Anti-IL-6 receptor monoclonal antibody as a new treatment of endometriosis

Ahmed A El-Zayadi, Sara A Mohamed, Mohammad Arafa, Shereen M Mohammed, Abdelhady Zayed, Mohamed S Abdelhafez, Ahmed M Badawy

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10 Citations (Scopus)


Many pro-inflammatory cytokines especially tumor necrotic factor alpha (TNFα), interleukin (IL)-1β, and IL-6 have crucial role in the pathogenesis of endometriosis. In this study, we investigated the immune-modulatory role of humanized anti-IL-6 receptor monoclonal antibodies in the treatment of endometriosis. This is a prospective, randomized, controlled, blinded study in which Sprague Dawley rats were used as animal model of endometriosis. Animals were randomly divided into two groups, a test group which received tocilizumab (Actemra; Roche, Switzerland) and a control group which received saline. Afterwards, a comparison was done between the eutopic and ectopic endometrium that was excised from both groups, histopathologically and immune-histochemically. Histopathologic assessment and immune-histochemical staining were performed using antibodies against IL-6. Tocilizumab significantly suppressed the volume of endometriotic lesions compared with non-treated rats (P = 0.006) and atrophied the ectopic endometrial-like epithelium (in 42.8% of treated rats vs 0% in the control group). Tocilizumab also decreased the anti-IL-6 receptor immune-histochemical staining intensity in ectopic endometrium (from non to +++ in the test group vs ++ or more in the control group), with no apparent difference in the eutopic one reflecting the down-regulation of IL-6-producing cells in ectopic endometriotic lesions. In rats with induced endometriosis, anti-IL-6 receptor monoclonal antibodies could offer a new horizon of usage of this immune-modulatory biologic drug, used in other autoimmune diseases, in treatment of endometriosis.

Original languageEnglish
Pages (from-to)389-397
Number of pages9
JournalImmunologic Research
Issue number6
Publication statusPublished - Dec 2020


  • Animals
  • Antibodies, Monoclonal/pharmacology
  • Biomarkers
  • Endometriosis/drug therapy
  • Female
  • Immunohistochemistry
  • Rats
  • Rats, Sprague-Dawley
  • Receptors, Interleukin-6/antagonists & inhibitors

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