1
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Calabrese L, Fiocco Z, Satoh TK, Peris K, French LE. Therapeutic potential of targeting IL-1 family cytokines in chronic inflammatory skin diseases. Br J Dermatol 2022; 186:925-941. [PMID: 34990008 DOI: 10.1111/bjd.20975] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 12/15/2021] [Accepted: 12/30/2021] [Indexed: 11/27/2022]
Abstract
The interleukin-1 (IL-1) family of cytokines is a central regulator of a myriad of immunological responses. It comprises several cytokines, including those belonging to the IL-1, IL-36 and IL-18 subfamilies, as well as IL-33. The IL-1 family primarily plays a role in orchestrating innate immune responses but also in adaptive immunity. Increased interest in the IL-1 family occurred following the discovery that dysregulation of IL-1 signalling underlies the pathogenesis of several monogenic auto-inflammatory diseases, characterized by sterile inflammation involving the skin and other organs. This also provided increased understanding of the role of innate immunity and the IL-1 family in polygenic auto-inflammatory skin conditions, such as neutrophilic dermatoses, as well as in some of the most common chronic inflammatory skin diseases, such as psoriasis or hidradenitis suppurativa. Several therapeutic agents have been developed to inhibit the IL-1 family members and their signalling pathways. These have shown therapeutic efficacy in several chronic inflammatory skin disorders. The aim of this review is to thoroughly describe the consequences of pathological dysregulation of IL-1, IL-33, IL-36, IL-18 pathways in dermatological conditions and to provide a forward-looking update on therapeutic strategies targeting signalling by IL-1 family cytokines.
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Affiliation(s)
- Laura Calabrese
- Institute of Dermatology, Catholic University of the Sacred Heart, Rome, Italy.,Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.,Department of Dermatology and Allergy, University Hospital, LMU, Munich, Germany
| | - Zeno Fiocco
- Department of Dermatology and Allergy, University Hospital, LMU, Munich, Germany
| | - Takashi K Satoh
- Department of Dermatology and Allergy, University Hospital, LMU, Munich, Germany
| | - Ketty Peris
- Institute of Dermatology, Catholic University of the Sacred Heart, Rome, Italy.,Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Lars E French
- Department of Dermatology and Allergy, University Hospital, LMU, Munich, Germany.,Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami, Miller School of Medicine, Miami, Florida
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2
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Stefania S, Colia R, Cinzia R, Corrado A, Cantatore FP. Off-label use of anti-IL-1 drugs in rheumatic diseases. Int J Immunopathol Pharmacol 2021; 35:20587384211006584. [PMID: 33855881 PMCID: PMC8056561 DOI: 10.1177/20587384211006584] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Interleukin-1 (IL-1) plays a key role in the pathogenesis of different rheumatic diseases. There are now several agents available on the market capable of blocking IL-1. The proven effectiveness and excellent safety of these drugs makes them a possible therapeutic option in the treatment of IL-1 driven diseases, when previous therapies are contraindicated or ineffective. This article discusses the European wide off-label use of these drugs for the treatment of rheumatic diseases.
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Affiliation(s)
- Silvia Stefania
- Rheumatology Clinic, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Ripalta Colia
- Rheumatology Clinic, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Rotondo Cinzia
- Rheumatology Clinic, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Addolorata Corrado
- Rheumatology Clinic, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Francesco Paolo Cantatore
- Rheumatology Clinic, Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
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3
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Abstract
Erdheim-Chester disease (ECD) is a rare but increasingly recognized multi-system disorder. Its diagnosis and treatment require integration of clinical information, imaging studies, and pathology studies. Of note, ECD can now be defined as a clonal myeloid disorder due to mutations which activate mitogen-activated protein kinase (MAPK) pathways and where an inflammatory milieu is important in the pathogenesis and clinical manifestations of the disease. Biopsy demonstrating characteristic histopathologic features in addition to clinical and radiographic features, most often sclerosing long bone involvement, is required to establish a diagnosis. Detection of somatic MAPK pathway mutations can also assist in the differential diagnosis of ECD and related histiocytic neoplasms. Also, genetic analysis establishing BRAF and RAS mutational status is critical in all ECD patients, as these features will impact therapy with MAPK inhibition. Therapy is recommended at diagnosis in all patients, except for those patients with minimally symptomatic disease. Prospective therapeutic trials are essential to furthering therapeutic progress in ECD.
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Affiliation(s)
- Gordon Starkebaum
- University of Washington, Division of Rheumatology, 1959 NE Pacific St., Box 356428, Seattle, WA, 98195-6428, USA.
| | - Paul Hendrie
- Division of Hematology, University of Washington, 1959 NE Pacific St., Box 358081, Seattle, WA, 98195-6428, USA.
