Neuromyelitis optica used to be part of the MS disease spectrum, where people have notably spinal cord and optic nerve involvement. With the finding that this disease is associated with antibodies against brain rptoeins and that is responds differntly to some MS drugs..it has become a new syndrome. As such it is getting its own treatments. These include blocking a complement component, a different type of B cell depleter and a B cell cytokine blocker.
Interleukin–6 (IL-6) is a molecule produced by different cells and tissues of the organism. It is involved in the production of acute phase proteins, proliferation of B–lymphocytes and neutrophils.
Interleukin- 6 also causes fever. Therefore it is known as an Endogenous pyrogen. They are produced by activated immune cells and cause the increase in the tempertature control set point in the hypothalamus in the Brain. Major endogenous pyrogens are interleukin 1 (α and β) and interleukin 6 (IL-6). Interleukin IL-1 causes the production of interleukin 6 and this causes FEVER. that is why they are called a Pyrogen (Fire).
Interleukin 6 works because it binds to the interleukin 6 receptor. This interaction can be blocked via antibodies such as tocilizumab that has been used to Arthritis but also treat neuromyelitis optica and sarilumab used to treat rheumatoid arthritis.
Excessive interleukin 6 has been found in the blood of people with severe lung problems who have COVID-19 infection and ARDS. It is also one of the cytokines that is elevated in the cytokine storm that occurs in people doing badly with COVID 19. Indeed anti-IL-6 receptor was approved for use in treating cytokine release syndrome, a side effect of CAR-T cell therapies. Therefore tests have been done on people with cytokine storm problems,
News is filtering through from Italy that blocking this pathway may be of some rapid benefit in some people with severe respiratory problems. We will have to wait and see what happens, but it is the appliance of science.
There is a question mark over anti-Interleukin 6 receptor therapy and multiple sclerosis as a few people with arthritis have developed MS and so does it make MS worse in a few people? There are reports of benefit. I doubt a few days of treatment is going to make any big difference and if it is saving your life….I think it is worth studying.
I will be watching the Iranian space. One advantage for Iran is that with International Embargoing…they have said sod the Patent law. What are you going to do to us that you aren’t already doing? Therefore, as soon as an MS or other drug is approved, they make their own variant for their population. They have made their own anti-interleukin 6 receptor antibody. I bet they will be testing beta interferon also…..If these approaches works there would be a big bonanza for the Pharma companies…and now people may not see them as the big evil, but a vital part of the health of our Society. They are the people that are going to make a vaccine, which will sadly be too late for many…..that’s because they will have had the virus and a vaccines are often not that great after infection has occurred