Options For Treating Castleman Disease

Antiviral Drugs

Often, Castleman disease (particularly multicentric) is associated with individuals diagnosed with HIV or AIDS. This is because they have a compromised immune system that allows for the infection of a virus called HHV8. HHV8 is a virus scientifically linked with an abnormal overgrowth of noncancerous cells in the lymph nodes around the body. Antiviral drugs are specially designed to fight off viruses in a way similar to how antibiotics are formulated to fight off bacteria. Antiviral medications also reduce the widespread inflammatory response by the immune system. They are also used in Castleman disease to help fight off the HHV8 virus when it is what caused the disease. The objective of antivirals in this respect is to actually inhibit the environment that fosters the growth and multiplication of the HHV8 virus, causing the virus to eventually die off. Antivirals do not actually kill off the virus themselves. If the antiviral medication is effective at treating the infection of the HHV8 virus, then it will also be effective at treating Castleman disease.

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Immunotherapy

Immunotherapy is a treatment that uses a man-made variation of normal elements of the immune system, or boosts the patient's immune function. The immune system makes antibodies to help fight off infections. Monoclonal antibodies or the man-made variation of antibodies are able to be formulated to target specific substances. With this type of therapy, the antibodies are programmed to target a certain substance that exists on the lymphocyte cell surfaces of which the disease initiates. In some cases of multicentric Castleman disease, there are increased levels of a protein named IL6 on the lymphocytes. A compound called siltuximab is effective at binding with this protein, and when this occurs, IL6 cannot act on the lymphocytes. In other cases of Castleman disease, a protein named CD20 exists on the surface of the lymphocyte cells. CD20 also plays a key role in the initiation of Castleman disease. An antibody called rituximab can attach to cells with the CD20 protein, and that attachment results in cell death. This helps stop the cell overgrowth in the lymph nodes.

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