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4
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Zhang SJ, Guo X, Hu P, Lu SY, Liu NN, Fu BQ, Wang N, Li YS, Wang LL, Chang J, Chang HZ, Liu ZS, Zhou Y, Ren HL. Characterization of a Novel Interleukin-1 Receptor Antagonist from Sheep ( Ovis aries). J Interferon Cytokine Res 2020; 40:268-278. [PMID: 32233931 DOI: 10.1089/jir.2019.0182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Interleukin-1 receptor antagonist (IL-1Ra) is an antagonist of IL-1β binding IL-1β receptors but does not induce intracellular responses or signal transduction. In this study, the full-length complementary DNA (cDNA) of the IL-1Ra gene (OaIL-1Ra) was identified from sheep (Ovis aries) using rapid amplification of cDNA ends PCR and submitted to GenBank with the accession number KC425613. The OaIL-1Ra cDNA comprised an open reading frame of 525 bp encoding a protein of 19765.8 Da, a 5'-untranslated region (UTR) of 27 bp, and a 3'-UTR of 676 bp with a poly(A) tail. Recombinant OaIL-1Ra with bioactivity was expressed in a prokaryotic expression system, and a monoclonal antibody against native OaIL-1Ra was prepared. Through Western blot analyses, the OaIL-1Ra protein was widely expressed in lung, heart, spleen, liver, kidney, muscle, intestine, lymphonodi, rumen, and white blood cells, with the highest levels in liver and spleen. The expression of OaIL-1Ra in primary cultured white blood cells of sheep were highly induced in a time-dependent manner when challenged with different bacteria. These results implied that OaIL-1Ra is associated with immune responses during bacterial infections.
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Affiliation(s)
- Shi-Jun Zhang
- Key Laboratory of Zoonosis Research, Ministry of Education, Institute of Zoonosis / College of Veterinary Medicine, Jilin University, Changchun, China
| | - Xing Guo
- Key Laboratory of Zoonosis Research, Ministry of Education, Institute of Zoonosis / College of Veterinary Medicine, Jilin University, Changchun, China.,Panjin Inspection and Testing Center, Panjin, China
| | - Pan Hu
- Key Laboratory of Zoonosis Research, Ministry of Education, Institute of Zoonosis / College of Veterinary Medicine, Jilin University, Changchun, China
| | - Shi-Ying Lu
- Key Laboratory of Zoonosis Research, Ministry of Education, Institute of Zoonosis / College of Veterinary Medicine, Jilin University, Changchun, China
| | - Nan-Nan Liu
- Key Laboratory of Zoonosis Research, Ministry of Education, Institute of Zoonosis / College of Veterinary Medicine, Jilin University, Changchun, China
| | - Bao-Quan Fu
- State Key Laboratory of Veterinary Etiological Biology, Key Laboratory of Veterinary Public Health of the Ministry of Agriculture, Key Laboratory of Veterinary Parasitology of Gansu Province, Lanzhou Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Lanzhou, China
| | - Nan Wang
- Jilin Provincal Center for Animal Disease Control and Prevention, Changchun, China
| | - Yan-Song Li
- Key Laboratory of Zoonosis Research, Ministry of Education, Institute of Zoonosis / College of Veterinary Medicine, Jilin University, Changchun, China
| | - Lu-Lu Wang
- Key Laboratory of Zoonosis Research, Ministry of Education, Institute of Zoonosis / College of Veterinary Medicine, Jilin University, Changchun, China
| | - Jiang Chang
- Key Laboratory of Zoonosis Research, Ministry of Education, Institute of Zoonosis / College of Veterinary Medicine, Jilin University, Changchun, China
| | - Heng-Zhen Chang
- Key Laboratory of Zoonosis Research, Ministry of Education, Institute of Zoonosis / College of Veterinary Medicine, Jilin University, Changchun, China
| | - Zeng-Shan Liu
- Key Laboratory of Zoonosis Research, Ministry of Education, Institute of Zoonosis / College of Veterinary Medicine, Jilin University, Changchun, China
| | - Yu Zhou
- Key Laboratory of Zoonosis Research, Ministry of Education, Institute of Zoonosis / College of Veterinary Medicine, Jilin University, Changchun, China
| | - Hong-Lin Ren
- Key Laboratory of Zoonosis Research, Ministry of Education, Institute of Zoonosis / College of Veterinary Medicine, Jilin University, Changchun, China
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5
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Cavalli G, Dagna L, Biavasco R, Villa A, Doglioni C, Ferrero E, Ferrarini M. Erdheim-Chester disease: An in vivo human model of Mϕ activation at the crossroad between chronic inflammation and cancer. J Leukoc Biol 2020; 108:591-599. [PMID: 32056262 DOI: 10.1002/jlb.3mr0120-203rr] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Revised: 01/16/2020] [Accepted: 01/20/2020] [Indexed: 12/13/2022] Open
Abstract
Erdheim-Chester disease (ECD) is a rare histiocytosis characterized by infiltration of multiple tissues by CD68+ foamy Mϕs (or 'histiocytes'). Clinical manifestations arise from mass-forming lesions or from tissue and systemic inflammation. ECD histiocytes harbor oncogenic mutations along the MAPK-kinase signaling pathway (BRAFV600E in more than half of the patients), and secrete abundant pro-inflammatory cytokines and chemokines. Based on these features, ECD is considered an inflammatory myeloid neoplasm, and is accordingly managed with targeted kinase inhibitors or immunosuppressive and cytokine-blocking agents. Evidence is emerging that maladaptive metabolic changes, particularly up-regulated glycolysis, represent an additional, mutation-driven feature of ECD histiocytes, which sustains deregulated and protracted pro-inflammatory activation and cytokine production. Besides translational relevance to the management of ECD patients and to the development of new therapeutic approaches, recognition of ECD as a natural human model of chronic, maladaptive Mϕ activation instructs the understanding of Mϕ dysfunction in other chronic inflammatory conditions.
