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Vyzhga Y, Frenkel J, Insalaco A, Anton J, Koné-Paut I, Legger GE, Fabio G, Cattalini M, Kamphuis S, Hachulla E, Krause K, Ekinci Z, Sanchez-Manubens J, Van den Berg JM, Mora CH, Brinkman D, Labrador E, Potjewijd J, Carlini L, Bustaffa M, Caorsi R, Ruperto N, Gattorno M. Monitoring of Adverse Events and Safety in Autoinflammatory Diseases: Real-Life Data from the Eurofever Registry. J Clin Immunol 2024; 44:119. [PMID: 38758228 DOI: 10.1007/s10875-024-01719-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2024] [Accepted: 04/22/2024] [Indexed: 05/18/2024]
Abstract
OBJECTIVES The study is aimed to evaluate the impact of safety events in the Eurofever registry for Autoinflammatory diseases. METHODS This was a retrospective and longitudinal observational multicentre study. Data were retrieved from the international registry Eurofever, starting patients' enrolment since 2009. All moderate, severe, or very severe AEs reported by treating physician in Eurofever were analyzed regardless of a possible suspected causal relationship to any therapies and according to the latest release of the Medical Dictionary for Regulatory Activities. RESULTS Complete information on safety were available in 2464 patients enrolled in the registry. In 1499 of them retrospective data encompassing the period from disease onset to enrolment were available, whereas 965 consecutive patients entered in the longitudinal part of the study. A total of 479 AEs have been reported in 275 patients. Eighty-two AEs were reported as serious and 99 were drug-related according to the physicians. Infections or infestations (94; 19.6%), gastrointestinal disorders (66; 13.8%), nervous system disorders (41; 8.6%) and systemic disorders or administration site reactions (35; 7.3%) were the most frequent reported events. The highest absolute number of drug-related AEs were related to biologic DMARDs (40/99 reports, 40,4%) and colchicine (31/99 reports, 31.3%). CONCLUSIONS Present study shows the importance of a longitudinal and homogeneous registration of the AEs in rare conditions, with a particular focus on the safety profile of the treatments used in these conditions.
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Affiliation(s)
- Yulia Vyzhga
- IRCCS Istituto Giannina Gaslini, UOC Reumatologia E Malattie Autoinfiammatorie, Genoa, Italy.
| | - Joost Frenkel
- Department of Pediatric Immunology and Rheumatology, Wilhelmina Kinderziekenhuis, Utrecht, Netherlands
| | - Antonella Insalaco
- Division of Rheumatology, IRCCS Ospedale Pediatrico Bambino Gesù, Rome, Italy
| | - Jordi Anton
- Hospital Sant Joan de Déu, Department of Pediatric Rheumatology, Universitat de Barcelona. Institut de Recerca Sant Joan de Deu, Barcelona, Spain
| | - Isabelle Koné-Paut
- Department of Pediatric Rheumatology, National Referral Centre of Auto-Inflammatory Diseases and Inflammatory Amyloidosis, CEREMAIA, CHU de Biĉetre, APHP, University of Paris Sud, Le Kremlin Biĉetre, Paris, France
| | - G Elizabeth Legger
- Department of Pediatric Rheumatology, University Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Giovanna Fabio
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Dipartimento Di Medicina Interna, UOS Malattie Rare, Milan, Italy
| | - Marco Cattalini
- Clinica Pediatrica Dell'Universita' Di Brescia, Unita' Di Immunologia E Reumatologia Pediatrica, Spedali Civili, Brescia, Italy
| | - Sylvia Kamphuis
- Department of Paediatric Rheumatology, Sophia Children's Hospital, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - Eric Hachulla
- Service Medecine Interne, CHRU de Lille- Hospital Claude, Huriez - 4 Étage EST, Lille, France
| | - Karoline Krause
- Dpt. of Dermatology and Allergy, Charite University Hospital Berlin, Berlin, Germany
| | - Zelal Ekinci
- Department of Pediatric Rheumatology, Başkent University İstanbul Hospital, Istanbul, Turkey
| | - Judith Sanchez-Manubens
- Hospital Parc Taulí de Sabadell, Reumatologia Pediàtrica - Servei de Medicina Pediàtrica, Barcelona, Spain
| | - J Merlijn Van den Berg
- Emma Children Hospital, Department of Pediatric Immunology, Rheumatology and Infectious Disease, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands
| | | | - Danielle Brinkman
