Open Access Open Badges Research article

Targeting IL-6 by both passive or active immunization strategies prevents bleomycin-induced skin fibrosis

Lucille Desallais1, Jérôme Avouac23*, Maxime Fréchet3, Muriel Elhai3, Rojo Ratsimandresy4, Matthieu Montes1, Hadley Mouhsine1, Hervé Do4, Jean-François Zagury1 and Yannick Allanore23

Author Affiliations

1 Chaire de Bioinformatique, Laboratoire Génomique, Bioinformatique et Applications, EA 4627, Conservatoire National des Arts et Métiers, 292 Rue Saint-Martin, 75003 Paris, France

2 Université Paris Descartes, Sorbonne Paris Cité, Service de Rhumatologie A, Hôpital Cochin, Université Paris Descartes, 27 rue du Faubourg Saint-Jacques, 75014 Paris, France

3 INSERM U1016/CNRS UMR8104, Institut Cochin, 22 Rue Mechain, 75014 Paris, France

4 Peptinov, Cochin Santé Business Accelerator ("Pépinière Cochin Santé"), Cochin Hospital, 29 rue du Faubourg Saint Jacques, 75014 Paris, France

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Arthritis Research & Therapy 2014, 16:R157  doi:10.1186/ar4672

Published: 24 July 2014



Interleukin-6 (IL-6) is a pleiotropic cytokine for which preliminary data have suggested that it might contribute to systemic sclerosis (SSc). Our aims were to investigate, firstly, IL-6 expression in patients with SSc and, secondly, the efficacy of both passive and active immunization against IL-6 to reduce skin fibrosis in complementary mouse models of SSc.


Human serum levels and skin expression of IL-6 were determined by enzyme-linked immunosorbent assay and immunohistochemistry, respectively. We first evaluated the antifibrotic properties of the monoclonal anti-IL-6R antibody, MR16-1, in the bleomycin-induced dermal fibrosis mouse model, reflecting early and inflammatory stages of SSc. Then, we assessed the efficacy of MR16-1 in tight skin-1 (Tsk-1) mice, an inflammation-independent model of skin fibrosis. Additionally, we have developed an innovative strategy using an anti-IL-6 peptide-based active immunization. Infiltrating leukocytes, T cells, and B cells were quantified, and IL-6 levels were measured in the serum and lesional skin of mice after passive or active immunization.


Serum and skin levels of IL-6 were significantly increased in patients with early SSc. Treatment with MR16-1 led in the bleomycin mouse model to a 25% (P = 0.02) and 30% (P = 0.007) reduction of dermal thickness and hydroxyproline content, respectively. MR16-1 demonstrated no efficacy in Tsk-1 mice. Thereafter, mice were immunized against a small peptide derived from murine IL-6 and this strategy led in the bleomycin model to a 20% (P = 0.02) and 25% (P = 0.005) decrease of dermal thickness and hydroxyproline content, respectively. Passive and active immunization led to decreased T-cell infiltration in the lesional skin of mice challenged with bleomycin. Upon bleomycin injections, serum and skin IL-6 levels were increased after treatment with MR16-1 and were significantly reduced after anti-IL-6 active immunization.


Our results support the relevance of targeting IL-6 in patients with early SSc since IL-6 is overexpressed in early stages of the disease. Targeting IL-6 by both passive and active immunization strategies prevented the development of bleomycin-induced dermal fibrosis in mice. Our results highlight the therapeutic potential of active immunization against IL-6, which is a seductive alternative to passive immunization.