{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T20:06:22Z","timestamp":1790366782776,"version":"4.1.0"},"reference-count":29,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T00:00:00Z","timestamp":1779840000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T00:00:00Z","timestamp":1779840000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100005897","name":"Soci\u00e9t\u00e9 Fran\u00e7aise de Dermatologie et de Pathologie Sexuellement Transmissible","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100005897","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acad Dermatol Venereol"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Mucous membrane pemphigoid (MMP) is a rare autoimmune blistering disease involving mucous membranes with a potentially devastating fibrosing course. Laryngotracheal and\/or oesophageal involvement may lead to life\u2010threatening complications, while corneal involvement may lead to blindness.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To characterize the serum cytokine profile of MMP and to evaluate the efficacy of tocilizumab in nine cases of severe MMP according to the serum levels of IL\u20106.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Sera from MMP patients were compared to sex\u2010 and age\u2010matched healthy donors (HD) and patients with bullous pemphigoid (BP), using two proteomic assays (Olink and Luminex). The Olink assay included 40\u2009MMP, 40 BP and 40 HD sera, and the Luminex assay included 63\u2009MMP, 31 BP and 24 HD sera. Based on these findings, nine patients with severe and refractory MMP received tocilizumab on a compassionate use basis after failure of standard therapies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Proteomic analyses revealed high serum levels of IL\u20106, IL\u20108, MIP\u20101\u03b1\/CCL3 and MIP\u20101\u03b2\/CCL4 in MMP compared to BP and HD. Patients with MMP who achieved complete remission during follow\u2010up had lower baseline serum levels of IL\u20106 (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.0001), IL\u20108 (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0382), MIP\u20101\u03b1\/CCL3 (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0005) and MIP\u20101\u03b2\/CCL4 (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0009) than those with persistent disease activity.\n                    <\/jats:p>\n                    <jats:p>\n                      Nine patients with severe and refractory MMP were treated with tocilizumab. Their mean MMPDAI score decreased from 14.8\u2009\u00b1\u20096.6 to 4.2\u2009\u00b1\u20093.2 (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.009). At the last evaluation, seven patients (78%) were in partial remission, one (11%) in complete remission and one (11%) recently treated achieved control of disease activity. Baseline IL\u20106 was elevated in five of eight tested patients; all three with normal IL\u20106 levels improved clinically. Four non\u2010severe adverse events were observed (two neutropenias, one thrombocytopenia, one hepatic cytolysis).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Proteomic analyses identified a distinct MMP cytokine profile with increased IL\u20106, IL\u20108, MIP\u20101\u03b1\/CCL3 and MIP\u20101\u03b2\/CCL4, supporting IL\u20106 targeting, with tocilizumab as a potential option in severe refractory MMP.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jdv.70510","type":"journal-article","created":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T10:06:52Z","timestamp":1779876412000},"page":"1682-1691","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Tocilizumab for severe and refractory mucous membrane pemphigoid"],"prefix":"10.1111","volume":"40","author":[{"given":"Billal","family":"Tedbirt","sequence":"first","affiliation":[{"name":"Department of Dermatology, French Reference Center for Auto Immune Blistering Diseases Rouen University Hospital, Normandie University  Rouen France"},{"name":"Univ Rouen Normandie, Inserm, Normandie Univ, PANTHER UMR 1234  Rouen France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maud","family":"Maho\u2010Vaillant","sequence":"additional","affiliation":[{"name":"Univ Rouen Normandie, Inserm, Normandie Univ, PANTHER UMR 1234  Rouen France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8592-3810","authenticated-orcid":false,"given":"Julie","family":"Gueudry","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology Rouen University Hospital  Rouen 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France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S\u00e9bastien","family":"Calbo","sequence":"additional","affiliation":[{"name":"Univ Rouen Normandie, Inserm, Normandie Univ, PANTHER UMR 1234  Rouen France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andr\u00e9","family":"Gillibert","sequence":"additional","affiliation":[{"name":"Department of Biostatistics CHU Rouen  Rouen France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5734-0255","authenticated-orcid":false,"given":"Pascal","family":"Joly","sequence":"additional","affiliation":[{"name":"Department of Dermatology, French Reference Center for Auto Immune Blistering Diseases Rouen University Hospital, Normandie University  Rouen France"},{"name":"Univ Rouen Normandie, Inserm, Normandie Univ, PANTHER UMR 1234  Rouen 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