title: Role of interleukin-1 (IL-1) in the pathogenesis of systemic onset juvenile idiopathic arthritis and clinical response to IL-1 blockade.
abstract: Systemic onset juvenile idiopathic arthritis (SoJIA) encompasses approximately 10% of cases of arthritis that begin in childhood. The disease is unique in terms of clinical manifestations, severity of joint involvement, and lack of response to tumor necrosis factor blockade. Here, we show that serum from SoJIA patients induces the transcription of innate immunity genes, including interleukin (IL)-1 in healthy peripheral blood mononuclear cells (PBMCs). Upon activation, SoJIA PBMCs release large amounts of IL-1beta. We administered recombinant IL-1 receptor antagonist to nine SoJIA patients who were refractory to other therapies. Complete remission was obtained in seven out of nine patients and a partial response was obtained in the other two patients. We conclude that IL-1 is a major mediator of the inflammatory cascade that underlies SoJIA and that this cytokine represents a target for therapy in this disease.
authors.affiliation: Baylor Institute for Immunology Research, Dallas, TX 75204, USA. virginip@Baylorhealth.edu
authors.forename: Virginia
authors.initials: V
authors.lastname: Pascual
authors.forename: Florence
authors.initials: F
authors.lastname: Allantaz
authors.forename: Edsel
authors.initials: E
authors.lastname: Arce
authors.forename: Marilynn
authors.initials: M
authors.lastname: Punaro
authors.forename: Jacques
authors.initials: J
authors.lastname: Banchereau
mesh_terms: D000293:Adolescent; D001171:Arthritis, Juvenile / Q000097:blood / Q000188:drug therapy / Q000276:immunology* / Q000378:metabolism*; D018925:Chemokines / Q000378:metabolism; D002648:Child; D002675:Child, Preschool; D016207:Cytokines / Q000378:metabolism; D005260:Female; D005786:Gene Expression Regulation / Q000187:drug effects*; D006801:Humans; D053590:Interleukin 1 Receptor Antagonist Protein; D007375:Interleukin-1 / Q000037:antagonists & inhibitors* / Q000235:genetics / Q000378:metabolism*; D007963:Leukocytes, Mononuclear / Q000378:metabolism; D008297:Male; D046228:Microarray Analysis; D011241:Prednisone / Q000494:pharmacology* / Q000627:therapeutic use; D020133:Reverse Transcriptase Polymerase Chain Reaction; D044967:Serum / Q000378:metabolism; D012795:Sialoglycoproteins / Q000494:pharmacology* / Q000627:therapeutic use
chemical_list: D018925:Chemokines; D016207:Cytokines; C507763:IL1RN protein, human; D053590:Interleukin 1 Receptor Antagonist Protein; D007375:Interleukin-1; D012795:Sialoglycoproteins; D011241:Prednisone