Idiopathic recurrent pericarditis  — a paradigm shift?

Мячикова, В. Ю.; Титов, В. А.; Маслянский, А. Л.; Моисеева, О. М.

doi:10.15829/1560-4071-2019-11-155-163

Cited by 8 publications

(2 citation statements)

References 46 publications

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“…The safety profile is similar to those of the other IL-1 blockers. 59,60 The striking results of the IL-1 blockers (anakinra, rilonacept, and goflikicept) in patients who are colchicineresistant, with or without glucocorticoid dependence, provide a paradigm shift in the treatment of recurrent pericarditis. These data are also supported by translational research that used a novel murine model of AP to study in more detail the role of the NLRP3 inflammasome/IL-1b axis in the pathophysiology of acute and recurrent pericarditis.…”

Section: The Nlrp3 Inflammasome/il-1b Axis As a Central Player In Per...mentioning

confidence: 99%

Novel Therapeutic Insights Into the Treatment of Pericarditis: Targeting the Innate Immune System

Vecchié,

Bonaventura,

Golino

et al. 2024

Journal of Cardiovascular Pharmacology

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Acute pericarditis is characterized by pericardial inflammation which can be treated with anti-inflammatory drugs. A considerable percentage of patients develops recurrent pericarditis with several relapses. In developed countries, the idiopathic form is the most frequent and has a high risk of recurrences. Two pathophysiological mechanisms have been described for idiopathic recurrent pericarditis, autoimmune and autoinflammatory. The autoimmune mechanism is more frequently encountered in patients with rheumatologic disorders, especially systemic lupus erythematosus. The innate immune system plays a central role in the pathophysiology of pericarditis, especially in the autoinflammatory phenotype. Current evidence highlights the central role played by interleukin 1 (IL-1) and NLRP3 (NACHT, leucine-rich repeat, and pyrin domain-containing protein 3) in idiopathic recurrent pericarditis. Accordingly, IL-1 blockers have been approved for the treatment of this condition. Neutrophils are likely to be important in such setting, however their role has only been partially investigated. In the present review we have collected the current knowledge on the role of innate immune system in pericarditis pathophysiology and how this can be used to provide targeted treatments for patients with recurrent pericarditis.

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Section: The Nlrp3 Inflammasome/il-1b Axis As a Central Player In Per...mentioning

confidence: 99%

Novel Therapeutic Insights Into the Treatment of Pericarditis: Targeting the Innate Immune System

Vecchié,

Bonaventura,

Golino

et al. 2024

Journal of Cardiovascular Pharmacology

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“…Goflkicept, a heterodimer fusion protein binding both IL-1α and IL-1β, significantly reduced recurrences even after weaning from background therapy in patients with idiopathic recurrent pericarditis compared to placebo. 23 F I G U R E 1 NLRP3 inflammasome is highly expressed in patients with acute pericarditis. The figure shows the more intense expression of the three components of the NLRP3 inflammasome-namely NLRP3 (A), caspase-1 (B) and ASC (C)-in the pericardium of patients experiencing acute pericarditis.…”

Section: Introductionmentioning

confidence: 99%

Pathogenic pathways and therapeutic targets of inflammation in heart diseases: A focus on Interleukin‐1