- Department of Pediatrics, Division of Pediatric Rheumatology, Willem-Alexander Children`S Hospital, Leiden University Medical Center, Leiden, Netherlands
| | | | - Judith Potjewijd
- Department of Internal Medicine, Section Clinical Immunology, Maastricht University Medical Center, Maastricht, Netherlands
| | - Luca Carlini
- Gaslini Trial Centre/Servizio Di Sperimentazioni Cliniche Pediatriche, IRCCS Istituto Giannina Gaslini, PRINTO, Genoa, Italy
| | - Marta Bustaffa
- IRCCS Istituto Giannina Gaslini, UOC Reumatologia E Malattie Autoinfiammatorie, Genoa, Italy
| | - Roberta Caorsi
- IRCCS Istituto Giannina Gaslini, UOC Reumatologia E Malattie Autoinfiammatorie, Genoa, Italy
| | - Nicolino Ruperto
- Gaslini Trial Centre/Servizio Di Sperimentazioni Cliniche Pediatriche, IRCCS Istituto Giannina Gaslini, PRINTO, Genoa, Italy
| | - Marco Gattorno
- IRCCS Istituto Giannina Gaslini, UOC Reumatologia E Malattie Autoinfiammatorie, Genoa, Italy
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Parlar K, Ates MB, Egeli BH, Ugurlu S. The clinical role of anakinra in the armamentarium against familial Mediterranean fever. Expert Rev Clin Immunol 2024; 20:441-453. [PMID: 38133629 DOI: 10.1080/1744666x.2023.2299230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 12/21/2023] [Indexed: 12/23/2023]
Abstract
INTRODUCTION Familial Mediterranean Fever (FMF) is the most common autoinflammatory disease that has mainly been treated with colchicine since 1972. A significant portion of patients do not respond to colchicine and require further treatment, mainly IL-1β antagonists such as anakinra, canakinumab and rilonacept as IL-1β has a crucial role in pathogenesis of FMF. This review summarizes the current approach to treating FMF and discovers the pharmacological and clinical utility of IL-1 blocking agents based on accumulated evidence with a focus on anakinra. AREAS COVERED This review focuses on anakinra treatment in FMF. The data obtained from case reports, case series, retrospective studies and a Phase III trial are analyzed. Safety and efficacy profiles of anakinra are discussed. EXPERT OPINION Anakinra is the cheapest anti-IL-1 agent used in the treatment of colchicine-resistant FMF. It is shown to be effective and safe when used in adjunct to colchicine however its short half-life and potential to cause injection site reactions limit its use.
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Affiliation(s)
- Kerem Parlar
- Cerrahpasa University Faculty of Medicine, Istanbul, Turkey
| | | | - Bugra Han Egeli
- Department of Pediatrics, Children's Hospital of Los Angeles, University of Southern California, Los Angeles, CA, USA
| | - Serdal Ugurlu
- Division of Rheumatology, Department of Internal Medicine, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Istanbul, Turkey
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Sun Y, Li F, Liu Y, Qiao D, Yao X, Liu GS, Li D, Xiao C, Wang T, Chi W. Targeting inflammasomes and pyroptosis in retinal diseases-molecular mechanisms and future perspectives. Prog Retin Eye Res 2024; 101:101263. [PMID: 38657834 DOI: 10.1016/j.preteyeres.2024.101263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Revised: 04/15/2024] [Accepted: 04/16/2024] [Indexed: 04/26/2024]
Abstract
Retinal diseases encompass various conditions associated with sight-threatening immune responses and are leading causes of blindness worldwide. These diseases include age-related macular degeneration, diabetic retinopathy, glaucoma and uveitis. Emerging evidence underscores the vital role of the innate immune response in retinal diseases, beyond the previously emphasized T-cell-driven processes of the adaptive immune system. In particular, pyroptosis, a newly discovered programmed cell death process involving inflammasome formation, has been implicated in the loss of membrane integrity and the release of inflammatory cytokines. Several disease-relevant animal models have provided evidence that the formation of inflammasomes and the induction of pyroptosis in innate immune cells contribute to inflammation in various retinal diseases. In this review article, we summarize current knowledge about the innate immune system and pyroptosis in retinal diseases. We also provide insights into translational targeting approaches, including novel drugs countering pyroptosis, to improve the diagnosis and treatment of retinal diseases.
