Examining the Role of and Treatment Directed at IL-1 in Atherosclerosis

PurposeThe purpose of this review was to examine the role of IL-1 in the inflammatory process central to the development of atherosclerosis and to discuss current clinical evidence for treatments targeting IL-1 in coronary artery disease.Recent FindingsIL-1 has been shown to modulate atherosclerotic plaque progression by upregulating the synthesis of adhesion molecules on endothelial cells, as well increasing activation and proliferation of vascular smooth muscle cells. Animal studies have further suggested that alterations in the balance between agonists and antagonists of IL-1 are important in promoting atherosclerosis. In humans, preliminary assessment of therapy targeting IL-1 noted early reductions in serum inflammatory biomarkers among those with systemic inflammatory or coronary artery disease. The CANTOS trial, a large randomized double-blind study found that canakinumab, a monoclonal antibody targeting IL-1, reduced ischemic events in patients being treated for secondary prevention.SummaryCellular, animal, and now clinical studies have suggested a role for therapies aimed at IL-1 for treatment of CAD. However, given potential side effects and costs of these medications, further study is required to determine which patients may be most suited for treatment above current standard of care.