Treating inflammation by blocking interleukin-1 in a broad spectrum of diseases

Interleukin-1 (IL-1) is a highly active pro-inflammatory cytokine that lowers pain thresholds and damages tissues. Monotherapy blocking IL-1 activity in autoinflammatory syndromes results in a rapid and sustained reduction in disease severity, including reversal of inflammation-mediated loss of sight, hearing and organ function. This approach can therefore be effective in treating common conditions such as post-infarction heart failure, and trials targeting a broad spectrum of new indications are underway. So far, three IL-1-targeted agents have been approved: the IL-1 receptor antagonist anakinra, the soluble decoy receptor rilonacept and the neutralizing monoclonal anti-IL-1β antibody canakinumab. In addition, a monoclonal antibody directed against the IL-1 receptor and a neutralizing anti-IL-1α antibody are in clinical trials.     

Biological response modifiers in the management of rheumatoid arthritis.

The management of rheumatoid arthritis (RA) with biological response modifiers (BRMs) is reviewed. RA, an autoimmune disorder affecting 1-2% of the world's population, is characterized by inflammation of synovial tissues, joint swelling, stiffness, and pain that may progress to joint erosion. There is strong evidence that inflammatory mediators, such as tissue necrosis factor-alpha (TNF-alpha) and interleukin-1 (IL-1), play a critical role in the pathogenesis of this disorder. IL-1-receptor antagonist (IL-1Ra) is produced in healthy subjects and helps to protect against the adverse effects associated with IL-1 overexpression. Administration of IL-1Ra or similar agents may reduce the effects of IL-1 and ameliorate inflammatory conditions. Traditional treatment of RA has been based on symptomatic management with non-steroidal antiinflammatory drugs, disease-modifying antirheumatic drugs, and corticosteroids, each of which has substantial drawbacks in terms of effectiveness or adverse effects. Newer therapeutic strategies for blocking the biological effects of inflammatory cytokines include antibodies directed against TNF (e.g., infliximab), soluble receptors (e.g., etanercept) and receptor antagonists to IL-1 (anakinra) [corrected]. Clinical trials indicate that these BRMs may be more effective than traditional agents because they are able to alter joint remodeling in addition to attenuating symptoms. Anti-TNF therapies may be associated with increased risk for infections, sepsis, tuberculosis reactivation, demyelination disorders, and blood dyscrasias; anakinra appears to be safer. Combination therapy with BRMs may be more appropriate for RA than monotherapy. The role of BRMs in the treatment of RA will evolve as investigators learn more about the drugs and the disorder.     

Population pharmacokinetic–pharmacodynamic–disease progression model for effects of anakinra in Lewis rats with collagen-induced arthritis

A population pharmacokinetic–pharmacodynamic–disease progression (PK/PD/DIS) model was developed to characterize the effects of anakinra in collagen-induced arthritic (CIA) rats and explore the role of interleukin-1β (IL-1β) in rheumatoid arthritis. The CIA rats received either vehicle, or anakinra at 100 mg/kg for about 33 h, 100 mg/kg for about 188 h, or 10 mg/kg for about 188 h by subcutaneous infusion. Plasma concentrations of anakinra were assayed by enzyme-linked immunosorbent assay. Swelling of rat hind paws was measured. Population PK/PD/DIS parameters were computed for the various groups using non-linear mixed-effects modeling software (NONMEM^® Version VI). The final model was assessed using visual predictive checks and nonparameter stratified bootstrapping. A two-compartment PK model with two sequential absorption processes and linear elimination was used to capture PK profiles of anakinra. A transduction-based feedback model incorporating logistic growth rate captured disease progression and indirect response model I captured drug effects. The PK and paw swelling versus time profiles in CIA rats were fitted well. Anakinra has modest effects (I _max  = 0.28) on paw edema in CIA rats. The profiles are well-described by our PK/PD/DIS model which provides a basis for future mechanism-based assessment of anakinra dynamics in rheumatoid arthritis.     