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Affiliation(s)
- Yimeng Sun
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, 510060, China
| | - Fan Li
- Eye Center, Zhongshan City People's Hospital, Zhongshan, 528403, China
| | - Yunfei Liu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, 510060, China
| | - Dijie Qiao
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, 510060, China
| | - Xinyu Yao
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, 510060, China
| | - Guei-Sheung Liu
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, East Melbourne, VIC, 3002, Australia; Ophthalmology, Department of Surgery, University of Melbourne, East Melbourne, VIC, 3002, Australia
| | - Dequan Li
- Department of Ophthalmology, Baylor College of Medicine, Houston, TX, 77030, USA
| | - Chuanle Xiao
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, 510060, China
| | - Tao Wang
- Institute of Infectious Diseases, Shenzhen Bay Laboratory, Guangming District, Shenzhen, 518132, China; School of Basic Medical Sciences, Capital Medical University, 10 Xitoutiao You'anMen Street, Beijing, 100069, China
| | - Wei Chi
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, 510060, China.
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Kilic B, Guler Y, Azman FN, Bostanci E, Ugurlu S. Efficacy and safety of anti-interleukin-1 treatment in familial Mediterranean fever patients: a systematic review and meta-analysis. Rheumatology (Oxford) 2024; 63:925-935. [PMID: 37769252 DOI: 10.1093/rheumatology/kead514] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 09/08/2023] [Accepted: 09/11/2023] [Indexed: 09/30/2023] Open
Abstract
OBJECTIVES FMF is the most common hereditary monogenic fever syndrome marked by recurrent attacks of fever and polyserositis. Colchicine is the current recommended first-line treatment for FMF. However, a small portion of FMF patients are unresponsive or intolerant to colchicine. Anti-IL-1 agents are alternative treatment options for colchicine-resistant or -intolerant FMF patients. This systematic review and meta-analysis aimed to provide qualitative and quantitative evidence for the efficacy and safety of anti-IL-1 agents in adult and paediatric FMF patients. METHODS MEDLINE, EMBASE, CENTRAL and Web of Science were screened from inception to May 2023. We included adult and paediatric FMF patients who received continuous treatment with at least one of the anti-IL-1 drugs: anakinra, canakinumab and rilonacept. The primary efficacy outcome was the proportion of patients who achieved complete remission of attacks and the primary safety outcome was the proportion of patients who experienced at least one adverse event during treatment. A random-effects meta-analysis was performed for the quantitative synthesis. RESULTS Fourty-four reports consisting of 1399 FMF patients were included. Sixty percent (95% CI 49%, 72%) of the adult patients and 81% (95% CI 72%, 89%) of the paediatric patients achieved complete remission. Anti-IL-1 agents significantly decreased levels of inflammatory markers. At least one adverse event was observed in 25% (95% CI 13%, 37%) of the adult patients and 12% (95% CI 3%, 21%) of the paediatric patients. CONCLUSION Anti-IL-1 agents were effective and demonstrated a low adverse event profile in paediatric and adult FMF patients.
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Affiliation(s)
- Berkay Kilic
- Department of Internal Medicine, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Yelin Guler
- Department of Internal Medicine, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Feyza N Azman
- Department of Internal Medicine, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Ece Bostanci
- Department of Internal Medicine, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Serdal Ugurlu
- Division of Rheumatology, Department of Internal Medicine, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Istanbul, Turkey
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La Bella S, Di Ludovico A, Di Donato G, Basaran O, Ozen S, Gattorno M, Chiarelli F, Breda L. The pyrin inflammasome, a leading actor in pediatric autoinflammatory diseases. Front Immunol 2024; 14:1341680. [PMID: 38250061 PMCID: PMC10796709 DOI: 10.3389/fimmu.2023.1341680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 12/14/2023] [Indexed: 01/23/2024] Open
Abstract
The activation of the pyrin inflammasome represents a highly intriguing mechanism employed by the innate immune system to effectively counteract pathogenic agents. Despite its key role in innate immunity, pyrin has also garnered significant attention due to its association with a range of autoinflammatory diseases (AIDs) including familial Mediterranean fever caused by disruption of the MEFV gene, or in other genes involved in its complex regulation mechanisms. Pyrin activation is strictly dependent on homeostasis-altering molecular processes, mostly consisting of the disruption of the small Ras Homolog Family Member A (RhoA) GTPases by pathogen toxins. The downstream pathways are regulated by the phosphorylation of specific pyrin residues by the kinases PKN1/2 and the binding of the chaperone 14-3-3. Furthermore, a key role in pyrin activation is played by the cytoskeleton and gasdermin D, which is responsible for membrane pores in the context of pyroptosis. In addition, recent evidence has highlighted the role of steroid hormone catabolites and alarmins S100A8/A9 and S100A12 in pyrin-dependent inflammation. The aim of this article is to offer a comprehensive overview of the most recent evidence on the pyrin inflammasome and its molecular pathways to better understand the pathogenesis behind the significant group of pyrin-related AIDs.
