Found this on FB....

[Joseph14612]

New insights into mysterious blood vessel disease temporal arteritis...medicalxpress.com/news/2023...

[PMRpro Ambassador]

That second trigger is the reason that half of patients with GCA do not respond entirely to TCZ s the T-cell factor produces IL-9, TCZ works on IL-6 and that alone.

Not a bad historical article - more about the T-cell stuff would have been nice!

Thank-you

[Sharitone in reply to PMRpro]

Is IL-6 the cytokine that is referred to as the first breakpoint?

[Joseph14612 in reply to Sharitone]

My understanding is that it is the main culprit...buy for me, I don't know. because I have problems getting under 20 mg prednisone.

[PMRpro Ambassador in reply to Sharitone]

Not familiar with the term - what is it?

[Sharitone in reply to PMRpro]

Breakpoint? It was my predhead recollection of 'checkpoint' in the article, eg 'They found a second immune checkpoint that is not working in GCA.' (CD155)

[PMRpro Ambassador in reply to Sharitone]

Hahahahaha!!!! Well done - like it

[Sharitone in reply to PMRpro]

But I still don't know whether it is IL6 that they are referring to!

[PMRpro Ambassador in reply to Sharitone]

Oh right - it is the primary cause of the inflammation yes, but there is now evidence for T-cells and IL-9 (I think) to also be involved.

[DorsetLady PMRGCAuk volunteer]

Some interesting points - but I wish "they" would explain that -

a. a bulging temporal artery is not ALWAYS present, and

b. and even if it is affected, it does not cause sight loss- it's the ophthalmic artery deeper within within the brain that starves the optic nerve and affects sight.

I know - I didn't have an affected temporal artery [so no "obvious" sign] but I sure as heck had GCA and lost sight. .. and sure I wasn't, nor will continue to be the only one.

[Sophiestree]

Thank you. That was very interesting

[DAB-T]

Interesting article. Food for thought. Thank you.

Probably not unreasonable to extrapolate these findings and speculate a similar process occurs in PMR although I am not aware of any evidence for irreversible vascular damage in PMR and complete remission does occur.

A step too far to speculate that the abnormal immune response may protect those who suffer from GCA/PMR from some cancers though!

[Broseley in reply to DAB-T]

That is a reasonable conclusion though!