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Affiliation(s)
- Giulio Cavalli
- Vita-Salute San Raffaele University, Milan, Italy.,Unit of Immunology, Rheumatology, Allergy and Rare Diseases (UnIRAR), San Raffaele Scientific Institute, Milan, Italy
| | - Lorenzo Dagna
- Vita-Salute San Raffaele University, Milan, Italy.,Unit of Immunology, Rheumatology, Allergy and Rare Diseases (UnIRAR), San Raffaele Scientific Institute, Milan, Italy
| | - Riccardo Biavasco
- Vita-Salute San Raffaele University, Milan, Italy.,San Raffaele Telethon Institute for Gene Therapy (SR-Tiget), San Raffaele Scientific Institute, Milan, Italy
| | | | - Claudio Doglioni
- Vita-Salute San Raffaele University, Milan, Italy.,Pathology Unit, San Raffaele Scientific Institute, Milan, Italy
| | - Elisabetta Ferrero
- Division of Experimental Oncology, San Raffaele Scientific Institute, Milan, Italy
| | - Marina Ferrarini
- Division of Experimental Oncology, San Raffaele Scientific Institute, Milan, Italy
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6
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Tomelleri A, Cavalli G, De Luca G, Campochiaro C, D’Aliberti T, Tresoldi M, Dagna L. Treating Heart Inflammation With Interleukin-1 Blockade in a Case of Erdheim-Chester Disease. Front Immunol 2018; 9:1233. [PMID: 29910817 PMCID: PMC5992291 DOI: 10.3389/fimmu.2018.01233] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2018] [Accepted: 05/16/2018] [Indexed: 12/30/2022] Open
Abstract
Pericarditis is an inflammatory heart disease, which may be idiopathic or secondary to autoimmune or auto-inflammatory diseases and often leads to severe or life-threatening complications. Colchicine and non-steroidal anti-inflammatory drugs represent the mainstay of treatment, whereas use of corticosteroids is associated with recurrence of disease flares. While effective and safe anti-inflammatory therapies remain an unmet clinical need, emerging clinical and experimental evidence points at a promising role of inhibition of the pro-inflammatory cytokine interleukin-1 (IL-1). We thus evaluated treatment with the IL-1 receptor antagonist anakinra in a case of extremely severe pericarditis with cardiac tamponade and heart failure secondary to Erdheim-Chester disease (ECD), a rare clonal disorder of macrophages characterized by rampant inflammation and multiorgan involvement. A 62-year-old man was admitted to the Emergency Department with severe pericardial effusion requiring the creation of a pleuro-pericardial window. A whole-body contrast-enhanced computed tomography pointed at a diagnosis of ECD with involvement of the heart and pericardium and of the retroperitoneal space. Over the following days, an echocardiography revealed a closure of the pleuro-pericardial window and a relapse of the pericardial effusion. Treatment with anakinra, the recombinant form of the naturally occurring IL-1 receptor antagonist, was started at a standard subcutaneous dose of 100 mg/day. After 2 days, we observed a dramatic clinical improvement, an abrupt reduction of the inflammatory markers, and a reabsorption of the pericardial effusion. Anakinra was maintained as monotherapy, and the patient remained asymptomatic in the absence of disease flares for the following year. Recent studies point at inhibition of IL-1 activity as an attractive treatment option for patients with refractory idiopathic recurrent pericarditis. Anakinra treatment may also have a role in patients with pericarditis in the setting of systemic inflammatory disorders, such as ECD.