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Affiliation(s)
- Saverio La Bella
- Department of Pediatrics, "G. D'Annunzio" University of Chieti, Chieti, Italy
| | - Armando Di Ludovico
- Department of Pediatrics, "G. D'Annunzio" University of Chieti, Chieti, Italy
| | - Giulia Di Donato
- Department of Pediatrics, "G. D'Annunzio" University of Chieti, Chieti, Italy
| | - Ozge Basaran
- Department of Pediatrics, Division of Rheumatology, Hacettepe University Faculty of Medicine, Ankara, Türkiye
| | - Seza Ozen
- Department of Pediatrics, Division of Rheumatology, Hacettepe University Faculty of Medicine, Ankara, Türkiye
| | - Marco Gattorno
- UOC Rheumatology and Autoinflammatory Diseases, IRCCS Istituto Giannina Gaslini, Genova, Italy
| | - Francesco Chiarelli
- Department of Pediatrics, "G. D'Annunzio" University of Chieti, Chieti, Italy
| | - Luciana Breda
- Department of Pediatrics, "G. D'Annunzio" University of Chieti, Chieti, Italy
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Yoshida S, Sumichika Y, Saito K, Matsumoto H, Temmoku J, Fujita Y, Matsuoka N, Asano T, Sato S, Migita K. Effectiveness of Colchicine or Canakinumab in Japanese Patients with Familial Mediterranean Fever: A Single-Center Study. J Clin Med 2023; 12:6272. [PMID: 37834916 PMCID: PMC10573209 DOI: 10.3390/jcm12196272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Revised: 09/11/2023] [Accepted: 09/26/2023] [Indexed: 10/15/2023] Open
Abstract
Background: To investigate the clinical features of Japanese patients with Familial Mediterranean Fever (FMF), we evaluated the frequency of attacks, treatment responses, and adverse effects in 27 patients with FMF treated with colchicine or canakinumab in a real-world clinical setting. Methods: We retrospectively reviewed 27 Japanese patients with FMF treated at our institute between April 2012 and June 2023. All patients were diagnosed with FMF according to the Tel-Hashomer criteria. We performed genetic analyses of the MEFV gene using targeted next-generation sequencing. The clinical response was monitored through the number of attacks, and inflammatory markers were monitored through the C-reactive protein (CRP), and serum amyloid A (SAA) concentrations. Colchicine resistance was defined as the presence of at least one attack/month despite administration of the maximum tolerated dose of colchicine for at least 6 months, and C-reactive protein and serum amyloid A levels above the normal range between attacks. Results: A total of 27 patients diagnosed with FMF were enrolled in this study and the median follow-up period was 36.4 months. The median attack frequency was 1.0 (interquartile range: 0.33-1.0) every 3 months before treatment initiation. All the patients (n = 27) were treated with colchicine. Among the 27 patients, 20 (71.8%) showed a clinical response and 7 (25.9%) showed an incomplete response with sufficient doses of colchicine (n = 5) and non-sufficient doses (n = 2). Two patients on non-sufficient doses were unable to increase colchicine to the maximum dose due to diarrhea and liver dysfunction. All seven patients achieved a reduction in attack frequency after the initiation of canakinumab. No serious adverse events associated with canakinumab treatment were observed. In these seven patients with colchicine-resistant FMF (crFMF), the MEFV exon 10 variant was not detected, and the absence ratio of the MEFV variant was significantly higher compared to those without crFMF. Conclusions: Colchicine was effective in 71.8% (20/27) of Japanese patients with FMF; however, the remaining patients (7/27) had crFMF. Canakinumab effectively controlled febrile attacks in crFMF, even in the absence of pathogenic MEFV exon 10 variants.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Kiyoshi Migita
- Department of Rheumatology, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima 960-1295, Japan (N.M.)
