Kuet K, Goodfield M
Department of Dermatology, Chapel Allerton Hospital, Leeds, West Yorkshire, UK.
Clin Exp Dermatol. 2014 Aug;39(6):717-9. doi: 10.1111/ced.12385. Epub 2014 Jul 1.
Tocilizumab, a humanized monoclonal antibody directed against the interleukin (IL)-6 receptor, is approved for the treatment of rheumatoid arthritis and juvenile idiopathic arthritis (JIA). We describe a case of multiple halo naevi occurring in a patient with a history of JIA treated with tocilizumab. IL-6 is a key cytokine in the setting of cancer through its effects on angiogenesis and inhibition of adaptive anti-tumour immunity. IL-6 also plays a role in melanocyte function, and increased levels have been noted in vitiligo skin, where it is a paracrine inhibitor of melanocytes. Tocilizumab may therefore lead to the development of halo naevi secondary to subsequent activation of adaptive immunity. Alternatively, as tocilizumab results in increased serum IL-6 levels, the epidermal cytokine profile is altered. Increased levels of IL-6 may therefore have a direct inhibitory effect on melanocytes, where access by tocilizumab may be limited due to differential size difference.
托珠单抗是一种靶向白细胞介素（IL）-6受体的人源化单克隆抗体，已被批准用于治疗类风湿性关节炎和幼年特发性关节炎（JIA）。我们描述了1例有JIA病史且接受托珠单抗治疗的患者出现多发性晕痣的病例。IL-6通过其对血管生成的影响以及对适应性抗肿瘤免疫的抑制作用，在癌症发生过程中是一种关键细胞因子。IL-6在黑素细胞功能中也起作用，白癜风皮肤中IL-6水平升高，在那里它是黑素细胞的旁分泌抑制剂。因此，托珠单抗可能导致继发于适应性免疫激活后的晕痣形成。或者，由于托珠单抗导致血清IL-6水平升高，表皮细胞因子谱发生改变。因此，IL-6水平升高可能对黑素细胞有直接抑制作用，由于大小差异，托珠单抗可能难以作用于黑素细胞。
