IL-6 Receptor Blockade by Tocilizumab Has Anti-absence and Anti-epileptogenic Effects in the WAG/Rij Rat Model of Absence Epilepsy

• Published in: Neurotherapeutics Vol. 17; no. 4; pp. 2004 - 2014
• Main Authors: Leo, Antonio, Nesci, Valentina, Tallarico, Martina, Amodio, Nicola, Gallo Cantafio, Eugenia M., De Sarro, Giovambattista, Constanti, Andrew, Russo, Emilio, Citraro, Rita
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 01.10.2020; Springer Nature B.V
• Subjects: Animals; Antibodies, Monoclonal, Humanized - pharmacology; Antibodies, Monoclonal, Humanized - therapeutic use; Anxiety; Biomedical and Life Sciences; Biomedicine; Cerebrospinal fluid; Children; Comorbidity; Convulsions & seizures; Disease Models, Animal; Dose-Response Relationship, Drug; Epilepsy; Epilepsy, Absence - drug therapy; Epilepsy, Absence - genetics; Epilepsy, Absence - metabolism; Immunosuppressive agents; Inflammation; Interleukin 6; Interleukin 6 receptors; Lipopolysaccharides; Male; Monoclonal antibodies; Neurobiology; Neurology; Neurosciences; Neurosurgery; Original; Original Article; Rats; Rats, Transgenic; Rats, Wistar; Receptors, Interleukin-6 - antagonists & inhibitors; Receptors, Interleukin-6 - metabolism; Seizures; anxiety; tocilizumab; depressive-like behavior; Absence epilepsy; neuroinflammation; epileptogenesis
• ISSN: 1933-7213; 1878-7479; 1878-7479
• DOI: 10.1007/s13311-020-00893-8

Increased expression of interleukin-6 (IL-6) both in cerebrospinal fluid (CSF) and plasma is closely associated with convulsive epilepsy and symptom severity of depression. By comparison, at present, little is known about the role of this cytokine in childhood (non-convulsive) absence epilepsy. The aim of this work was to investigate the potential effects of acute and chronic treatment with tocilizumab (TCZ, 10 and 30 mg/kg/day), on absence seizures, their development, and related psychiatric comorbidity in WAG/Rij rats. It is known that lipopolysaccharide (LPS)-induced changes in inflammatory processes increase absence epileptic activity. In order to study the central effects of TCZ, we investigated whether administration of this anti-IL-6R antibody could modulate the lipopolysaccharide (LPS) or IL-6-evoked changes in absence epileptic activity in WAG/Rij rats. Our results demonstrate that TCZ, at both doses, significantly reduced the development of absence seizures in adult WAG/Rij rats at 6 months of age (1 month after treatment suspension) compared with untreated controls, thus showing disease-modifying effects. Decreased absence seizure development at 6 months of age was also accompanied by reduced comorbid depressive-like behavior, whereas no effects were observed on anxiety-related behavior. Acute treatment with TCZ, at 30 mg/kg, had anti-absence properties lasting ~25 h. The co-administration TCZ with i.c.v . LPS or IL-6 showed that TCZ inhibited the worsening of absence seizures induced by both proinflammatory agents in the WAG/Rij rats, supporting a central anti-inflammatory-like protective action. These results suggest the possible role of IL-6 and consequent neuroinflammation in the epileptogenic process underlying the development and maintenance of absence seizures in WAG/Rij rats. Accordingly, IL-6 signaling could be a promising pharmacological target in absence epilepsy and depressive-like comorbidity.