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Affiliation(s)
- Alessandro Tomelleri
- Unit of Immunology, Rheumatology, Allergy and Rare Diseases, IRCCS San Raffaele Hospital and Vita-Salute San Raffaele University, Milan, Italy
| | - Giulio Cavalli
- Unit of Immunology, Rheumatology, Allergy and Rare Diseases, IRCCS San Raffaele Hospital and Vita-Salute San Raffaele University, Milan, Italy
| | - Giacomo De Luca
- Unit of Immunology, Rheumatology, Allergy and Rare Diseases, IRCCS San Raffaele Hospital and Vita-Salute San Raffaele University, Milan, Italy
| | - Corrado Campochiaro
- Unit of Immunology, Rheumatology, Allergy and Rare Diseases, IRCCS San Raffaele Hospital and Vita-Salute San Raffaele University, Milan, Italy
| | - Teresa D’Aliberti
- Department of Internal Medicine and Advanced Therapies, San Raffaele Hospital (IRCCS), Milan, Italy
| | - Moreno Tresoldi
- Department of Internal Medicine and Advanced Therapies, San Raffaele Hospital (IRCCS), Milan, Italy
| | - Lorenzo Dagna
- Unit of Immunology, Rheumatology, Allergy and Rare Diseases, IRCCS San Raffaele Hospital and Vita-Salute San Raffaele University, Milan, Italy
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7
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Franconieri F, Deshayes S, de Boysson H, Trad S, Martin Silva N, Terrier B, Bienvenu B, Galateau-Sallé F, Emile JF, Johnson AC, Aouba A. Superior efficacy and similar safety of double dose anakinra in Erdheim-Chester disease after single dose treatment. Oncoimmunology 2018; 7:e1450712. [PMID: 30221042 DOI: 10.1080/2162402x.2018.1450712] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2018] [Revised: 02/13/2018] [Accepted: 03/03/2018] [Indexed: 10/17/2022] Open
Abstract
Objectives. In Erdheim-Chester disease (ECD), the empirical single dose (SD, 100 mg/day) anakinra sometimes induces only partial responses. Since SD is usually well tolerated, doubling the dose might improve response while maintaining an acceptable safety profile. Methods. A retrospective analysis was performed of outcomes under double-dose (DD) of anakinra in 4 ECD patients who did not exhibit a complete response (CR) under SD treatment. Bone, retroperitoneal, neurologic/orbital, peritoneal, pericardial, right atrium, and pleural involvements were recorded. CR, partial response (PR), stable disease, progressive disease (PD) and tolerance of DD were assessed. Results. SD treatment was a second or third line treatment in three patients after interferon-therapy failure. Two patients, including one with a BRAF mutation, achieved a CR and one patient with a NRAS mutation achieved a PR with DD treatment. The fourth patient, wild-type for both genes, did not respond to a first DD treatment, but then achieved CR under SD associated with a reduced dose of vemurafenib (960 mg/d). Bone and retroperitoneal lesions partially improved on imaging with SD in all patients, but were further improved under DD with two patients achieving CR. With SD treatment, two patients with right atrial masses showed sustained CR. Under DD treatment, two patients with massive serositis refractory to SD, showed PR. Conclusion. DD improved the response to anakinra and lead to two CRs and a PR in three out of four ECD patients, with minor and comparable side-effects to those of SD, while failures were essentially related to massive serositis.
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Affiliation(s)
- Fréderic Franconieri
- CHU de Caen, Department of Internal Medicine and Clinical Immunology, Caen, F-14000, France
| | - Samuel Deshayes
- CHU de Caen, Department of Internal Medicine and Clinical Immunology, Caen, F-14000, France
| | - Hubert de Boysson
- CHU de Caen, Department of Internal Medicine and Clinical Immunology, Caen, F-14000, France
| | - Salim Trad
- CHU Ambroise Paré - Université Paris Ouest, Department of Internal Medicine, Boulogne-Billancourt, France
| | - Nicolas Martin Silva
- CHU de Caen, Department of Internal Medicine and Clinical Immunology, Caen, F-14000, France
| | | | - Boris Bienvenu
- CHU de Caen, Department of Internal Medicine and Clinical Immunology, Caen, F-14000, France
| | - Françoise Galateau-Sallé
- National referent center MESOPATH-Base National Clinicobiologic Databasis MESOBANK Register multicenter MESONAT-Sante public cancer center of Léon Bérard, Department of Biopathology, Lyon, France
| | - Jean-François Emile
- Department of Pathology, Ambroise Paré Hospital & EA4340, Versailles, Boulogne, France
| | - Alison C Johnson
- François Baclesse Cancer Center, Department of Oncology, Caen, France
| | - Achille Aouba
- CHU de Caen, Department of Internal Medicine and Clinical Immunology, Caen, F-14000, France
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8
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Li T, Li YT, Song DY. The expression of IL-1β can deteriorate the prognosis of nervous system after spinal cord injury. Int J Neurosci 2018; 128:778-782. [PMID: 29308940 DOI: 10.1080/00207454.2018.1424154] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
PURPOSE We used Anakinra to inhibit the expression of IL-1β based on the model of spinal cord injury in the rat stomach and explored whether it had a certain neuroprotective effect after spinal cord injury. MATERIALS AND METHODS The spinal cord injury model of four segments (T5-T8) was prepared by using vascular clamp. Thirty rats were randomized to the control group and the experimental group, and the control group used normal saline, while the experimental group used Anakinra after spinal cord injury. The spinal cord tissue was extracted at 6 h and 24 h after the operation to carry out the histopathological evaluation and to analyze the contents of IL-1β and malondialdehyde and the activities of glutathione peroxidase and superoxide dismutase. RESULTS Edema and inflammatory cell infiltration were obviously seen after spinal cord injury, the IL-1β level in serum was significantly increased, but the activity of glutathione peroxidase, superoxide dismutase and catalase was decreased in the control group compared with the experimental group. The experimental group could increase the activity of antioxidant enzymes, but had no significant effect on malondialdehyde. CONCLUSIONS Anakinra had a certain protective effect through the inhibition of IL-1β on spinal cord injury.
