Abstract
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.
Recent Findings
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.
Summary
Blocking the IL-1 pathway is a possible new therapeutic strategy, potentially leading to innovative therapies in many acute and chronic cardiovascular diseases.
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Abbreviations
- IL-1:
-
Interleukin-1
- NOD:
-
Nucleotide-binding domain
- NLR:
-
Nucleotide-binding domain-like receptor
- CARD:
-
Caspase activation recruitment domain
- AIM:
-
Absent in melanoma
- NLRP:
-
Nucleotide-binding domain, leucine-rich-containing family, pyrin domain-containing
- NLRC:
-
NLR-CARD (caspase activating and recruitment domain) containing
- PAMPs:
-
Pathogen-associated molecular patterns
- DAMPs:
-
Damage-associated molecular patterns
- TIR:
-
Toll/interleukin-1 receptor
- MyD88:
-
Myeloid differentiation primary response protein 88
- NF-kb:
-
Nuclear factor-kb
- MAPK:
-
Mitogen-activated protein kinase
- RA:
-
Rheumatoid arthritis
- CAPS:
-
Cryopyrin-associated periodic syndromes
- IRP:
-
Idiopathic recurrent pericarditis
- TRAPS:
-
Tumor necrosis factor receptor-1-associated periodic syndrome
- AIRTRIP:
-
Anakinra treatment of recurrent idiopathic pericarditis
- NSAIDs:
-
Non-steroidal anti-inflammatory drugs
- AIR-HF:
-
Anakinra (recombinant human interleukin-1 receptor antagonist) in heart failure
- CRP:
-
C-reactive protein
- ADHF:
-
Acute decompensated heart failure
- HF:
-
Heart failure
- LVEF:
-
Left ventricle ejection fraction
- D-HART:
-
Decompensated Heart failure Anakinra Response Trial
- HFpEF:
-
HF and preserved ejection fraction
- NYHA:
-
New York Heart Association
- REDHART:
-
Recently Decompensated Heart failure Anakinra Response Trial
- MI:
-
Myocardial infarction
- CAD:
-
Coronary artery disease
- VCU-ART:
-
Virginia Commonwealth University - Anakinra Remodeling Trial
- STEMI:
-
ST segment elevation
- MR:
-
Magnetic resonance
- QTc:
-
Corrected QT
- AF:
-
Atrial fibrillation
- FMF:
-
familial Mediterranean fever
- CANTOS:
-
Canakinumab Anti-inflammatory Thrombosis Outcome Study
- IL-6:
-
Interleukin-6
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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.
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Emmi, G., Urban, M.L., Imazio, M. et al. Use of Interleukin-1 Blockers in Pericardial and Cardiovascular Diseases. Curr Cardiol Rep 20, 61 (2018). https://doi.org/10.1007/s11886-018-1007-6
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DOI: https://doi.org/10.1007/s11886-018-1007-6