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Tocilizumab是一种人源化单克隆抗体,通过特异性结合白细胞介素-6(IL-6)的膜结合型受体(mIL-6R)与可溶性受体(sIL-6R),阻断IL-6与其受体IL-6R的相互作用,从而抑制下游JAK-STAT、MAPK/NF-κB等信号通路的激活[1]。该机制可有效干扰IL-6介导的炎症级联反应。Tocilizumab在人原代软骨细胞体外实验中能显著降低SOX-9、HIF-1α、BMP-2蛋白表达(分别下降71%、55%、81%)及IL-1β水平(下降67%),同时细胞活力仅轻微降低(27.7%),且未见明显细胞膜或核形态损伤,提示其具有较低细胞毒性[2]。
Tocilizumab在三阴性乳腺癌细胞模型中,通过抑制IL-6/STAT3/NF-κB正反馈环,能抑制细胞的增殖、迁移侵袭和上皮-间质转化过程,并下调Wnt/β-catenin通路以抑制肿瘤干细胞特性;同时可增强顺铂(Cisplatin,CDDP, 顺铂)的细胞毒性作用,并在人源化原位乳腺肿瘤小鼠模型中显著抑制肿瘤生长与EMT进程[3]。值得注意的是,体外实验证实Tocilizumab(RG-1569)能有效抑制人源细胞IL-6信号传导,但因种属特异性,无法与小鼠或大鼠IL-6受体结合,故在啮齿类细胞中无阻断效应[4]。
目前在动物实验层面,食蟹猴被选为Tocilizumab(托珠单抗)相关研究中最常用的物种,因为该抗体在体外和体内均能与猴IL-6R发生交叉反应。在食蟹猴胶原诱导性关节炎模型中,Tocilizumab给药后能显著减轻食蟹猴关节局部和全身的炎症反应,抑制炎症驱动的破骨细胞分化并使骨稳态恢复正常[5]。此外在猪崽(幼猪)缺血性骨坏死模型中使用15–20 mg/kg的Tocilizumab(每两周静脉注射),有效降低了滑膜炎程度、减少滑膜巨噬细胞的数量、抑制破骨细胞活性并促进新骨形成[6]。
参考文献及鸣谢
[1] Choong, D. J.; Tan, E. Does tocilizumab have a role in dermatology? A review of clinical applications, its adverse side effects and practical considerations. Dermatologic therapy 2021, 34 (4), e14990.
[2] Kilinc, B. R.; Kostak, F.; Yilmaz, O. F.; et al. The Effects of Tocilizumab on Inflammatory and Differentiation Pathways in Primary Human Chondrocytes: A Bioinformatic and In Vitro Approaches. International journal of rheumatic diseases 2025, 28 (7), e70336.
[3] Alraouji, N. N.; Al-Mohanna, F. H.; Ghebeh, H.; et al. Tocilizumab potentiates cisplatin cytotoxicity and targets cancer stem cells in triple-negative breast cancer. Molecular carcinogenesis 2020, 59 (9), 1041-1051.
[4] Lokau, J.; Kleinegger, F.; Garbers, Y.; et al. Tocilizumab does not block interleukin-6 (IL-6) signaling in murine cells. PloS one 2020, 15 (5), e0232612.
[5] Sheppard, M.; Laskou, F.; Stapleton, P. P.; et al. Tocilizumab (Actemra). Human vaccines & immunotherapeutics 2017, 13 (9), 1972-1988.
[6] Ren, Y.; Deng, Z.; Gokani, V.; et al. Anti-Interleukin-6 Therapy Decreases Hip Synovitis and Bone Resorption and Increases Bone Formation Following Ischemic Osteonecrosis of the Femoral Head. Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research 2021, 36 (2), 357-368.
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