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Affiliation(s)
- Tao Li
- a Department of Spinal Surgery , Shandong Provincial Hospital Affiliated to Shandong University , Jinan , Shandong , P.R. China
| | - Yu-Tang Li
- b Department of Microbiology and Infectious Disease Center , School of Basic Medical Sciences, Peking University Health Science Center , Beijing , P.R. China
| | - Di-Yu Song
- c Department of Orthopedics , The General Hospital of the PLA Rocket Force , Beijing , P.R. China
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9
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Jia X, Ning X, Bai Q, Leng N, Wang S, Wang X, Yang S. Combination of adalimumab with lower dose of methylprednisolone in Erdheim-Chester disease with systemic involvement. Acta Oncol 2017; 56:753-756. [PMID: 28080175 DOI: 10.1080/0284186x.2016.1276213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Xin Jia
- Department of Geriatrics, Xi Jing Hospital, The Fourth Military Medical University, Xi’an, China
| | - Xiaoxuan Ning
- Department of Geriatrics, Xi Jing Hospital, The Fourth Military Medical University, Xi’an, China
| | - Qingxian Bai
- Department of Hemotology, Xi Jing Hospital, The Fourth Military Medical University, Xi’an, China
| | - Nan Leng
- Department of Clinical Immunology, Xi Jing Hospital, The Fourth Military Medical University, Xi’an, China
| | - Shengjun Wang
- Department of Nuclear Medicine, Xi Jing Hospital, The Fourth Military Medical University, Xi’an, China
| | - Xiaoming Wang
- Department of Geriatrics, Xi Jing Hospital, The Fourth Military Medical University, Xi’an, China
| | - Shoujing Yang
- Department of Pathology, Xi Jing Hospital, The Fourth Military Medical University, Xi’an, China
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10
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Cavalli G, De Luca G, Dagna L. Advances in potential targeted therapies for Erdheim-Chester disease. Expert Opin Orphan Drugs 2017. [DOI: 10.1080/21678707.2017.1285226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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11
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Anakinra as efficacious therapy for 2 cases of intracranial Erdheim-Chester disease. Blood 2016; 128:1896-1898. [PMID: 27535996 DOI: 10.1182/blood-2016-06-725143] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
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12
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Variability in the efficacy of the IL1 receptor antagonist anakinra for treating Erdheim-Chester disease. Blood 2016; 127:1509-12. [PMID: 26847247 DOI: 10.1182/blood-2015-09-672667] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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13
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Cavalli G, Dinarello CA. Treating rheumatological diseases and co-morbidities with interleukin-1 blocking therapies. Rheumatology (Oxford) 2015. [PMID: 26209330 DOI: 10.1093/rheumatology/kev269] [Citation(s) in RCA: 76] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
The inflammatory cytokines IL-1α and IL-1β orchestrate local and systemic inflammatory responses underlying a broad spectrum of diseases. Three agents for reducing IL-1 activities are currently available. Anakinra is a recombinant form of the naturally occurring IL-1 receptor antagonist. Anakinra binds to the IL-1 receptor and prevents the activity of IL-1α and IL-1β. The soluble decoy receptor rilonacept and the neutralizing mAb canakinumab block IL-1β. A mAb directed against the IL-1 receptor and a neutralizing anti-human IL-1α are in clinical trials. The availability of therapies specifically targeting IL-1 unveiled the pathological role of IL-1-mediated inflammation in a broadening list of diseases. Conditions effectively treated with agents blocking IL-1 range from classic rheumatic diseases, such as RA and gout, to autoinflammatory syndromes, such as systemic JIA and FMF. However, IL-1 antagonism is also effective against highly prevalent inflammatory diseases, namely cardiovascular diseases and type 2 diabetes, conditions that are frequently encountered as co-morbidities in patients with rheumatic diseases. Thereby, IL-1 inhibition has the potential to lift the burden of disease for patients with rheumatic conditions, but also to provide clinical benefits beyond the efficacy on osteoarticular manifestations.
