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Activation and Measurement of NLRP3 Inflammasome Activity Using IL-1β in Human Monocyte-derived Dendritic Cells
Published on: May 22, 2014
Interleukin-1 and the NLRP3 inflammasome in COVID-19: Pathogenetic and therapeutic implications
Nicola Potere1, Marco Giuseppe Del Buono2, Roberto Caricchio3
1Department of Medicine and Ageing Sciences and Department of Innovative Technologies in Medicine and Dentistry, G. D'Annunzio University, Chieti, Italy.
Abstract:
A hyperinflammatory response during severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection crucially worsens clinical evolution of coronavirus disease 2019 (COVID-19). The interaction between SARS-CoV-2 and angiotensin-converting enzyme 2 (ACE2) triggers the activation of the NACHT, leucine-rich repeat, and pyrin domain-containing protein 3 (NLRP3) inflammasome. Enhanced inflammasome activity has been associated with increased disease severity and poor prognosis. Evidence suggests that inflammasome activation and interleukin-1β (IL-1β) release aggravate pulmonary injury and induce hypercoagulability, favoring progression to respiratory failure and widespread thrombosis eventually leading to multiorgan failure and death. Observational studies with the IL-1 blockers anakinra and canakinumab provided promising results. In the SAVE-MORE trial, early treatment with anakinra significantly shortened hospital stay and improved survival in patients with moderate-to-severe COVID-19. In this review, we summarize current evidence supporting the pathogenetic role of the NLRP3 inflammasome and IL-1β in COVID-19, and discuss clinical trials testing IL-1 inhibition in COVID-19.
Insights
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection triggers the NLRP3 inflammasome, worsening COVID-19. Blocking interleukin-1 (IL-1) with anakinra improved survival in moderate-to-severe cases.
Area of Science:
- Immunology
- Virology
- Pathophysiology
Background:
- Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection can lead to a hyperinflammatory response, worsening COVID-19 outcomes.
- The SARS-CoV-2 interaction with angiotensin-converting enzyme 2 (ACE2) activates the NACHT, leucine-rich repeat, and pyrin domain-containing protein 3 (NLRP3) inflammasome.
- Enhanced NLRP3 inflammasome activity correlates with increased COVID-19 severity and poorer prognosis.
Purpose of the Study:
- To review the role of NLRP3 inflammasome and IL-1β in COVID-19 pathogenesis.
- To discuss clinical trials investigating IL-1 inhibition for COVID-19 treatment.
Main Methods:
- Review of current scientific literature on NLRP3 inflammasome activation in COVID-19.
- Analysis of evidence linking inflammasome activity to disease severity, pulmonary injury, and hypercoagulability.
- Summary of findings from clinical trials, including the SAVE-MORE trial, evaluating IL-1 blockers.
Main Results:
- NLRP3 inflammasome activation and subsequent IL-1β release contribute to lung injury and hypercoagulability in COVID-19.
- Observational studies and the SAVE-MORE trial demonstrated promising results with IL-1 blockers like anakinra.
- Early anakinra treatment in the SAVE-MORE trial significantly reduced hospital stay and improved survival in moderate-to-severe COVID-19 patients.
Conclusions:
- The NLRP3 inflammasome and IL-1β play a significant pathogenetic role in severe COVID-19.
- Targeting IL-1 signaling represents a promising therapeutic strategy for managing moderate-to-severe COVID-19.
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