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mechanism of autoinflammatory Disease

The IL-1 Pathway

The IL-1 pathway is critical in autoinflammatory disease activity1

There are 2 forms of IL-1: IL-1α and IL-1β2,3

  • IL-1α and IL-1β have different roles in inflammation:
    • IL-1α is constitutively expressed in normal cells* and is the primary driver of local inflammation as part of the host defense
    • IL-1β is primarily induced and actively produced by immune cells under disease conditions
IL-1α
IL-1β

Proinflammatory cytokine3

Protein constitutively present in normal cells2,3*

Primary driver of local inflammation as part of host defense2

Primarily induced and actively produced by innate immune cells under disease conditions2,3

Key driver of systemic inflammation that can lead to tissue/organ damage2-4

Triggers downstream activation of proinflammatory cytokines (eg, IL-6, TNF)5-7

Further induces its own production2

*Keratinocytes of the skin, epithelial cells of mucosal membranes throughout the body, and cells of organs such as the liver, lung, and kidney.

No clinical implications can be derived from these data. Prospective, head-to-head studies comparing inhibition of both IL-1α and IL-1β, vs IL-1β alone, have not been done in patients with autoinflammatory diseases.

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Better understand autoinflammatory diseases and the various characteristics found in certain types of diseases

IL-1=interleukin 1; IL-1α=interleukin 1 alpha; IL-1β=interleukin 1 beta; IL-6=interleukin 6; TNF=tumor necrosis factor.
References: 1. Lachmann HJ, Quartier P, So A, Hawkins PN. The emerging role of interleukin-1β in autoinflammatory diseases. Arthritis Rheum. 2011;63(2):314-324. doi:10.1002/art.30105 2. Dinarello CA, Simon A, van der Meer JWM. Nat Rev Drug Discov. 2012;11(8):633-652. doi:10.1038/nrd3800 3. Dinarello CA. Overview of the IL-1 family in innate inflammation and acquired immunity. Immunol Rev. 2018;281(1):8-27. doi:10.1111/imr.12621 4. Jesus AA, Goldbach-Mansky R. Annu Rev Med. 2014;65:223-244. doi:10.1146/annurev-med-061512-150641 5. McGeough MD, Pena CA, Mueller JL, et al. Cutting edge: IL-6 is a marker of inflammation with no direct role in inflammasome-mediated mouse models. J Immunol. 2012;189:2707-2711. doi:10.4049/jimmunol.1101737 6. Ostrov BE. Immunotherapeutic biologic agents to treat autoinflammatory diseases. In: Metodiev K, ed. Immunotherapy - Myths, Reality, Ideas, Future. InTech; 2017: chap 12. Accessed March 2, 2020. doi:10.5772/66547 7. Mellins ED, Macaubas C, Grom AA. Pathogenesis of systemic juvenile idiopathic arthritis: some answers, more questions. Nat Rev Rheumatol. 2011;7(7):416-426. doi:10.1038/nrrheum.2011.68