Effectiveness and tuberculosis-related safety profile of interleukin-1 blocking agents in the management of Behçet's disease

Cantarini, Luca; Lopalco, Giuseppe; Caso, Francesco; Costa, Luisa; Iannone, Florenzo; Lapadula, Giovanni; Anelli, Maria Grazia; Franceschini, Rossella; Menicacci, Cristina; Gargiulo, Mauro; Selmi, Carlo; Rigante, Donato

doi:10.1016/j.autrev.2014.08.008

Cited by 84 publications

(58 citation statements)

References 111 publications

(133 reference statements)

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“…Several case reports suggest that IL-1 and IL-6 are also promising targets in patients resistant or intolerant to other regimens including anti-TNFs [37]. Favourable responses to IL-1 blockade by anakinra, canakinumab or gevokizumab have been described for several BD manifestations including refractory uveitis and mucocutaneous lesions [38,39], and it has been suggested that anti-IL-1 agents may provide a better tuberculosis-related safety profile in BD patients compared to anti-TNF agents [39]. Blocking IL-6 activity with tocilizumab has also been shown to be effective in BD patients with refractory neurologic or ocular disease [40,41].…”

Section: Folding Problems and Er Stressmentioning

confidence: 99%

Pathogenesis of Behçet’s disease: autoinflammatory features and beyond

Gül

2015

Semin Immunopathol

115

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Behçet's disease (BD) is an inflammatory disorder of unknown aetiology characterised by recurrent attacks affecting the mucocutaneous tissues, eyes, joints, blood vessels, brain and gastrointestinal tract. It is a multifactorial disease classified as a variable vessel vasculitis, and several environmental triggers may induce inflammatory episodes in genetically susceptible individuals. BD has several autoinflammatory features including recurrent self-limited clinical manifestations overlapping with monogenic autoinflammatory disorders, significant host predisposition and abnormally increased inflammatory response, with a robust innate component. Human leukocyte antigen (HLA)-B*51 is the strongest susceptibility factor described so far affecting the disease risk and typical phenotype. Non-HLA genetic associations such as endoplasmic reticulum aminopeptidase 1 (ERAP1), interleukin 23 receptor (IL23R) and IL10 variations suggest that BD shares susceptibility genes and inflammatory pathways with spondyloarthritis. Although genomewide association studies revealed an increased risk associated with recessively inherited ERAP1 variations in HLA-B*51 positive patients, it is not clear yet whether certain peptide-HLA allele combinations result in an adaptive response by a self-antigen-directed cytotoxic response or an innate response by modulating an NK cell activity or causing an unfolded protein response. Understanding of major histocompatibility complex (MHC) Class I-driven inflammatory response is expected to provide insights for the development of better treatment and remission-induction options in BD as well as in ankylosing spondylitis (AS) and psoriasis.

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Section: Folding Problems and Er Stressmentioning

confidence: 99%

Pathogenesis of Behçet’s disease: autoinflammatory features and beyond

Gül

2015

Semin Immunopathol

115

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“…In a pilot study of 7 patients with relapsing posterior uveitis refractory to azathioprine and/or cyclosporine, the anti-IL1b antibody Gevokizumab was beneficial (Arida and Sfikakis, 2014). Numerous observational studies on both large and small cohorts of patients with BD have demonstrated that the potential for Mycobacterium tuberculosis reactivation and tuberculosis development appears to be significantly lower with interleukin-1 blockers compared to TNF-a inhibitors (Cantarini et al, 2014). Use of an interleukin-1 receptor antagonist has also been used successfully to attenuate experimental animal models of uveitis (Chu et al, 2012a).…”

Section: Introductionmentioning

confidence: 98%

Expression profile of IL-1 family cytokines in aqueous humor and sera of patients with HLA-B27 associated anterior uveitis and idiopathic anterior uveitis

Zhao

Chen

Jiang

et al. 2015

Experimental Eye Research

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“…Even though the aetiology of BS is still unknown [4][5][6], recently, the combination of clinical features, lack of autoantibodies and beneficial effects derived from IL-1 inhibition has reinvigorated the concept of BS as an autoinflammatory disease [7][8][9][10]. Since there are no established laboratory findings to define BS, the diagnosis remains mainly dependent on the identification of the typical clinical pictures.…”

Section: Introductionmentioning

confidence: 99%

Development of de novo major involvement during follow-up in Behçet’s syndrome

et al. 2015

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The primary aim of the study was to evaluate the incidence of de novo major involvement during follow-up in a cohort of patients with Behçet's syndrome (BS); the secondary aim was to analyse the epidemiological profile and the long-term outcome of those patients who developed new major involvement. Among our cohort of 120 BS patients, we evaluated all subjects who had no major organ involvement during the early years of their disease; specifically, at disease onset, the 52% of the cohort presented a prevalent mucocutaneous involvement. The primary outcomes were represented by the following: Hatemi et al. (Rheum Dis Clin North Am 39(2):245-61, 2013) the incidence of de novo major involvement during the follow-up and Hatemi et al. (Clin Exp Rheumatol 32(4 Suppl 84):S112-22, 2014) the use of immunosuppressive drugs during the follow-up. We have defined the development of de novo major involvement during the follow-up as the occurrence of severe ocular, vascular or CNS involvement after a latency period from the diagnosis of at least 3 years. Among 62 patients characterized by a mild onset of disease, we observed that after at least 3 years from the diagnosis, 21 BS patients (34%) still developed serious morbidities. Specifically, three patients developed ocular involvement, nine patients developed neurological involvement and nine patients presented vascular involvement. Comparing main epidemiological and clinical findings of the two groups, we observed that patients who developed de novo major involvement were more frequently males and younger; furthermore, 95% of these patients were characterized by a young onset of disease (p < 0.001). Being free of major organ complication in the first years of BS is not necessary a sign of a favourable outcome. Globally, the development of de novo major involvement during the coursfce of BS suggests that a tight control is strongly recommended during the course of the disease.

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Effectiveness and tuberculosis-related safety profile of interleukin-1 blocking agents in the management of Behçet's disease

Cited by 84 publications

References 111 publications

Pathogenesis of Behçet’s disease: autoinflammatory features and beyond

Pathogenesis of Behçet’s disease: autoinflammatory features and beyond

Expression profile of IL-1 family cytokines in aqueous humor and sera of patients with HLA-B27 associated anterior uveitis and idiopathic anterior uveitis

Development of de novo major involvement during follow-up in Behçet’s syndrome

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