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Affiliation(s)
- Giulio Cavalli
- Department of Medicine, University of Colorado Denver, Aurora, CO, USA, Division of Internal Medicine and Clinical Immunology, IRCCS San Raffaele Scientific Institute, Milan, Italy and
| | - Charles A Dinarello
- Department of Medicine, University of Colorado Denver, Aurora, CO, USA, Department of Internal Medicine, Radboud University Medical Centre, Nijmegen, The Netherlands
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14
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Hasturk AE, Yilmaz ER, Turkoglu E, Arikan M, Togral G, Hayirli N, Erguder BI, Evirgen O. Potential neuroprotective effect of Anakinra in spinal cord injury in an in vivo experimental animal model. ACTA ACUST UNITED AC 2015; 20:124-30. [PMID: 25864064 PMCID: PMC4727622 DOI: 10.17712/nsj.2015.2.20140483] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To evaluate the therapeutic effects of inhibiting interleukin-1 beta (IL-1 beta) in vivo using Anakinra in an experimental model of spinal cord injury (SCI). METHODS All experimental procedures were performed in the animal laboratory of Ankara Education and Research Hospital, Ankara, Turkey between August 2012 and May 2014. The SCI was induced by applying vascular clips to the dura via a 4-level T5-T8 laminectomy. Fifty-four rats were randomized into the following groups: controls (n = 18), SCI + saline (n = 18), and SCI + Anakinra (n = 18). Spinal cord samples were obtained from animals in both SCI groups at one, 6, and 24 hours after surgery (n = 6 for each time point). Spinal cord tissue and serum were extracted, and the levels of IL-1 beta, malondialdehyde, glutathione peroxidase, superoxide dismutase, and catalase were analyzed. Furthermore, histopathological evaluation of the tissues was performed. RESULTS The SCI in rats caused severe injury characterized by edema, neutrophil infiltration, and cytokine production followed by recruitment of other inflammatory cells, lipid peroxidation, and increased oxidative stress. After SCI, tissue and serum IL-1 beta levels were significantly increased, but were significantly decreased by Anakinra administration. Following trauma, glutathione peroxidase, superoxide dismutase, and catalase levels were decreased; however, Anakinra increased the activity of these antioxidant enzymes. Malondialdehyde levels were increased after trauma, but were unaffected by Anakinra. Histopathological analysis showed that Anakinra effectively protected the spinal cord tissue from injury. CONCLUSION Treatment with Anakinra reduces inflammation and other tissue injury events associated with SCI.
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Affiliation(s)
- Askin E Hasturk
- Department of Neurosurgery, Oncology Training and Research Hospital, Demetevler, Ankara, Turkey. E-mail:
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15
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Dinarello CA. An expanding role for interleukin-1 blockade from gout to cancer. Mol Med 2014; 20 Suppl 1:S43-58. [PMID: 25549233 PMCID: PMC4374514 DOI: 10.2119/molmed.2014.00232] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2014] [Accepted: 11/17/2014] [Indexed: 01/08/2023] Open
Abstract
There is an expanding role for interleukin (IL)-1 in diseases from gout to cancer. More than any other cytokine family, the IL-1 family is closely linked to innate inflammatory and immune responses. This linkage is because the cytoplasmic segment of all members of the IL-1 family of receptors contains a domain, which is highly homologous to the cytoplasmic domains of all toll-like receptors (TLRs). This domain, termed "toll IL-1 receptor (TIR) domain," signals as does the IL-1 receptors; therefore, inflammation due to the TLR and the IL-1 families is nearly the same. Fundamental responses such as the induction of cyclo-oxygenase type 2, increased surface expression of cellular adhesion molecules and increased gene expression of a broad number of inflammatory molecules characterizes IL-1 signal transduction as it does for TLR agonists. IL-1β is the most studied member of the IL-1 family because of its role in mediating autoinflammatory disease. However, a role for IL-1α in disease is being validated because of the availability of a neutralizing monoclonal antibody to human IL-1α. There are presently three approved therapies for blocking IL-1 activity. Anakinra is a recombinant form of the naturally occurring IL-1 receptor antagonist, which binds to the IL-1 receptor and prevents the binding of IL-1β as well as IL-1α. Rilonacept is a soluble decoy receptor that neutralizes primarily IL-1β but also IL-1α. Canakinumab is a human monoclonal antibody that neutralizes only IL-1β. Thus, a causal or significant contributing role can be established for IL-1β and IL-1α in human disease.