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Ehlers L, Rolfes E, Lieber M, Müller D, Lainka E, Gohar F, Klaus G, Girschick H, Hörstermann J, Kümmerle-Deschner J, Brunner J, Palm-Beden K, Tenbrock K, von Wrangel L, Faßhauer M, Blank N, Trauzeddel R, von Stuckrad ASL, Higgins S, Welzel T, Lutz T, Hentgen V, Foell D, Wittkowski H, Kallinich T. Treat-to-target strategies for the management of familial Mediterranean Fever in children. Pediatr Rheumatol Online J 2023; 21:108. [PMID: 37752496 PMCID: PMC10521475 DOI: 10.1186/s12969-023-00875-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 08/11/2023] [Indexed: 09/28/2023] Open
Abstract
BACKGROUND The objective of this initiative was to develop a treat-to-target (T2T) approach for the management of patients with Familial Mediterranean Fever (FMF), including the definition of a complex treatment target, and establish strategies that improve patient care and long-term outcome. METHODS An initial set of statements as well as a flow chart visualising the proposed concept was developed. To adapt the preliminary statements to the current state of knowledge, a systematic literature search was performed and the modified statements were subject to a Delphi approach. To ensure the applicability of the statements in daily practice, an online survey was conducted among paediatric rheumatologists in Germany. In addition, data from the national AID-NET registry were analysed with respect to therapeutic response. RESULTS This T2T initiative yielded a total of 26 statements guiding FMF management with respect to diagnosis, treatment targets, treatment strategies and monitoring. The online survey identified cut-off values for inflammatory markers indicating treatment intensification and appropriate measures in case of colchicine intolerance or non-adherence. The analysis of data derived from the national AID-NET showed that colchicine therapy was successfully terminated in 61% of patients (27 out of 44) with heterozygous MEFV mutations. Multidimensional treatment targets incorporating objective and subjective reported outcome measures were developed. These provide the basis for stratifying patients into the following treatment paths: continue colchicine, persisting attacks / inflammation, colchicine intolerance, persisting arthritis, colchicine reduction and adjustment/reduction of biologics. CONCLUSIONS The proposed consensus treatment plan for the management of FMF incorporates multidimensional targets allowing transparent treatment decisions, which will promote personalised disease management and increase adherence to therapy.
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Affiliation(s)
- Lisa Ehlers
- Department of Paediatric Pulmonology, Immunology and Critical Care Medicine, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Elisabeth Rolfes
- Department of Paediatric Pulmonology, Immunology and Critical Care Medicine, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Mareike Lieber
- Department of Paediatric Pulmonology, Immunology and Critical Care Medicine, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Dominik Müller
- Department of Paediatrics, Division of Gastroenterology, Nephrology and Metabolic Diseases, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Elke Lainka
- Department of Paediatrics II, University Hospital Essen, Children's Hospital, Essen, Germany
| | - Faekah Gohar
- Clinic of Paediatric and Adolescent Rheumatology, St. Josef-Stift Sendenhorst, Northwest German Center for Rheumatology, Sendenhorst, Germany
| | - Günter Klaus
- KfH Center of Paediatric Nephrology, Department of Paediatric Nephrology, Marburg, Germany
| | - Hermann Girschick
- Vivantes Klinikum Friedrichshain, Children's Hospital, Berlin, Germany
| | - Jana Hörstermann
- Deutsches Rheuma-Forschungszentrum (DRFZ), An Institute of the Leibniz Association, Berlin, Germany
| | - Jasmin Kümmerle-Deschner
- Autoinflammation Reference Center Tübingen (arcT), Division of Paediatric Rheumatology, Department of Paediatrics, University Hospital Tübingen, Tübingen, Germany
| | - Jürgen Brunner
- Department of Paediatrics, Medical University Innsbruck, Danube Private University, Innsbruck, Krems, Austria
| | - Katharina Palm-Beden
- Clinic of Paediatric and Adolescent Rheumatology, St. Josef-Stift Sendenhorst, Northwest German Center for Rheumatology, Sendenhorst, Germany
| | - Klaus Tenbrock
- Department of Paediatric Pneumology, Allergology and Immunology, RWTH Aachen, Aachen, Germany
| | | | - Maria Faßhauer
- ImmunoDeficiencyCenter Leipzig (IDCL), Hospital St. Georg GmbH Leipzig, Academic Teaching Hospital of the University of Leipzig, Leipzig, Germany
| | - Norbert Blank
- Department of Hematology, Oncology and Rheumatology, Internal Medicine V, University Hospital of Heidelberg, Heidelberg, Germany
| | - Ralf Trauzeddel
- Department of Paediatrics, Helios Klinikum Berlin-Buch, Berlin, Germany
| | - Anne Sae Lim von Stuckrad
- Department of Paediatric Pulmonology, Immunology and Critical Care Medicine, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Sonja Higgins
- Paediatric medical practice Hürthpark, Hürth, Germany
| | - Tatjana Welzel
- Autoinflammation Reference Center Tübingen (arcT), Division of Paediatric Rheumatology, Department of Paediatrics, University Hospital Tübingen, Tübingen, Germany
- Paediatric Pharmacology and Pharmacometrics, University Children's Hospital Basel (UKBB), University Basel, Basel, Switzerland
| | - Thomas Lutz
- Center for Rheumatology, Paediatric Rheumatology, Heidelberg, Germany
| | - Véronique Hentgen
- Department of Paediatrics, National Reference Center for Auto-inflammatory Diseases and Amyloidosis, CEREMAIA, Versailles Hospital, Versailles, France
| | - Dirk Foell
- Department of Paediatric Rheumatology and Immunology, University Hospital Münster, Münster, Germany
| | - Helmut Wittkowski
- Department of Paediatric Rheumatology and Immunology, University Hospital Münster, Münster, Germany
| | - Tilmann Kallinich
- Department of Paediatric Pulmonology, Immunology and Critical Care Medicine, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.
