Peripheral blood gene expression and IgG glycosylation profiles as markers of tocilizumab treatment in rheumatoid arthritis

Bertalan Mesko, Szilard Poliska, Szilvia Szamosi, Zoltan Szekanecz, Janos Podani, Csaba Varadi, Andras Guttman, Laszlo Nagy

Research output: Contribution to journalArticlepeer-review


Objective: Tocilizumab, a humanized anti-interleukin-6 receptor monoclonal antibody, has recently been approved as a biological therapy for rheumatoid arthritis (RA) and other diseases. It is not known if there are characteristic changes in gene expression and immunoglobulin G glycosylation during therapy or in response to treatment. Methods: Global gene expression profiles from peripheral blood mononuclear cells of 13 patients with RA and active disease at Week 0 (baseline) and Week 4 following treatment were obtained together with clinical measures, serum cytokine levels using ELISA, and the degree of galactosylation of the IgG N-glycan chains. Gene sets separating responders and nonresponders were tested using canonical variates analysis. This approach also revealed important gene groups and pathways that differentiate responders from nonresponders. Results: Fifty-nine genes showed significant differences between baseline and Week 4 and thus correlated with treatment. Significantly, 4 genes determined responders after correction for multiple testing. Ten of the 12 genes with the most significant changes were validated using real-time quantitative polymerase chain reaction. An increase in the terminal galactose content of N-linked glycans of IgG was observed in responders versus nonresponders, as well as in treated samples versus samples obtained at baseline. Conclusion: As a preliminary report, gene expression changes as a result of tocilizumab therapy in RA were examined, and gene sets discriminating between responders and nonresponders were found and validated. A significant increase in the degree of galactosylation of IgG N-glycans in patients with RA treated with tocilizumab was documented.

Original languageEnglish (US)
Pages (from-to)916-928
Number of pages13
JournalJournal of Rheumatology
Issue number5
StatePublished - May 2012
Externally publishedYes


  • Anti-interleukin-6 receptor
  • Drug response
  • Gene expression
  • IgG glycosylation
  • Tocilizumab

ASJC Scopus subject areas

  • Immunology and Allergy
  • Rheumatology
  • Immunology


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