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Affiliation(s)
- Charles Anthony Dinarello
- Department of Medicine, Division of Infectious Diseases, University of Colorado Denver, Aurora, Colorado, United States of America; and Department of Medicine, Radboud University, Nijmegen, the Netherlands
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Tran TA, Pariente D, Guitton C, Delwail A, Barat-Houari M, Meinzer U. Treatment of Erdheim–Chester disease with canakinumab. Rheumatology (Oxford) 2014; 53:2312-4. [DOI: 10.1093/rheumatology/keu344] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Cavalli G, Biavasco R, Borgiani B, Dagna L. Oncogene-induced senescence as a new mechanism of disease: the paradigm of erdheim-chester disease. Front Immunol 2014; 5:281. [PMID: 24982657 PMCID: PMC4056107 DOI: 10.3389/fimmu.2014.00281] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2014] [Accepted: 05/29/2014] [Indexed: 12/31/2022] Open
Abstract
Erdheim–Chester disease (ECD) is a rare form of systemic histiocytosis characterized by the diffuse infiltration of tissues by lipid-laden macrophages. As the clinical course and prognosis are highly influenced by site of disease involvement, ECD course ranges from asymptomatic to life threatening, with a reported global 5-year mortality of 30–40%. Whether ECD is an inflammatory or clonal disease in its nature has long been debated. The disease is characterized by a network of pro-inflammatory cyto/chemokines responsible for the recruitment and activation of histiocytes into ECD lesions, similarly to what reported in Langerhans cell histiocytosis (LCH). Growing evidence supports a central role of the oncogenic BRAFV600E mutation in histiocytosis pathogenesis, and suggests oncogene-induced senescence (OIS), a major protective mechanism against oncogenic events characterized by cell-cycle arrest and the induction of pro-inflammatory molecules, as the possible link between the oncogenic mutation and the observed inflammation. Indeed, ECD recapitulates in vivo the molecular events associated with OIS, i.e., cell-cycle arrest and a potent local inflammatory response. Accordingly, the infiltration of different tissues by macrophages and the inflammatory local and systemic effects observed in ECD likely represent a drawback of OIS. Therefore, these findings delineate a new conception of OIS as a new pathogenic mechanism intrinsically responsible for disease development.
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Affiliation(s)
- Giulio Cavalli
- Unit of Internal Medicine and Clinical Immunology, IRCCS San Raffaele Scientific Institute , Milan , Italy ; Vita-Salute San Raffaele University , Milan , Italy
| | | | - Bruno Borgiani
- Unit of Internal Medicine and Clinical Immunology, IRCCS San Raffaele Scientific Institute , Milan , Italy
| | - Lorenzo Dagna
- Unit of Internal Medicine and Clinical Immunology, IRCCS San Raffaele Scientific Institute , Milan , Italy ; Vita-Salute San Raffaele University , Milan , Italy
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Abstract
Erdheim-Chester disease (ECD) is a rare, non-Langerhans histiocytosis. Recent findings suggest that ECD is a clonal disorder, marked by recurrent BRAFV600E mutations in >50% of patients, in which chronic uncontrolled inflammation is an important mediator of disease pathogenesis. Although ∼500 to 550 cases have been described in the literature to date, increased physician awareness has driven a dramatic increase in ECD diagnoses over the last decade. ECD frequently involves multiple organ systems and has historically lacked effective therapies. Given the protean clinical manifestations and the lack of a consensus-derived approach for the management of ECD, we provide here the first multidisciplinary consensus guidelines for the clinical management of ECD. These recommendations were outlined at the First International Medical Symposium for ECD, comprised of a comprehensive group of international academicians with expertise in the pathophysiology and therapy of ECD. Detailed recommendations on the initial clinical, laboratory, and radiographic assessment of ECD patients are presented in addition to treatment recommendations based on critical appraisal of the literature and clinical experience. These formalized consensus descriptions will hopefully facilitate ongoing and future research efforts in this disorder.
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[Polyuria-polydipsia syndrome associated with bone pains]. Presse Med 2014; 43:1136-9. [PMID: 24742615 DOI: 10.1016/j.lpm.2013.12.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2013] [Revised: 11/03/2013] [Accepted: 12/17/2013] [Indexed: 11/20/2022] Open
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Li C, Ge H, Cui L, Li Y, Cheng B, Zhang G, Zhang Z, Qi H, Ruan Y, Gu Q, Xu J. Molecular mechanism of action of K(D)PT as an IL-1RI antagonist for the treatment of rhinitis. RSC Adv 2014. [DOI: 10.1039/c4ra09046b] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
K(D)PT curing allergic rhinitis through keeping IL-1RI in close status.
