{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T17:02:43Z","timestamp":1789664563359,"version":"4.0.1"},"reference-count":53,"publisher":"American Society of Hematology","issue":"17","content-domain":{"domain":["ashpublications.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,9,14]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Idiopathic multicentric Castleman disease (iMCD) is a poorly understood hematologic disorder involving cytokine-induced polyclonal lymphoproliferation, systemic inflammation, and potentially fatal multiorgan failure. Although the etiology of iMCD is unknown, interleukin-6 (IL-6) is an established disease driver in approximately one-third of patients. Anti\u2013IL-6 therapy, siltuximab, is the only US Food and Drug Administration\u2013approved treatment. Few options exist for siltuximab nonresponders, and no validated tests are available to predict likelihood of response. We procured and analyzed the largest-to-date cohort of iMCD samples, which enabled classification of iMCD into disease categories, discovery of siltuximab response biomarkers, and identification of therapeutic targets for siltuximab nonresponders. Proteomic quantification of 1178 analytes was performed on serum of 88 iMCD patients, 60 patients with clinico-pathologically overlapping diseases (human herpesvirus-8\u2013associated MCD, N = 20; Hodgkin lymphoma, N = 20; rheumatoid arthritis, N = 20), and 42 healthy controls. Unsupervised clustering revealed iMCD patients have heterogeneous serum proteomes that did not cluster with clinico-pathologically overlapping diseases. Clustering of iMCD patients identified a novel subgroup with superior response to siltuximab, which was validated using a 7-analyte panel (apolipoprotein E, amphiregulin, serum amyloid P-component, inactivated complement C3b, immunoglobulin E, IL-6, erythropoietin) in an independent cohort. Enrichment analyses and immunohistochemistry identified Janus kinase (JAK)\/signal transducer and activator of transcription 3 signaling as a candidate therapeutic target that could potentially be targeted with JAK inhibitors in siltuximab nonresponders. Our discoveries demonstrate the potential for accelerating discoveries for rare diseases through multistakeholder collaboration.<\/jats:p>","DOI":"10.1182\/bloodadvances.2020004016","type":"journal-article","created":{"date-parts":[[2021,8,26]],"date-time":"2021-08-26T21:57:33Z","timestamp":1630015053000},"page":"3445-3456","update-policy":"https:\/\/doi.org\/10.1182\/blood.2019cm0000","source":"Crossref","is-referenced-by-count":48,"title":["Discovery and validation of a novel subgroup and therapeutic target in idiopathic multicentric Castleman disease"],"prefix":"10.1182","volume":"5","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3736-1411","authenticated-orcid":false,"given":"Sheila K.","family":"Pierson","sequence":"first","affiliation":[{"name":"Center for Cytokine Storm Treatment & Laboratory, Department of Medicine, University of Pennsylvania, Philadelphia, PA;"},{"name":"Castleman Disease Collaborative Network, Philadelphia, PA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sushila","family":"Shenoy","sequence":"additional","affiliation":[{"name":"Medidata Solutions, New York, NY;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana B.","family":"Oromendia","sequence":"additional","affiliation":[{"name":"Medidata Solutions, New York, NY;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander M.","family":"Gorzewski","sequence":"additional","affiliation":[{"name":"Center for Cytokine Storm Treatment & Laboratory, Department of Medicine, University of Pennsylvania, Philadelphia, PA;"},{"name":"Castleman Disease Collaborative Network, Philadelphia, PA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruth-Anne","family":"Langan Pai","sequence":"additional","affiliation":[{"name":"Center for Cytokine Storm Treatment & Laboratory, Department of Medicine, University of Pennsylvania, Philadelphia, PA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher Shield","family":"Nabel","sequence":"additional","affiliation":[{"name":"Castleman Disease Collaborative Network, Philadelphia, PA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason R.","family":"Ruth","sequence":"additional","affiliation":[{"name":"Castleman Disease Collaborative Network, Philadelphia, PA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1917-0184","authenticated-orcid":false,"given":"Sophia A. 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