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. 2019 Sep 16;129(10):4086–4088. doi: 10.1172/JCI131332

Figure 1. Inhibition of the IL-6 and mTOR pathways in iMCD influences symptoms.

Figure 1

IL-6 and IL-6 receptor (IL-6R) associate with the signal transducer gp130, leading to dimerization and activation of the JAK/STAT signaling cascade. Siltuximab neutralizes IL-6 and tocilizumab blocks the IL-6R. Growth factor (GF) binds to the receptor tyrosine kinase (RTK) leading to downstream activation of PI3 kinase (PI3K), AKT, and ultimately mTOR. Sirolimus binds to the tacrolimus binding protein (FKBP), and together sirolimus and FKBP inhibit mTOR activity.