动脉粥样硬化性疾病的抗炎治疗：卡那单抗

Atherosclerosis (AS) is a chronic inflammatory disease and one of the important causes of the occurrence and development of cardiovascular disease (CVD), which seriously endangers human life and health. Potential pathogenesis of atherosclerosis includes chronic inflammation of the arterial wall caused by imbalances in lipid metabolism and dysregulated immune responses. Targeting IL-1 represents a new treatment method for atherosclerosis. Currently, some IL-1 antibodies have been used in clinical research and have made certain progress, such as canakinumab (trade name ilaris), which has received widespread attention as a new anti-inflammatory drug.

Canakinumab is a human monoclonal antibody targeting IL-1β and has anti-inflammatory effects. Canakinumab is beneficial in IL-1β-mediated inflammatory diseases, including Muckle-Wells syndrome, acute gouty arthritis, rare forms of juvenile inflammatory arthritis, and type 2 diabetes. Canakinumab has a long biological half-life, allowing subcutaneous administration every 3 months, and is well tolerated by most patients.

CANTOS is a double-blind and placebo-controlled randomized clinical trial targeting inflammation. The study found that selective neutralization of IL-1β with canakinumab did not affect plasma lipid levels, but could reduce plasma levels of inflammation downstream biomarkers high-sensitivity C-reactive protein and IL-6, significantly reducing recurrent cardiovascular events in patients with residual inflammation risk. Because I-1β plays multiple roles in the development of atherosclerotic plaques, and its activation can stimulate the downstream IL-6 receptor signaling pathway, which is a potential cause of atherothrombosis, the CANTOS trial confirmed the inflammatory hypothesis of atherothrombosis, indicating that targeting the inflammatory branch of atherosclerosis can provide clinical benefits for atherosclerosis even in the context of statin therapy, laying an important foundation for clinical targeting of IL-1β in the treatment of atherosclerosis.

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