Problems of immunopathology and prospects for pharmacotherapy of idiopathic recurrent pericarditis: Using an interleukin 1 inhibitor (Anakinra)
https://doi.org/10.47360/1995-4484-2023-47-61
Abstract
Pericarditis, a clinical syndrome characterized by inflammation and thickening of the pericardium, is one of the most common forms of inflammatory diseases of the cardiovascular system. The most common and severe complication of acute pericarditis is idiopathic recurrent pericarditis (IRP), which has a poor prognosis associated with the risk of cardiac tamponade and constrictive pericarditis. The pathogenesis of pericarditis is associated with a complex interaction of environmental factors, genetic predisposition, and pathological activation of innate and acquired immunity. Autoinflammatory mechanisms associated with hyperproduction of interleukin (IL) 1 attract particular attention. Standard therapy for pericarditis includes non-steroidal antiinflammatory drugs, colchicine, glucocorticoids, and immunosuppressive drugs. A new direction in the pharmacotherapy of pericarditis is associated with the use of Anakinra (a recombinant non-glycosylated analog of an IL-1 receptor antagonist), which blocks the signaling of IL-1β and IL-1α. The materials of numerous studies are summarized, indicating that Anakinra is an effective drug for the treatment of patients with IRI who are resistant to standard therapy. It is assumed that the wider use of Anakinra, especially in the early stages of pericarditis, will not only improve the prognosis, but also be important for the identification of the autoinflammatory phenotype of IRI and the development of personalized therapy programs.
About the Authors
E. L. Nasonov
V.A. Nasonova Research Institute of Rheumatology;
I.M. Sechenov First Moscow State Medical University of the Ministry of Health Care of Russian Federation (Sechenov University)
Russian Federation
Russian Federation
115522, Russian Federation, Moscow, Kashirskoye Highway, 34A
119991, Russian Federation, Moscow, Trubetskaya str., 8, building 2
Z. N. Sukmarova
V.A. Nasonova Research Institute of Rheumatology
Russian Federation
Russian Federation
115522, Russian Federation, Moscow, Kashirskoye Highway, 34A
T. V. Popkova
V.A. Nasonova Research Institute of Rheumatology
Russian Federation
Russian Federation
115522, Russian Federation, Moscow, Kashirskoye Highway, 34A
B. S. Belov
V.A. Nasonova Research Institute of Rheumatology
Russian Federation
Russian Federation
115522, Russian Federation, Moscow, Kashirskoye Highway, 34A
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Nasonov E.L., Sukmarova Z.N., Popkova T.V., Belov B.S. Problems of immunopathology and prospects for pharmacotherapy of idiopathic recurrent pericarditis: Using an interleukin 1 inhibitor (Anakinra). Rheumatology Science and Practice. 2023;61(1):47-61. (In Russ.) https://doi.org/10.47360/1995-4484-2023-47-61
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