Autoimmune and Autoinflammatory Pericarditis: Definitions and New Treatments

Bizzi, Emanuele; Trotta, Lucia; Pancrazi, Massimo; Nivuori, Mariangela; Giosia, Valeria; Matteucci, Luca; Montori, Daniela; Brucato, Antonio

doi:10.1007/s11886-021-01549-5

Cited by 9 publications

(11 citation statements)

References 80 publications

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“…The secretion of IL-1 by mast cells or macrophages activates a series of pro-inflammatory cytokines, contributing to adverse inflammatory reactions. Excess IL-1 activities were found in numerous situations, including autoinflammatory events [ 73 , 74 , 75 , 76 , 77 ], metabolic syndromes [ 78 , 79 , 80 , 81 ], acute/chronic inflammation [ 82 , 83 , 84 , 85 ] and malignancy [ 83 , 86 , 87 ]. In the current COVID-19 virus pandemic, the viruses were exerted not only through direct cytotoxic mechanisms but also by triggering cytokine storms that cause severe Grade 4 life threatening cytokines release syndrome [ 88 ].…”

Section: Discussionmentioning

confidence: 99%

A Three-Dimensional Xeno-Free Culture Condition for Wharton’s Jelly-Mesenchymal Stem Cells: The Pros and Cons

Koh

Sulaiman

Law

et al. 2023

IJMS

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Xeno-free three-dimensional cultures are gaining attention for mesenchymal stem cell (MSCs) expansion in clinical applications. We investigated the potential of xeno-free serum alternatives, human serum and human platelet lysate, to replace the current conventional use of foetal bovine serum for subsequent MSCs microcarrier cultures. In this study, Wharton’s Jelly MSCs were cultured in nine different media combinations to identify the best xeno-free culture media for MSCs culture. Cell proliferation and viability were identified, and the cultured MSCs were characterised in accordance with the minimal criteria for defining multipotent mesenchymal stromal cells by the International Society for Cellular Therapy (ISCT). The selected culture media was then used in the microcarrier culture of MSCs to determine the potential of a three-dimensional culture system in the expansion of MSCs for future clinical applications, and to identify the immunomodulatory potential of cultured MSCs. Low Glucose DMEM (LG) + Human Platelet (HPL) lysate media appeared to be good candidates for replacing conventional MSCs culture media in our monolayer culture system. MSCs cultured in LG-HPL achieved high cell yield, with characteristics that remained as described by ISCT, although the overall mitochondrial activity of the cells was lower than the control and the subsequent effects remained unknown. MSC microcarrier culture, on the other hand, showed comparable cell characteristics with monolayer culture, yet had stagnated cell proliferation, which is potentially due to the inactivation of FAK. Nonetheless, both the MSCs monolayer culture and the microcarrier culture showed high suppressive activity on TNF-α, and only the MSC microcarrier culture has a better suppression of IL-1 secretion. In conclusion, LG-HPL was identified as a good xeno-free media for WJMSCs culture, and although further mechanistic research is needed, the results show that the xeno-free three-dimensional culture maintained MSC characteristics and improved immunomodulatory activities, suggesting the potential of translating the monolayer culture into this culture system in MSC expansion for future clinical application.

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Section: Discussionmentioning

confidence: 99%

A Three-Dimensional Xeno-Free Culture Condition for Wharton’s Jelly-Mesenchymal Stem Cells: The Pros and Cons

Koh

Sulaiman

Law

et al. 2023

IJMS

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“…Potential thresholds were identified but should be used cautiously and should be confirmed in larger studies. A possible explanation of such predictive potential is that peripheral blood neutrophilia with low lymphocyte count not only herald the forms with an autoinflammatory phenotype, 10 but also identify subjects with intrinsic deregulation of innate immunity, at higher risk of developing recurrences. Alternatively, we cannot exclude that a high activity of pericardial‐infiltrating neutrophils might result in more severe tissue damage and release of damage‐associated molecular patterns, fostering an autoimmune response that might serve as primer for future recurrences.…”

