The pivotal role of interleukin-1 in the clinical manifestations of rheumatoid arthritis.

Abstract

The role of the cytokine network in mediating inflammation and joint destruction in rheumatoid arthritis (RA) has been investigated extensively in recent years. Interleukin-1 (IL-1) and tumour necrosis factor alpha (TNFalpha) are two pivotal proinflammatory cytokines that have been shown to contribute to the clinical manifestations of RA. The ability of IL-1 to drive inflammation and joint erosion and to inhibit tissue repair processes has been clearly established in in vitro systems and animal models. Under physiological conditions, the activity of IL-1 is balanced by IL-1 receptor antagonist (IL-1R alpha). Understanding of the respective roles of IL-1 and IL-1R alpha in conditions of health and disease has led to the development of a recombinant IL-1ra, anakinra (Kineret; Amgen Inc., Thousand Oaks, CA), which offers a new therapeutic modality for RA.