IL-6 levels in 23 of active SSc-ILD patients under i.v. cyclophosphamide (IVCY) therapy and 20 of stabilized SSc-ILD, using the high-sensitivity enzyme-linked immunoassay system. Serum IL-6 levels in active SSc-ILD patients were significantly higher than those in stabilized SSc-ILD patients. Among active SSc-ILD patients, baseline serum IL-6 levels were not significantly different between IVCY responders and non-responders. Meanwhile, serum IL-6 levels after three IVCY doses out of a total of six were decreased in responders but not in non-responders. Regarding changes of parameters by the three doses of a total of six of IVCY, change in serum IL-6 levels correlated inversely with that in values of pulmonary function test. Thus, the rapid decrease in serum IL-6 levels during a couple of doses may predict the efficacy of IVCY therapy against SSc-ILD.

Keywords: i.v. cyclophosphamide; interleukin-6; micro-enzyme-linked immunoassay; predictive factor; systemic sclerosis interstitial lung disease.

MeSH terms

  • Adult
  • Aged
  • Cyclophosphamide / therapeutic use*
  • Feasibility Studies
  • Female
  • Humans
  • Immunosuppressive Agents / therapeutic use*
  • Injections, Intravenous
  • Interleukin-6 / blood*
  • Lung Diseases, Interstitial / blood
  • Lung Diseases, Interstitial / drug therapy*
  • Lung Diseases, Interstitial / immunology
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Pulse Therapy, Drug / methods
  • Scleroderma, Systemic / blood
  • Scleroderma, Systemic / complications
  • Scleroderma, Systemic / drug therapy*
  • Scleroderma, Systemic / immunology
  • Treatment Outcome

Substances

  • IL6 protein, human
  • Immunosuppressive Agents
  • Interleukin-6
  • Cyclophosphamide