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Flow Cytometric Analysis of Lymphocyte Infiltration in Central Nervous System during Experimental Autoimmune Encephalomyelitis
Published on: November 17, 2020
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Cerebrospinal Fluid Interleukin-6 in Immune Checkpoint Inhibitor-Induced Autoimmune Meningoencephalitis.
Takeshi Mizukami1, Teruaki Masuda1, Noriyuki Kimura1
1Department of Neurology, Faculty of Medicine, Oita University.
The Tohoku Journal of Experimental Medicine
|September 1, 2022
Summary
Immune checkpoint inhibitors can cause autoimmune meningoencephalitis. Elevated cerebrospinal fluid interleukin-6 (IL-6) levels correlated with meningoencephalitis severity in two cancer patients treated with ICIs.
Area of Science:
- Neuroimmunology
- Oncology
- Neurology
Background:
- Immune checkpoint inhibitors (ICIs) are effective cancer treatments but can cause immune-related adverse events.
- Autoimmune meningoencephalitis is a severe ICI-induced complication with unclear clinical features.
Observation:
- Two patients with advanced cancers developed autoimmune meningoencephalitis after ICI therapy.
- Both patients presented with neurological symptoms and elevated cerebrospinal fluid (CSF) interleukin-6 (IL-6) levels.
Findings:
- Case 1: Renal cell carcinoma patient had severe headache, high CSF IL-6 (6,620 pg/mL), and pleocytosis after nivolumab. Case 2: Patient with renal cell carcinoma had consciousness alterations, neck stiffness, and high CSF IL-6 (49.3 pg/mL) after nivolumab plus ipilimumab.
- CSF IL-6 levels were proportional to meningoencephalitis severity and clinical parameters.
Implications:
- Elevated CSF IL-6 may serve as a biomarker for ICI-associated meningoencephalitis.
- Understanding IL-6's role could elucidate central nervous system complications from ICIs.
- Steroid pulse therapy showed efficacy in treating these cases.