- Deutsches Rheuma-Forschungszentrum (DRFZ), An Institute of the Leibniz Association, Berlin, Germany.
- Berlin Institute of Health (BIH), Berlin, Germany.
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Lancieri M, Bustaffa M, Palmeri S, Prigione I, Penco F, Papa R, Volpi S, Caorsi R, Gattorno M. An Update on Familial Mediterranean Fever. Int J Mol Sci 2023; 24:ijms24119584. [PMID: 37298536 DOI: 10.3390/ijms24119584] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Revised: 05/18/2023] [Accepted: 05/20/2023] [Indexed: 06/12/2023] Open
Abstract
(1) Background: Familial Mediterranean Fever (FMF) is the prototypal autoinflammatory disease, characterized by recurrent bursts of neutrophilic inflammation. (2) Methods: In this study we look at the most recent literature on this condition and integrate it with novel information on treatment resistance and compliance. (3) Results: The canonical clinical presentation of FMF is in children with self-limited episodes of fever and polyserositis, associated with severe long-term complications, such as renal amyloidosis. It has been described anecdotally since ancient times, however only recently it has been characterized more accurately. We propose an updated overview on the main aspects of pathophysiology, genetics, diagnosis and treatment of this intriguing disease. (4) Conclusions: Overall, this review presents the all the main aspects, including real life outcome of the latest recommendation on treatment resistance of FMF, a disease, that not only helped understanding the pathophysiology of the auto inflammatory process but also the functioning of the innate immune system itself.
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Affiliation(s)
- Maddalena Lancieri
- UOC Malattie Autoinfiammatorie e Immunodeficenze, IRCCS Istituto Giannina Gaslini, 16147 Genova, Italy
| | - Marta Bustaffa
- UOC Malattie Autoinfiammatorie e Immunodeficenze, IRCCS Istituto Giannina Gaslini, 16147 Genova, Italy
| | - Serena Palmeri
- UOC Malattie Autoinfiammatorie e Immunodeficenze, IRCCS Istituto Giannina Gaslini, 16147 Genova, Italy
| | - Ignazia Prigione
- UOC Malattie Autoinfiammatorie e Immunodeficenze, IRCCS Istituto Giannina Gaslini, 16147 Genova, Italy
| | - Federica Penco
- UOC Malattie Autoinfiammatorie e Immunodeficenze, IRCCS Istituto Giannina Gaslini, 16147 Genova, Italy
| | - Riccardo Papa
- UOC Malattie Autoinfiammatorie e Immunodeficenze, IRCCS Istituto Giannina Gaslini, 16147 Genova, Italy
| | - Stefano Volpi
- UOC Malattie Autoinfiammatorie e Immunodeficenze, IRCCS Istituto Giannina Gaslini, 16147 Genova, Italy
| | - Roberta Caorsi
- UOC Malattie Autoinfiammatorie e Immunodeficenze, IRCCS Istituto Giannina Gaslini, 16147 Genova, Italy
| | - Marco Gattorno
- UOC Malattie Autoinfiammatorie e Immunodeficenze, IRCCS Istituto Giannina Gaslini, 16147 Genova, Italy
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Saad N, Duroux-Richard I, Touitou I, Jeziorski E, Apparailly F. MicroRNAs in inflammasomopathies. Immunol Lett 2023; 256-257:48-54. [PMID: 37023968 DOI: 10.1016/j.imlet.2023.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 03/17/2023] [Accepted: 04/03/2023] [Indexed: 04/08/2023]
Abstract
microRNAs (miRNAs) are small non-coding RNA sequences that negatively regulate the expression of protein-encoding genes at the post-transcriptional level. They play a role in the regulation of inflammatory responses by controlling the proliferation and activation of immune cells and their expression is disrupted in several immune-mediated inflammatory disorders. Among these, autoinflammatory diseases (AID) are a group of rare hereditary disorders caused by abnormal activation of the innate immune system and characterized by recurrent fevers. Major groups of AID are inflammasomopathies, which are associated with hereditary defects in the activation of inflammasomes, cytosolic multiprotein signaling complexes regulating IL-1 family cytokine maturation and pyroptosis. The study of the role of miRNAs in AID is only recently emerging and remains scarce in inflammasomopathies. In this review, we describe the AID and inflammasomopathies, and the current knowledge on the role of miRNAs in disease processes.
