Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2016:2016:7840724.
doi: 10.1155/2016/7840724. Epub 2016 Jan 31.

The Use of IL-1 Receptor Antagonist (Anakinra) in Idiopathic Recurrent Pericarditis: A Narrative Review

Shankar Baskar  1 , Allan L Klein  2 , Andrew Zeft  3
Affiliations
Review

The Use of IL-1 Receptor Antagonist (Anakinra) in Idiopathic Recurrent Pericarditis: A Narrative Review

Shankar Baskar et al. Cardiol Res Pract. 2016.

Abstract

Recurrent pericarditis is a complication of acute pericarditis in 20-30% of the patients and is usually idiopathic in nature. The underlying pathogenesis of this condition remains unclear, although immune-mediated mechanisms seem likely. A subgroup of these patients with refractory symptoms can be challenging to manage, and multiple immunosuppressive medications have been used without consistent benefit. Anakinra, an interleukin-1 receptor antagonist, has been used in treatment of rheumatoid arthritis and autoinflammatory syndromes. Preliminary evidence suggests that anakinra could be a promising therapy for idiopathic recurrent pericarditis. In this narrative review, we summarize the current understanding of the etiopathogenesis of idiopathic recurrent pericarditis, mechanism of action of anakinra, and the preliminary evidence, supporting the use of anakinra in pericarditis.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Mechanism of action of anakinra. Both IL-1α and IL-1β act through IL-1 receptor 1 to stimulate the production of inflammatory cytokines and TNFα that lead to the inflammatory cascade. The inflammasome is a complex of distinct proteins which together convert inactive prointerleukin-1β to active IL-1β. Environmental and infectious triggers can mediate the formation of the inflammasome. Anakinra blocks IL-1 receptor 1, antagonizing the effects of both IL-1α and IL-1β. ASC: Apoptosis associated speck-like protein containing caspase activation and recruitment domain, IL: interleukin, IL-1-R1: interleukin-1 receptor 1, NF-κB: nuclear factor kappa-light-chain-enhancer of activated B cells, NLRP3: NOD-Like Receptor containing pyrin domain 3.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Imazio M. Treatment of recurrent pericarditis. Revista Espanola de Cardiologia. 2014;67(5):345–348. doi: 10.1016/j.recesp.2013.08.016. - DOI - PubMed
    1. Imazio M., Demichelis B., Parrini I., et al. Management, risk factors, and outcomes in recurrent pericarditis. American Journal of Cardiology. 2005;96(5):736–739. doi: 10.1016/j.amjcard.2005.04.055. - DOI - PubMed
    1. Cantarini L., Lopalco G., Selmi C., et al. Autoimmunity and autoinflammation as the yin and yang of idiopathic recurrent acute pericarditis. Autoimmunity Reviews. 2015;14(2):90–97. doi: 10.1016/j.autrev.2014.10.005. - DOI - PubMed
    1. Doria A., Zen M., Bettio S., et al. Autoinflammation and autoimmunity: bridging the divide. Autoimmunity Reviews. 2012;12(1):22–30. doi: 10.1016/j.autrev.2012.07.018. - DOI - PubMed
    1. Caforio A. L. P., Brucato A., Doria A., et al. Anti-heart and anti-intercalated disk autoantibodies: evidence for autoimmunity in idiopathic recurrent acute pericarditis. Heart. 2010;96(10):779–784. doi: 10.1136/hrt.2009.187138. - DOI - PubMed
-