Autoinflammation in der Inneren Medizin – therapeutische Konsequenzen?

Zusammenfassung

Während bei Kindern die monogenen autoinflammatorischen Erkrankungen („Fiebersyndrome”) dominieren, wenn vom Inflammasom die Rede ist, hat sich der Fokus bei Erwachsenen erheblich verschoben, Gerade bei klassischen Volkskrankheiten spielt die Freisetzung von Interleukin-1 (IL-1) durch das NLRP-3-Inflammasom offenbar eine entscheidende Rolle. So aktivieren Harnsäurekristalle diesen Weg, entsprechend wirksam ist die IL-1-Blockade in der Behandlung, vor allem aber der Prophylaxe von Anfällen. Andere Kristalle haben dieses Potenzial ebenfalls, was nicht nur die für die CPPD-Kristalle der Pyrophosphatgicht, sondern zum Beispiel auch für Cholesterin im Rahmen der Atherosklerose gelten könnte. Und für den Diabetes mellitus Typ II gibt es bereits erste klinische Studienergebnisse, die einen Effekt der IL-1-Blockade zeigen.

Abstract

Among diseases associated with the inflammasome, monogenic autoinflammatory syndromes dominate in paediatric medicine. In contrast, in adults, the focus has shifted to very common diseases, where interleukin-1 (IL-1) release by the NLRP-3 inflammasome apparently plays an essential role. For one major example, uric acid crystals activate this pathway, and IL-1 blockade has been shown to be very effective for treating, but even more for preventing, gout attacks. Other crystals also have this potential, which does not only include the CPPD crystals of pseudogout, but also cholesterol deposits in atherosclerosis, for example, and for type II diabetes mellitus, first clinical trial results also showed an effect of IL-1 blockade.

Schlüsselwörter

Inflammasom - Interleukin-1 - Gicht - Diabetes - Atherosklerose

Key words

inflammasome - interleukin-1 - gout - diabetes - atherosclerosis

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