Related Experiment Video

Updated: May 10, 2026

An Adoptive Transfer Model of Rheumatoid Arthritis in Mice
07:37

An Adoptive Transfer Model of Rheumatoid Arthritis in Mice

Published on: June 6, 2025

Pro-atherogenic lipid changes and decreased hepatic LDL receptor expression by tocilizumab in rheumatoid arthritis

Aart C Strang1, Radjesh J Bisoendial, Ruud S Kootte

  • 1Department of Vascular Medicine, Academic Medical Center, Amsterdam, The Netherlands. a.c.strang@amc.uva.nl

Atherosclerosis
|June 11, 2013
PubMed
Abstract

Insights

Tocilizumab (TCZ) treatment in rheumatoid arthritis (RA) patients increased LDL cholesterol and triglycerides in both fasting and non-fasting states. This suggests TCZ may directly impact liver LDL receptor expression, potentially affecting cardiovascular risk.

Area of Science:

  • Rheumatology
  • Cardiovascular Risk
  • Lipid Metabolism

Background:

  • Tocilizumab (TCZ) targets the interleukin-6 pathway.
  • TCZ use in rheumatoid arthritis (RA) may alter lipoprotein profiles.
  • Potential adverse cardiovascular (CV) risk implications exist.

Purpose of the Study:

  • To evaluate TCZ's effect on lipoproteins in RA patients.
  • To assess lipid profiles in both fasting and non-fasting states.
  • To investigate TCZ's impact on LDL receptor (LDLr) expression in vitro.

Main Methods:

  • Twenty RA patients received TCZ intravenously.
  • Lipid profiles and HDL antioxidative capacity were measured at baseline, week 1, and week 6.
  • Blood samples were collected pre- and post-oral fat load.
  • TCZ's effect on LDLr expression was tested in HepG2 cells.

Main Results:

  • TCZ increased total cholesterol (22%), LDLc (22%), and HDLc (17%) after 6 weeks.
  • Fasting triglycerides rose by 48%, and postprandial TG increased by 62%.
  • In vitro studies showed decreased LDLr expression in liver cells treated with TCZ.

Conclusions:

  • TCZ adversely affects LDLc and triglyceride levels in RA patients.
  • Observed lipid changes may stem from TCZ's direct hepatic effect on LDLr expression.
  • Further clinical trials are needed to confirm TCZ's net effect on CV morbidity.

Related Concept Videos

T Cell Types and Functions01:24

T Cell Types and Functions

When T cells with CD4 markers are activated, they give rise to two types of effector cells: helper T cells and regulatory T cells. Meanwhile, T cells with CD8 markers differentiate into effector cytotoxic T cells. The differentiation of CD4 T cells into helper T cell subsets, such as Th1, Th2, and Th17 cells, is dependent on the antigen type, antigen-presenting cell, and regulatory cytokines.
Th1 cells stimulate dendritic cells to express necessary co-stimulatory molecules on their surfaces for...
Drugs for Treatment of Crohn's Disease in IBD Using Biologic Agents: Anti-TNF01:24

Drugs for Treatment of Crohn's Disease in IBD Using Biologic Agents: Anti-TNF

Tumor Necrosis Factor (TNF), a proinflammatory cytokine, contributes significantly to the inflammation seen in Crohn's disease. It exists as soluble TNF and membrane-bound TNF, with actions mediated through TNF receptors (TNFR). TNFR activation leads to the release of proinflammatory cytokines, T-cell activation, collagen production, and leukocyte migration, all contributing to inflammation in Crohn's disease. Anti-TNF monoclonal antibodies, namely infliximab (Remicade), adalimumab (Humira),...
Atherosclerosis III: Management01:26

Atherosclerosis III: Management

Management of atherosclerosis involves an integrated strategy encompassing pharmacological treatment, surgical interventions, lifestyle changes, and nutrition therapy to address the multifactorial nature of the disease.Pharmacological TherapyA cornerstone of atherosclerosis management is the use of pharmacological agents. Statins, such as atorvastatin, are pivotal in inhibiting HMG-CoA reductase, an enzyme that catalyzes an initial step in cholesterol synthesis in the liver. This reduction in...
Lipid-Lowering Drugs: Statins and Miscellaneous Agents01:20

Lipid-Lowering Drugs: Statins and Miscellaneous Agents

Hyperlipidemia, a medical condition often referred to as high cholesterol, is characterized by abnormally elevated levels of lipids in the bloodstream. When present in excess, these lipids, specifically cholesterol and triglycerides, can lead to serious health complications, often involving cardiovascular diseases. Illnesses like atherosclerosis, heart attacks, and pancreatitis have all been linked to untreated hyperlipidemia. This means controlling and regulating cholesterol and triglyceride...
The JAK-STAT Signaling Pathway01:20

The JAK-STAT Signaling Pathway

Several cytokine receptors have tightly bound Janus kinase or JAK proteins attached at their cytosolic tail. Small signaling molecules such as cytokines, growth hormones, or prolactins bind to the cytokine receptors and initiate their dimerization. The dimerization brings the cytosolic JAKs together that trans-phosphorylate and activates each other. The activated JAKs now phosphorylate cytosolic tails of the cytokine receptors, which serve as binding sites for adaptor proteins such as  SH2...
Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents01:29

Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents

Crohn's disease is an inflammatory bowel disorder marked by chronic inflammation of the GI tract. Various treatment strategies for Crohn's disease are employed, such as immunomodulatory agents, glucocorticoids, and biologics or anti-TNF therapy. Azathioprine (Imuran), a commonly used immunomodulatory drug for Crohn's disease, is converted in the body to mercaptopurine, which inhibits purine biosynthesis and cell proliferation. Both are utilized in severe cases of Inflammatory Bowel Disease...