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Affiliation(s)
- Norma Saad
- Institute for Regenerative Medicine and Biotherapy, INSERM, U1183, University of Montpellier, Montpellier, France
| | - Isabelle Duroux-Richard
- Institute for Regenerative Medicine and Biotherapy, INSERM, U1183, University of Montpellier, Montpellier, France
| | - Isabelle Touitou
- Institute for Regenerative Medicine and Biotherapy, INSERM, U1183, University of Montpellier, Montpellier, France; Department of Molecular genetics, Medical Genetics of Rare and Autoinflammatory disease unit, Montpellier University Hospital, Montpellier, France; Centre de référence des maladies autoinflammatoires et des amyloses d'origine inflammatoire, CeRéMAIA, Montpellier University Hospital, Montpellier, France
| | - Eric Jeziorski
- Centre de référence des maladies autoinflammatoires et des amyloses d'origine inflammatoire, CeRéMAIA, Montpellier University Hospital, Montpellier, France; Department of Paediatric Emergency and Post-Emergency, Team of General Paediatrics, Infectious Diseases and Clinical Immunology, Montpellier University Hospital, Montpellier, France
| | - Florence Apparailly
- Institute for Regenerative Medicine and Biotherapy, INSERM, U1183, University of Montpellier, Montpellier, France; Clinical Department for Osteoarticular Diseases, University Hospital Lapeyronie, Montpellier, France.
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Brien ME, Gaudreault V, Hughes K, Hayes DJL, Heazell AEP, Girard S. A Systematic Review of the Safety of Blocking the IL-1 System in Human Pregnancy. J Clin Med 2021; 11:jcm11010225. [PMID: 35011965 PMCID: PMC8745599 DOI: 10.3390/jcm11010225] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 12/26/2021] [Accepted: 12/29/2021] [Indexed: 12/12/2022] Open
Abstract
Blockade of the interleukin-1 (IL-1) pathway has been used therapeutically in several inflammatory diseases including arthritis and cryopyrin-associated periodic syndrome (CAPS). These conditions frequently affect women of childbearing age and continued usage of IL-1 specific treatments throughout pregnancy has been reported. IL-1 is involved in pregnancy complications and its blockade could have therapeutic potential. We systematically reviewed all reported cases of IL-1 blockade in human pregnancy to assess safety and perinatal outcomes. We searched several databases to find reports of specific blockade of the IL-1 pathway at any stage of pregnancy, excluding broad spectrum or non-specific anti-inflammatory intervention. Our literature search generated 2439 references of which 22 studies included, following extensive review. From these, 88 different pregnancies were assessed. Most (64.8%) resulted in healthy term deliveries without any obstetrical/neonatal complications. Including pregnancy exposed to Anakinra or Canakinumab, 12 (15.0%) resulted in preterm birth and one stillbirth occurred. Regarding neonatal complications, 2 cases of renal agenesis (2.5%) were observed, and 6 infants were diagnosed with CAPS (7.5%). In conclusion, this systematic review describes that IL-1 blockade during pregnancy is not associated with increased adverse perinatal outcomes, considering that treated women all presented an inflammatory disease associated with elevated risk of pregnancy complications.