Anakinra‐Induced Acute Liver Failure in an Adolescent Patient with Still's Disease

The interleukin‐1 (IL‐1) family consists of 11 cytokines that play key regulatory roles in many immune and inflammatory processes. Anakinra (Kineret, Amgen, Inc.) is an IL‐1 receptor antagonist (IL‐1ra). Increased levels of IL‐1 are found in several disease states suggesting that anakinra may be beneficial in disorders associated with elevated IL‐1 levels. Anakinra has been effectively used in the treatment of systemic juvenile idiopathic arthritis and adult‐onset Still's disease (AOSD). Despite its therapeutic benefits, anakinra also has potential side effects, including hepatotoxicity. We present a case of AOSD in an adolescent male that was treated with anakinra. During treatment, the patient developed acute liver failure that resolved upon withdrawal of anakinra. Although anakinra‐induced liver injury has been reported in adults, including one case of subacute liver failure, we believe our case is the first to show severe acute liver failure in an adolescent treated with anakinra. This case provides significant insight into a potentially serious complication associated with anakinra. It is important to further delineate these complications as the treatment indications for this drug expand.     

纳洛酮对IL-1β致热大鼠体温及下丘脑中cAMP和HSP70含量的影响

目的研究阿片受体在IL-1β致热大鼠发热过程中的作用及机制。方法经大鼠侧脑室微量注射纳洛酮和(或)IL-1β,观察大鼠体温变化情况,并测定下丘脑中cAMP含量和HSP70表达。结果纳洛酮能够减弱IL-1β致热效应,同时下丘脑中cAMP含量和HSP70表达水平也相应减少(P<0.01)。结论阿片受体拮抗剂纳洛酮能够抑制大鼠IL-1β性发热,其机制可能与降低下丘脑中cAMP的合成有关;同时可见HSP70表达水平降低。     

IL-1Ra and its Delivery Strategies: Inserting the Association in Perspective

Interleukin-1 receptor antagonist (IL-1Ra) is a naturally occurring anti-inflammatory antagonist of interleukin-1 family of pro-inflammatory cytokines. The broad spectrum anti-inflammatory effects of IL-1Ra have been investigated against various auto-immune diseases such as diabetes mellitus, rheumatoid arthritis. Despite of its outstanding broad spectrum anti-inflammatory effects, IL-1Ra has short biological half-life (4–6 h) and to cope with this problem, up till now, many delivery strategies have been applied either to extend the half-life and/or prolong the steady-state sustained release of IL-1Ra from its target site. Here in our present paper, we have provided an overview of all approaches attempted to prolong the duration of therapeutic effects of IL-1Ra either by fusing IL-1Ra using fusion protein technology to extend the half-life and/or development of new dosage forms using various biodegradable polymers to prolong its steady-state sustained release at the site of administration. These approaches have been characterized by their intended impact on either in vitro release characteristics and/or pharmacokinetic and pharmacodynamic parameters of IL-1Ra. We have also compared these delivery strategies with each other on the basis of bioactivity of IL-1Ra after fusion with fusion protein partner and/or encapsulation with biodegradable polymer.     

Preventive effects and mechanisms of rhein on renal interstitial fibrosis in obstructive nephropathy

Renal interstitial fibrosis is a common outcome of a variety of chronic renal diseases. Here we evaluated the therapeutic efficacy of rhein on renal interstitial fibrosis induced by unilateral ureteral obstruction (UUO) and investigated the potential mechanisms. Mice underwent UUO, followed by orally administrated rhein (150 mg/kg/d) or control vehicle. Renal interstitial injury and the degree of fibrosis were evaluated by pathological staining and Western blot. The possible mechanisms were studied by Western blot, indirect immune-fluorescence and enzyme-linked immunosorbent assay. Our results showed that rhein therapy markedly ameliorated renal interstitial fibrotic lesions, reduced α-smooth muscle actin (α-SMA) expression, attenuated deposition of fibronectin (FN). Rhein also suppressed transforming growth factor-β1 (TGF-β1) and its type I receptor expression in obstructed kidneys. In vitro, rhein abolished the α-SMA and fibronectin expression of rat kidney interstitial fibroblasts cells (NRK-49F) induced by TGF-β1. These observations strongly suggest that rhein is a potent inhibitor of renal interstitial fibrosis, and its therapeutic mechanism is, at least in part, blocking interstitial fibroblasts cells activation.     

