Hallegua D S, Weisman M H
Cedars-Sinai Medical Center/UCLA School of Medicine, Los Angeles, CA 90048, USA.
Ann Rheum Dis. 2002 Nov;61(11):960-7. doi: 10.1136/ard.61.11.960.
To review publications relating to the blocking of interleukin 1 (IL1) as a strategy for treating human disease, ranging from rheumatoid arthritis (RA) to Alzheimer's disease.
The National Library of Medicine's PubMed database was searched for articles about pharmaceutical agents that reduce the biological actions of IL1.
Fish oils and corticosteroids were identified as non-selective pharmacological interventions that reduce the activity of IL1, whereas a recombinant human IL1 receptor antagonist (anakinra) and a soluble recombinant type I IL1 receptor act selectively. To date, anakinra is the only selective intervention that has been shown in controlled clinical trials to be effective and well tolerated in the treatment of a specific human disorder, RA. In controlled clinical trials, anakinra provided significant clinical improvement and slowed radiographic disease progression in patients with active RA. Moreover, addition of anakinra to existing methotrexate treatment significantly reduced signs and symptoms of active disease.
The clinical use of anakinra has been demonstrated in the management of RA, but blocking of IL1 in other human disorders, as well as the safety of the use of these blocking agents in chronic diseases, still needs to be defined by controlled clinical investigations.
综述有关阻断白细胞介素1（IL1）作为治疗人类疾病策略的相关文献，这些疾病涵盖类风湿性关节炎（RA）至阿尔茨海默病。
检索美国国立医学图书馆的PubMed数据库，查找有关降低IL1生物学活性的药物制剂的文章。
鱼油和皮质类固醇被确定为降低IL1活性的非选择性药理干预措施，而重组人IL1受体拮抗剂（阿那白滞素）和可溶性重组I型IL1受体具有选择性作用。迄今为止，阿那白滞素是唯一一种在对照临床试验中显示对治疗特定人类疾病RA有效且耐受性良好的选择性干预措施。在对照临床试验中，阿那白滞素使活动性RA患者的临床症状显著改善，并减缓了影像学疾病进展。此外，在现有的甲氨蝶呤治疗中加用阿那白滞素可显著减轻活动性疾病的体征和症状。
阿那白滞素在RA治疗中的临床应用已得到证实，但在其他人类疾病中阻断IL1以及这些阻断剂在慢性病中的使用安全性仍需通过对照临床研究来确定。
