Immunome Research
Open Access

Relation between severity of rheumatoid arthritis and elevated serum IgG4 with its potential etiopathogenetic role in excessive IL-6 release in a cohort of RA Egyptian patients treated with tocilizumab

11^th Annual Congress on Immunology & Immunotechnology

September 13-14, 2018 | Zurich, Swizerland

Hany El-Saadany

Armed Forces Medical Complex Kobry El Qobba, Egypt

Scientific Tracks Abstracts: Immunome Res

Abstract :

Background: Rheumatoid arthritis (RA) is a systemic autoimmune disease characterized by synovitis and joint destruction leading to severe deformity and disability without proper therapy. Subtyping of RA may be helpful for optimal therapeutic strategies and outcome prediction. Recently, much attention has been paid to IgG4 since recognition of IgG4-RD. Thus, elevation of IgG4 in RA patients, may define specific clinical phenotypes. The anti-IL-6 tocilizumab is used in refractory RA with good response. Objectives: To investigate the percentage of IgG4 among moderate to severe cases of RA refractory to the combination of synthetic disease-modifying antirheumatic drugs (DMARDs) and detection of response regarding the level of IgG4 after treatment with tocilizumab. Results: 27 patients of 60 included in the study (45%) had elevated sIgG4 group 1 and thirty three (55%) had normal sIgG4 group 2. Within group 1 the sIgG4 level correlated positively with sIgG level (p<0.001).The mean sIgG4/sIgG ratio of the group 1 was 14%±6%, which was significantly higher than that of group 27%±3%; (p<0.001). sIgG4/sIgG ratio>8 was reported by some authors as a sign of activity for the IgG4-RD [x2=44.96, p<0.001) sIgG4 and autoantibodies: RF, anti-CCP levels were significantly higher in group 1 than in group 2 at the base line before tocilizumab treatment and lowered significantly after the end of tocilizumab treatment. Conclusion: This study showed that elevated sIgG4 in moderate to severe RA is common especially in poor responders to the conventional treatment of synthetic DMARDS and their level decreased significantly after the use of tocilizumab (anti-IL-6). Large multicenter prospective studies are recommended to clarify the relation between raised sIgG4 in moderate to severe RA and the possibility of use tocilizumab in reducing IgG4 in cases of IgG4-RD.

Biography :

Hany El-Saadany is the Head of the Department of Internal Medicine & Rheumatology unit. Recently he shifted to Kobri El-Kobba Military Medical Complex. He has published many papers in reputed journals and attended many national conferences.

E-mail: hanyelsadany@yahoo.com