白介素受体拮抗剂在风湿性疾病中的应用及前景

针对白介素受体的新型生物制剂不良反应较少,其在风湿性疾病治疗中的应用前景值得期待。本文重点综述两种白介素受体拮抗剂(阿那白滞素和托珠单抗)在风湿性疾病尤其是风湿性关节炎中的应用的疗效和安全性。     

Protective effects of paeonol on inflammatory response in IL-1β-induced human fibroblast-like synoviocytes and rheumatoid arthritis progression via modulating NF-κB pathway

Various investigations have demonstrated that human fibroblast-like synoviocytes rheumatoid arthritis (HFLS-RA) take part in the chronic inflammatory responses and RA progression. Inhibition of synovium activation and inflammatory processes may represent a therapeutic target to alleviate RA. Paeonol, a major natural product, has many biological and pharmacological activities. However, its protective effects against RA considering HFLS-RA have not been explored. In this study, anti-inflammatory effects of paeonol were detected in interleukin-1β (IL-1β)-treated HFLS-RA. Our results demonstrated that paeonol had no effect on cell survival and IL-1β-induced proliferation in HFLS-RA. Pretreatment with paeonol significantly suppressed the production of pro-inflammatory TNF-α, IL-6 and IL-1β, and the expressions of matrix metalloproteinase-1/-3 in vitro and in vivo. Mice treated with paeonol (10 mg/kg) remarkablely attenuated arthritic symptoms based on clinical arthritis scores and histopathology in collagen-induced arthritis mice. Furthermore, the TLR4 expression and NF-κB p65 activation were inhibited by paeonol in vitro and in vivo. Our findings illustrated that paeonol had significantly suppressed inflammation effects in synovial tissues and RA progression. The potential mechanism might be based on the attenuation TLR4-NF-κB activation. These collective results indicated that paeonol might be a promising therapeutic agent for alleviating RA progress through inhibiting inflammations and NF-κB signalling pathway.     

金雀异黄素对IL-1α刺激破骨样细胞的组织蛋白酶K表达的影响(英文)

目的:探讨金雀异黄素对白细胞介素1α(IL-1α)刺激破骨样细胞组织蛋白酶K(CK)表达的作用。方法:从人骨巨细胞瘤组织中纯化出破骨样细胞(OCLs),用不同浓度的金雀异黄素或17β-雌二醇(17β-E2)孵育,并设空白对照组和阳性对照组,采用RT-PCR和Western blot方法,观察IL-1α刺激后CK的表达。结果:与空白对照组相比,IL-1α刺激CK表达显著增加(P<0.01);金雀异黄素在转录水平下调IL-1α刺激后CK的表达,且呈剂量依赖关系(r=0.68,P<0.01);金雀异黄素下调IL-1α刺激后CK的蛋白表达,且呈剂量依赖关系(r=0.61,P<0.01)。雌激素受体拮抗剂ICI 182.780可以部分抑制金雀异黄素的上述作用。结论:金雀异黄素可通过破骨样细胞的雌激素受体部分抑制IL-1α刺激后CK的表达。     

TGF-β1 as a therapeutic target for pulmonary fibrosis and COPD

TGF-β1 is a multifunctional molecule that is expressed in an exaggerated fashion during injury, inflammation and repair. Its expression is dysregulated in lung tissues from patients with pulmonary fibrosis and chronic obstructive pulmonary disease. In animal models, introduction of TGF-β1 expression in the lung causes prominent tissue fibrosis and alveolar destruction. On the other hand, the exaggerated production of TGF-β1, an inability to activate TGF-β1 or a block in TGF-β1 signaling have all been associated with the development of emphysematous pulmonary lesions. A number of studies have demonstrated that TGF-β1 is a major player in the pathogenesis of pulmonary fibrosis and emphysema. In this review, we discuss how TGF-β1 expression is regulated and mechanistically related to the development of tissue fibrosis and emphysema in experimental animal models and humans. We further highlight potential therapeutic options that control TGF-β1-associated genes or signals to restore extracellular matrix homeostasis in which TGF-β1 plays a central role.     

UFL1 attenuates IL-1β-induced inflammatory response in human osteoarthritis chondrocytes

Osteoarthritis (OA) is a chronic inflammatory joint disease characterized by degradation of articular cartilage. Ubiquitin-fold modifier 1 (UFM1)-specific ligase 1 (UFL1) is an UFM1 E3 ligase that has been identified as a regulator of inflammatory response. However, the role of UFL1 in OA remains unknown. The aim of the present study was to explore the function of UFL1 in an in vitro OA system in chondrocytes. Our results showed that UFL1 was lowly expressed in both OA articular tissues and chondrocytes with IL-1β induction. Ectopic expression of UFL1 improved cell viability of IL-1β-induced chondrocytes. UFL1 suppressed the production of NO and PGE2, as well the expression levels of iNOS and COX-2 in IL-1β-induced chondrocytes. The IL-1β-induced increases in TNF-α and IL-6 levels were attenuated by UFL1. Ectopic expression of UFL1 inhibited the production of extracellular matrix (ECM) degrading enzymes including matrix metalloproteinase 3 (MMP-3), MMP-13, ADAMTS-4 and ADAMTS-5 in chondrocytes with IL-1β induction. Additionally, UFL1 suppressed IL-1β-induced activation of NF-κB signaling pathway in chondrocytes. In conclusion, these findings indicated that UFL1 exerted protective effect on IL-1β-induced chondrocytes. Thus, UFL1 might be a potential target for the treatment of OA.     