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Affiliation(s)
- Marie-Eve Brien
- Ste-Justine Hospital Research Center, Montreal, QC H3T 1C5, Canada; (M.-E.B.); (V.G.); (K.H.)
| | - Virginie Gaudreault
- Ste-Justine Hospital Research Center, Montreal, QC H3T 1C5, Canada; (M.-E.B.); (V.G.); (K.H.)
| | - Katia Hughes
- Ste-Justine Hospital Research Center, Montreal, QC H3T 1C5, Canada; (M.-E.B.); (V.G.); (K.H.)
| | - Dexter J. L. Hayes
- Maternal and Fetal Health Research Centre, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester M13 9PL, UK; (D.J.L.H.); (A.E.P.H.)
| | - Alexander E. P. Heazell
- Maternal and Fetal Health Research Centre, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester M13 9PL, UK; (D.J.L.H.); (A.E.P.H.)
| | - Sylvie Girard
- Department of Obstetrics and Gynecology, Universite de Montreal, Montreal, QC H3T 1J4, Canada
- Department of Obstetrics and Gynecology, Department of Immunology, Mayo Clinic, Rochester, MN 55902, USA
- Correspondence: ; Tel.: +1-507-284-0545
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Tomokawa T, Koga T, Endo Y, Michitsuji T, Kawakami A. Efficacy and safety of canakinumab for colchicine-resistant or colchicine-intolerant familial Mediterranean fever: A single-centre observational study. Mod Rheumatol 2021; 32:797-802. [PMID: 34897516 DOI: 10.1093/mr/roab048] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 05/25/2021] [Accepted: 07/24/2021] [Indexed: 11/13/2022]
Abstract
OBJECTIVES To evaluate the efficacy and safety of canakinumab in Japanese patients with colchicine-resistant or colchicine-intolerant familial Mediterranean fever (FMF) in a real-world clinical setting. METHODS We reviewed 13 Japanese FMF patients to whom canakinumab was introduced during the period of October 2017 to December 2020. All patients were diagnosed as FMF according to Tel-Hashomer criteria. We performed genetic analyses for Mediterranean fever or MEFV by targeted next-generation sequencing. Efficacy was assessed by attack frequency and the percentage of patients who achieved attack improvement at 24 weeks. Safety was assessed by adverse events observed during canakinumab treatment. RESULTS The median duration and follow-up of canakinumab treatment were 13 and 16 months, respectively. The median attack frequency was 0.50 [0.30-1.00] at 24 weeks, which was a significant decrease from 2.00 [0.85-2.88] at the time of induction (p = .019). There were three patients (23%) with complete resolution of attacks at 24 weeks. No serious adverse events were observed. However, one patient had small intestinal ulceration which led to the discontinuation of canakinumab. CONCLUSIONS Although the number of cases is small, this study suggests that canakinumab is efficacious and safe for use in Japanese patients with colchicine-resistant or colchicine-intolerant FMF in a real-world clinical setting in Japan.
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Affiliation(s)
- Takuya Tomokawa
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Tomohiro Koga
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.,Center for Bioinformatics and Molecular Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Yushiro Endo
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Toru Michitsuji
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Atsushi Kawakami
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
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Korkmaz C, Üsküdar Cansu D, Kabay SC. Familial coexistence of demyelinating diseases and familial Mediterranean fever. Rheumatol Int 2021; 42:167-173. [PMID: 33715072 DOI: 10.1007/s00296-021-04821-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 02/20/2021] [Indexed: 11/26/2022]
Abstract
Familial Mediterranean fever (FMF) is a monogenic autoinflammatory disease characterized by fever and serositis attacks caused by mutations in the MEditerranean FeVer (MEFV) gene encoding the pyrin gene. Gain of the function mutations of the pyrin gene lead to stimulation of pro-inflammatory cytokines. Persistent pro-inflammatory situation in the course of FMF may play a role in the development of some other inflammatory diseases such as Behcet's disease, psoriasis, and vasculitis. Multiple sclerosis (MS), as a demyelinating disorder, is also more commonly seen in FMF patients compared to the general population. There are scarcely any research reporting that these two diseases coexist in more than one person in the same family. We have discovered cases of FMF and demyelinating disorders in five members of two different families. Besides the two families we are reporting, there are only four other families reported so far. Having combined the data of all these six families, we present a case-based review in this study. We aimed to draw attention of physicians to familial co-occurence of FMF and demyelinating disorders and also to discuss possible mechanisms of the coexistence of these two diseases in light of the literature.
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Affiliation(s)
- Cengiz Korkmaz
- Division of Rheumatology, Department of Internal Medicine, Eskişehir Osmangazi University, Eskişehir, Turkey.
| | - Döndü Üsküdar Cansu
- Division of Rheumatology, Department of Internal Medicine, Eskişehir Osmangazi University, Eskişehir, Turkey
| | - Sibel Canbaz Kabay
- Department of Neurology, Kütahya Health Science University, Kütahya, Turkey
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