Del Buono,

Bonaventura,

Vecchié

et al. 2023

Eur J Clin Investigation

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BackgroundAn exuberant and dysregulated inflammatory response contributes to the development and progression of cardiovascular diseases (CVDs).MethodsThis narrative review includes original articles and reviews published over the past 20 years and found through PubMed. The following search terms (or combination of terms) were considered: “acute pericarditis,” “recurrent pericarditis,” “myocarditis,” “cardiac sarcoidosis,” “atherosclerosis,” “acute myocardial infarction,” “inflammation,” “NLRP3 inflammasome,” “Interleukin‐1” and “treatment.”ResultsRecent evidence supports the role of inflammation across a wide spectrum of CVDs including myocarditis, pericarditis, inflammatory cardiomyopathies (i.e. cardiac sarcoidosis) as well as atherosclerotic CVD and heart failure. Interleukins (ILs) are the signalling mediators of the inflammatory response. The NACHT, leucine‐rich repeat and pyrin‐domain containing protein 3 (NLRP3) inflammasome play a key role in producing IL‐1β, the prototypical pro‐inflammatory cytokine involved in CVDs. Other pro‐inflammatory cytokines (e.g. tumour necrosis factor) have been implicated in cardiac sarcoidosis. As a proof of this, IL‐1 blockade has been proven efficacious in pericarditis and chronic coronary syndrome.ConclusionTailored strategies aiming at quenching the inflammatory response have emerged as promising to treat CVDs. In this review article, we summarize recent evidence regarding the role of inflammation across a broad spectrum of CVDs. We also review novel evidence regarding targeted therapeutic strategies.

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Comparative analysis of the concentrations of proinflammatory cytokines and glycosylated ferritin in patients with idiopathic recurrent pericarditis and adult-onset Still's disease

et al. 2021

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Idiopathic recurrent pericarditis (IRP) and adult-onset Still's disease (AOSD) are polygenic autoinflammatory diseases, in the pathogenesis of which pro-inflammatory cytokines from the interleukin-1 superfamily play a central role.Aim. To compare serum concentrations of proinflammatory cytokines and glycosylated ferritin (GF) in patients with IRP and AOSD during an exacerbation.Material and methods. The study included 15 patients with AOSD, 15 — IRP. The diagnosis of AOSD was established using the Yamaguchi criteria (1992). IRP was diagnosed in accordance with the 2015 European Society of Cardiology on the diagnosis and management of pericardial diseases. Blood sampling from all patients was carried out during the recurrence period prior to the anti-inflammatory therapy initiation. The serum levels of interleukin-1β (IL-1β), interleukin-6 (IL-6), interleukin-18 (IL-18), procalcitonin, total ferritin and GF was assessed. The results obtained were compared with levels of biochemical parameters, high-sensitivity C-reactive protein (CRP), as well as with white blood cell (WBC) and neutrophil counts.Results. The median age in the AOSD group was 28 years, and the IRP — 55 years. An increase WBC count >10*109/L was detected in 10 and 9 patients in the AOSD and IRP groups, respectively. The concentration of CRP was increased in all patients and did not differ in the study groups (p=0,836).The highest values of ferritin and GF levels were found in the AOSD group (1416 ng/ml vs 408 ng/ml, p=0,008) and (12% vs 33,9%, p=0,067), respectively. In both groups, increased concentrations of IL-6 and IL-18 were determined. In the AOSD group, the concentration of IL-18 was higher than in the IRP group (2114 pg/ml vs 161,5 pg/ml, p<0,001). IL-6 concentrations in the study groups did not differ (33,9 pg/ml vs 24,9 pg/ml, p=0,4). IL-1β serum concentration in all subjects corresponded to normal values.Correlation analysis in the AOSD group revealed a direct relationship between the IL-18 and ferritin concentrations (rs=0,73, p=0,03).Conclusion. The study established a similar pattern of changes in inflammatory biomarkers in patients with AOSD and IRI. The most informative marker of inflammation was IL-18.

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Idiopathic recurrent pericarditis — a paradigm shift?

Cited by 8 publications

References 46 publications

Novel Therapeutic Insights Into the Treatment of Pericarditis: Targeting the Innate Immune System

Novel Therapeutic Insights Into the Treatment of Pericarditis: Targeting the Innate Immune System

Pathogenic pathways and therapeutic targets of inflammation in heart diseases: A focus on Interleukin‐1

Comparative analysis of the concentrations of proinflammatory cytokines and glycosylated ferritin in patients with idiopathic recurrent pericarditis and adult-onset Still's disease

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