大黄蛰虫丸对AOM/DSS诱导结肠炎相关 结直肠癌小鼠的抑制作用

目的:研究大黄蛰虫丸(DZP)对结肠炎相关结直肠癌(CAC)的影响及其可能机制。方法:以C57BL/6小鼠为研究对象,随机分为对照组、模型组,DZP低(2 g·kg^-1)、高剂量组(4 g·kg^-1)。除对照组外,其余各组采用AOM/DSS诱导小鼠CAC模型,并于造模中各组给予相应的药物灌胃干预。实验结束,比较各组小鼠死亡率,并以ELISA检测小鼠血清IL-1β和IL-18水平;苏木素-伊红(HE)染色观察结肠组织损伤情况;免疫荧光染色分析小鼠结肠Occludin和ZO-1的表达;免疫组化染色分析小鼠结肠ATG5、IL-1β和IL-18的表达水平;蛋白印迹检测小鼠结肠中LC3BⅠ/Ⅱ、SQSTM1及ATG5的蛋白表达水平。结果:经8周灌胃给药,对照组、模型组,DZP低、高剂量组的死亡率分别为0%、40.00%、20.00%、6.67%。与模型组相比,DZP能显著降低血清IL-1β和IL-18水平,提高小鼠肠道组织中Occludin和ZO-1的表达水平。同时,DZP能显著降低模型小鼠结肠组织中IL-1β、IL-18及SQSTM1的表达水平,提高模型小鼠肠道组织中的LC3BⅠ/Ⅱ和ATG5的蛋白表达水平。结论:DZP能显著降低CAC模型小鼠的炎症和死亡率;其作用机制可能与促进CAC模型小鼠肠道自噬改善肠道紧密连接相关。     

金雀异黄素对IL-1α刺激破骨样细胞的组织蛋白酶K表达的影响

目的探讨金雀异黄素对白细胞介素1α(IL-1α)刺激破骨样细胞组织蛋白酶K(CK)表达的作用.方法从人骨巨细胞瘤组织中纯化出破骨样细胞(OCLs),用不同浓度的金雀异黄素或1 7β-雌二醇(17β-E2)孵育,并设空白对照组和阳性对照组,采用RT-PCR和Western blot方法,观察IL-1α刺激后CK的表达.结果与空白对照组相比,IL-1α刺激CK表达显著增加(P＜0.01);金雀异黄素在转录水平下调IL-1α刺激后CK的表达,且呈剂量依赖关系(r=0.68,P＜0.01);金雀异黄素下调IL-1α刺激后CK的蛋白表达,且呈剂量依赖关系(r=0.61,P＜0.01).雌激素受体拮抗剂ICI 182.780可以部分抑制金雀异黄素的上述作用.结论金雀异黄素可通过破骨样细胞的雌激素受体部分抑制IL-1α刺激后CK的表达.     

益母草碱抑制NLRP3炎症小体过度激活调控巨噬细胞M1/M2表型分化

目的研究益母草碱对脂多糖(LPS)诱导小鼠腹腔巨噬细胞免疫应答影响及相关机制。方法分离小鼠腹腔巨噬细胞,用脂多糖和益母草碱预处理24 h,MMT法检测巨噬细胞活性;Griess法检测NO释放量;ELISA法检测IL-1β、IL-18、IL-6、TNF-α的释放量;RT-PCR法检测NLRP3、ASC、caspase-1、TNF-α、iNOS、Arg-1和CD206的mRNA表达量;Western blot检测NLRP3、ASC、caspase-1蛋白表达量。结果益母草碱能显著抑制脂多糖引起的巨噬细胞上清液中NO、IL-1β、IL-18、IL-6、TNF-α的释放。RT-PCR及Western blot实验结果显示,益母草碱可以抑制脂多糖引起的巨噬细胞中NLRP3、ASC、caspase-1的mRNA及蛋白表达;益母草碱还能明显抑制脂多糖所诱导的巨噬细胞向M1型分化,并促进巨噬细胞向M2型分化。结论益母草碱能通过抑制NLRP3炎症小体,促进脂多糖诱导的巨噬细胞由M1表型向M2表型分化。     