Section: Discussionmentioning

confidence: 99%

“…During acute attacks, systemic acute‐phase response is common, typically documented by increased levels of C‐reactive protein (CRP) and white blood cell (WBC) count 9 . Recent studies have highlighted the role of innate immunity in the pathogenesis of inflammation during idiopathic pericarditis 10 . The clinical overlap between idiopathic recurrent pericarditis and recurrent serositis in the setting of autoinflammatory diseases has been recognized, and is characterized by interleukin (IL)‐1β overproduction, such as in familial Mediterranean fever, tumor necrosis factor‐associated periodic syndrome (TRAPS) and cryopyrin‐associated periodic syndromes.…”

Section: Introductionmentioning

confidence: 99%

Relapsing pericarditis: Peripheral blood neutrophilia, lymphopenia and high neutrophil‐to‐lymphocyte ratio herald acute attacks, high‐grade inflammation, multiserosal involvement, and predict multiple recurrences

et al. 2022

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Aims:To identify peripheral blood cellular correlates of active pericarditis and to verify whether peripheral blood neutrophils, lymphocytes and the neutrophil tolymphocyte ratio (NLR) are associated with disease phenotype or prognosis.Methods: Observational prospective study on a cohort of 63 patients with idiopathic pericarditis followed for 12 months after each pericarditis recurrence. Two distinct analyses were performed: the "index attack" analysis focused on the first pericarditis episode in each patient, while the "all attacks" analysis included all episodes occurring during the study.Results: Absolute and relative neutrophilia and lymphopenia, together with high NLR, were observed during active pericarditis, as compared with disease remission, at both analyses. Neutrophils showed a positive correlation with plasma C-reactive protein levels, while lymphocyte count showed a negative correlation. Relative neutrophil count was higher, and lymphocyte count lower in patients with pleural effusion; a higher NLR and lower absolute lymphocyte count were observed in those with peritoneal involvement. No correlations were found between peripheral blood neutrophil or lymphocyte counts and size of pericardial effusion, or with the presence of myocardial involvement. Peripheral neutrophilia, lymphopenia and NLR during acute attacks predicted the number of recurrences in the following 12 months.Conclusions: Peripheral blood neutrophilia and lymphopenia are typical of acute idiopathic pericarditis. Acute attacks of pericarditis are associated with neutrophilia and lymphopenia, as compared with disease remission. During acute attacks, neutrophilia and lymphopenia reflect the extent of serosal inflammation and could help to customize therapeutic management after remission has been achieved.

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“…Патогенез перикардита (как многих других воспалительных заболеваний) связывают со сложным взаимодействием факторов внешней среды, генетической предрасположенности и патологической активации врожденного и приобретенного иммунитета, составляющих основу аутоиммунных и/или аутовоспалительных болезней [26][27][28][29][30][31]. Однако в отсутствие адекватных лабораторных моделей перикардита патогенетические механизмы, лежащие в основе этой патологии, могут обсуждаться только гипотетически.…”

Section: иммунопатология перикардитаunclassified

Problems of immunopathology and prospects for pharmacotherapy of idiopathic recurrent pericarditis: Using an interleukin 1 inhibitor (Anakinra)

Насонов

Sukmarova²,

Попкова³

et al. 2023

Naučno-praktičeskaâ revmatologiâ

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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.

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Autoimmune and Autoinflammatory Pericarditis: Definitions and New Treatments

Cited by 9 publications

References 80 publications

A Three-Dimensional Xeno-Free Culture Condition for Wharton’s Jelly-Mesenchymal Stem Cells: The Pros and Cons

A Three-Dimensional Xeno-Free Culture Condition for Wharton’s Jelly-Mesenchymal Stem Cells: The Pros and Cons

Relapsing pericarditis: Peripheral blood neutrophilia, lymphopenia and high neutrophil‐to‐lymphocyte ratio herald acute attacks, high‐grade inflammation, multiserosal involvement, and predict multiple recurrences

Problems of immunopathology and prospects for pharmacotherapy of idiopathic recurrent pericarditis: Using an interleukin 1 inhibitor (Anakinra)

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