Use of Interleukin-1 Blockers in Pericardial and Cardiovascular Diseases
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Purpose of Review
This review aims to summarize the role of the interleukin-1 (IL-1) blocking agents in cardiovascular diseases, briefly describing the pathogenetic rationale and the most relevant clinical studies.
IL-1 is a pivotal cytokine of the innate immune system. Anti-IL-1 agents are currently used for the treatment of several autoimmune and autoinflammatory conditions. Recently, the role of IL-1 has also emerged in cardiovascular diseases. Indeed, two recent randomized controlled trials have shown that the IL-1 receptor antagonist anakinra is effective for the treatment of idiopathic recurrent pericarditis and the IL-1β blocking agent canakinumab is effective in reducing myocardial infarction in people at risk. Interestingly, interfering with IL-1 has proved to be also effective in other cardiovascular manifestations, such as myocarditis, arrhythmias, and heart failure.
Blocking the IL-1 pathway is a possible new therapeutic strategy, potentially leading to innovative therapies in many acute and chronic cardiovascular diseases.
KeywordsInterleukin-1 Anakinra Canakinumab Pericarditis Atherosclerosis Cardiovascular disease
Nucleotide-binding domain-like receptor
Caspase activation recruitment domain
Absent in melanoma
Nucleotide-binding domain, leucine-rich-containing family, pyrin domain-containing
NLR-CARD (caspase activating and recruitment domain) containing
Pathogen-associated molecular patterns
Damage-associated molecular patterns
Myeloid differentiation primary response protein 88
Mitogen-activated protein kinase
Cryopyrin-associated periodic syndromes
Idiopathic recurrent pericarditis
Tumor necrosis factor receptor-1-associated periodic syndrome
Anakinra treatment of recurrent idiopathic pericarditis
Non-steroidal anti-inflammatory drugs
Anakinra (recombinant human interleukin-1 receptor antagonist) in heart failure
Acute decompensated heart failure
Left ventricle ejection fraction
Decompensated Heart failure Anakinra Response Trial
HF and preserved ejection fraction
New York Heart Association
Recently Decompensated Heart failure Anakinra Response Trial
Coronary artery disease
Virginia Commonwealth University - Anakinra Remodeling Trial
ST segment elevation
familial Mediterranean fever
Canakinumab Anti-inflammatory Thrombosis Outcome Study
Compliance with Ethical Standards
Conflict of Interest
Giacomo Emmi has received personal fees for consultancy from GSK and for advisory board from Novartis.
Maria Letizia Urban and Silvia Maestroni declare that they have no conflict of interest.
Massimo Imazio has received an Institutional Grant for Clinical Research from SOBI.
Marco Gattorno has received fees and unrestricted grants from SOBI and Novartis.
Giuseppe Lopalco has received speaker fees from Novartis and SOBI.
Luca Cantarini has received personal fees from Novartis and SOBI.
Domenico Prisco has received grants for advisory boards from Bayer, Daichi Sankyo, Boehringer Ingelheim, BMS Pfizer, and Baxter.
Antonio Brucato has received unrestricted grants from ACARPIA and SOBI and for advisory board from SOBI.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Papers of particular interest, published recently, have been highlighted as: • Of importance•• Of major Importance
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