Pharmacological treatment options for cryopyrin-associated periodic syndromes

Introduction: Cryopyrin-associated periodic syndromes (CAPS) are rare monogenic autoinflammatory diseases, comprising a spectrum of phenotypes of varying severity. CAPS are associated with gain-of-function mutations in the NLRP3 inflammasome, a multiprotein complex critical for the activation of IL-1ß, and are characterized by episodes of fever, urticaria-like rash, musculoskeletal, ocular, and neurological symptoms.

Areas covered: Accounting for the pivotal role of IL-1ß in the pathogenesis of CAPS, three therapeutic options, all blocking the action of IL-1ß, are currently approved: anakinra, a recombinant IL-1 receptor antagonist, the IL-1 trap rilonacept and canakinumab, a monoclonal anti-IL-1ß antibody. All agents reduce or even resolve clinical symptoms, biochemical activity markers and improve quality of life in CAPS. This review also covers pharmacokinetic, pharmacodynamic and safety aspects of the approved drugs and the potential utility of IL-1β blockers in a wide range of other conditions with an autoinflammatory component.

Expert commentary: Due to the success story of current pharmaceutics, the therapeutic options in CAPS are not expected to expand in the near future. Prospective observational studies are needed to confirm long-term efficacy and sustained benefit. New IL-1ß blockers will likely address unmet clinical needs in other autoinflammatory conditions.     

雷公藤内酯醇抑制大鼠脑局灶性缺血再灌注后脑组织IL-1βmRNA表达的研究

目的　观察雷公藤内酯醇 (Triptolide ,TL)对局灶性脑缺血再灌注大鼠脑组织内IL 1βmRNA水平变化的影响 ,探讨雷公藤内酯醇对大鼠局灶性缺血再灌注脑损伤保护作用的机制。方法　建立大鼠局灶性脑缺血再灌注模型 ,观察应用雷公藤内酯醇 (0 2和 0 4mg·kg-1)对大鼠脑组织微血管内附壁中性粒细胞计数 ,以及神经功能受损程度的影响。应用RT PCR技术 ,检测大中动脉闭塞侧脑组织IL 1βmRNA表达水平的变化情况。结果　与对照组比较 ,雷公藤内酯醇两治疗组大脑中动脉闭塞侧微血管内附壁中性粒细胞计数、脑组织IL 1βmRNA水平均明显下降。神经功能受损程度也明显改善。结论　雷公藤内酯醇具有明显抑制缺血再灌注大鼠脑组织内IL 1βmRNA表达、降低IL 1β含量和抑制白细胞浸润的作用。这可能是雷公藤内酯醇对大鼠缺血再灌注脑损伤保护作用的机制之一     

The long non-coding RNA maternally expressed 3-micorRNA-15a-5p axis is modulated by melatonin and prevents nucleus pulposus cell inflammation and apoptosis

Nucleus pulposus (NP) cell apoptosis is regarded as a critical risk factor for intervertebral disc degeneration (IVDD). Melatonin exerts a protective role on NP cells. The study concentrates on the role and mechanism of lncRNA MEG3 in melatonin-mediated effects on NP cells. An in vitro IVDD model was constructed using IL-1β on human NP cells. qRT-PCR investigated MEG3, miR-15a-5p and PGC-1α mRNA levels in tissues and NP cells. IL-1β-treated NP cells subsequent to transfection, followed by melatonin treatment. NP cell proliferation, viability, apoptosis and inflammatory reactions were assayed. Western blot checked the profiles of PGC-1α, SIRT1 and NF-κB p65. Student's t-test or one-way analysis of variance (ANOVA) followed by Tukey's test was used for statistical tests. As indicated by the data, melatonin weakened NP cell inflammation and apoptosis and enhanced MEG3 expression. MEG3 expression was attenuated in IVDD tissues. MEG3 knockdown impaired the function of melatonin, which was, however, strengthened by miR-15a-5p knockdown. MEG3 targeted miR-15a-5p, which targeted PGC-1α and repressed the PGC-1α/SIRT1 pathway. Collectively, this study has disclosed that the MEG3-miR-15a-5p-PGC-1α/SIRT1 pathway modulated by melatonin can hamper NP cell apoptosis and inflammation elicited by IL-1β.