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Updated: May 28, 2026
05:05
Technique of Conjunctival Biopsy and Direct Immunofluorescence for Diagnosing Mucous Membrane Pemphigoid
Published on: June 17, 2025
Tocilizumab for severe and refractory mucous membrane pemphigoid
Billal Tedbirt1,2, Maud Maho-Vaillant2, Julie Gueudry3
1Department of Dermatology, French Reference Center for Auto Immune Blistering Diseases, Rouen University Hospital, Normandie University, Rouen, France.
Summary
Mucous membrane pemphigoid (MMP) is characterized by elevated serum cytokines IL-6, IL-8, MIP-1α/CCL3, and MIP-1β/CCL4. Tocilizumab showed promise in treating severe MMP by reducing disease activity and improving patient outcomes.
Area of Science:
- Immunology
- Dermatology
- Autoimmune Diseases
Background:
- Mucous membrane pemphigoid (MMP) is a rare, severe autoimmune blistering disease.
- MMP can cause life-threatening complications and blindness due to fibrosing effects.
Purpose of the Study:
- To determine the serum cytokine profile in MMP patients.
- To assess the efficacy of tocilizumab in severe, refractory MMP cases, particularly those with elevated IL-6.
Main Methods:
- Serum proteomic analysis (Olink and Luminex) compared MMP patients, bullous pemphigoid (BP) patients, and healthy donors (HD).
- Nine severe MMP patients refractory to standard therapies received tocilizumab on a compassionate use basis.
Main Results:
- MMP patients exhibited significantly higher serum levels of IL-6, IL-8, MIP-1α/CCL3, and MIP-1β/CCL4 compared to BP and HD.
- Lower baseline levels of these cytokines correlated with complete remission in MMP.
- Tocilizumab treatment led to a significant decrease in MMPDAI scores, with 78% achieving partial remission and 11% complete remission.
Conclusions:
- MMP is associated with a distinct cytokine profile, including elevated IL-6, IL-8, MIP-1α/CCL3, and MIP-1β/CCL4.
- Targeting IL-6 with tocilizumab represents a potential therapeutic strategy for severe, refractory MMP.
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