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Affiliation(s)
- Chanjuan Li
- School of Pharmaceutical Sciences & Institute of Human Virology
- Sun Yat-Sen University
- Guangzhou, China
| | - Hu Ge
- School of Pharmaceutical Sciences & Institute of Human Virology
- Sun Yat-Sen University
- Guangzhou, China
| | - Lujia Cui
- No. 1 Affiliated Hospital
- Guangzhou University of Chinese Medicine
- Guangzhou, China
| | - Yali Li
- School of Pharmaceutical Sciences & Institute of Human Virology
- Sun Yat-Sen University
- Guangzhou, China
| | - Bao Cheng
- School of Pharmaceutical Sciences & Institute of Human Virology
- Sun Yat-Sen University
- Guangzhou, China
| | - Guodong Zhang
- School of Pharmaceutical Sciences & Institute of Human Virology
- Sun Yat-Sen University
- Guangzhou, China
| | - Ziying Zhang
- School of Pharmaceutical Sciences & Institute of Human Virology
- Sun Yat-Sen University
- Guangzhou, China
| | - Hao Qi
- School of Pharmaceutical Sciences & Institute of Human Virology
- Sun Yat-Sen University
- Guangzhou, China
| | - Yan Ruan
- No. 1 Affiliated Hospital
- Guangzhou University of Chinese Medicine
- Guangzhou, China
| | - Qiong Gu
- School of Pharmaceutical Sciences & Institute of Human Virology
- Sun Yat-Sen University
- Guangzhou, China
| | - Jun Xu
- School of Pharmaceutical Sciences & Institute of Human Virology
- Sun Yat-Sen University
- Guangzhou, China
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Abstract
IL-1 is a master cytokine of local and systemic inflammation. With the availability of specific IL-1 targeting therapies, a broadening list of diseases has revealed the pathologic role of IL-1-mediated inflammation. Although IL-1, either IL-1α or IL-1β, was administered to patients in order to improve bone marrow function or increase host immune responses to cancer, these patients experienced unacceptable toxicity with fever, anorexia, myalgias, arthralgias, fatigue, gastrointestinal upset and sleep disturbances; frank hypotension occurred. Thus it was not unexpected that specific pharmacological blockade of IL-1 activity in inflammatory diseases would be beneficial. Monotherapy blocking IL-1 activity in a broad spectrum of inflammatory syndromes results in a rapid and sustained reduction in disease severity. In common conditions such as heart failure and gout arthritis, IL-1 blockade can be effective therapy. Three IL-1blockers have been approved: the IL-1 receptor antagonist, anakinra, blocks the IL-1 receptor and therefore reduces the activity of IL-1α and IL-1β. A soluble decoy receptor, rilonacept, and a neutralizing monoclonal anti-interleukin-1β antibody, canakinumab, are also approved. A monoclonal antibody directed against the IL-1 receptor and a neutralizing anti-IL-1α are in clinical trials. By specifically blocking IL-1, we have learned a great deal about the role of this cytokine in inflammation but equally important, reducing IL-1 activity has lifted the burden of disease for many patients.
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Key Words
- AOSD
- Autoimmune
- Autoinflammatory
- C-reactive protein
- CAPS
- CRP
- DIRA
- FCAS
- FMF
- HIDS
- Inflammation
- NLRP12
- NLRP3
- NOMID
- PAPA
- PASH
- PFAPA
- SAPHO
- SJIA
- TNF receptor associated periodic syndrome
- TRAPS
- adult onset Still's disease
- cryopyrin autoinflammatory periodic syndromes
- deficiency of IL-1Ra
- familial Mediterranean fever
- familial cold autoinflammatory syndrome
- hyper IgD syndrome
- neonatal onset multi-inflammatory diseases
- nucleotide-binding domain and leucine-rich repeat pyrin containing 12
- nucleotide-binding domain and leucine-rich repeat pyrin containing 3
- periodic fever, aphthous stomatitis, pharyngitis, and adenitis
- pyoderma-gangrenosum, acne, and suppurativa hidradenitis
- pyogenic arthritis, pyoderma gangrenosum, and acne
- synovitis, acne, pustulosis, hyperostosis and osteitis
- systemic-onset juvenile idiopathic arthritis
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Affiliation(s)
- Charles A Dinarello
- Department of Medicine, University of Colorado Denver, Aurora, CO, United States; Department of Medicine, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Jos W M van der Meer
- Department of Medicine, Radboud University Medical Center, Nijmegen, The Netherlands
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