Autoimmunity and autoinflammation as the yin and yang of idiopathic recurrent acute pericarditis
| Autor: | Carlo Selmi, Donato Rigante, Giuseppe Lopalco, Gabriella De Rosa, Florenzo Iannone, Luca Cantarini, Salvatore Napodano, Francesco Caso, Luisa Costa |
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| Přispěvatelé: | Cantarini, Luca, Lopalco, Giuseppe, Selmi, Carlo, Napodano, Salvatore, De Rosa, Gabriella, Caso, Francesco, Costa, Luisa, Iannone, Florenzo, Rigante, Donato |
| Rok vydání: | 2014 |
| Předmět: |
Immunology
Familial Mediterranean fever Pericardial effusion Autoimmunity Chest pain medicine.disease_cause Autoimmune Disease Autoimmune Diseases Pericarditis Acute pericarditis Recurrence Pericardial friction rub medicine Pericarditi Immunology and Allergy Humans Inflammation Anakinra Interleukin-1 business.industry medicine.disease Settore MED/38 - PEDIATRIA GENERALE E SPECIALISTICA Acute Disease Autoinflammation medicine.symptom business Human medicine.drug |
| Zdroj: | Europe PubMed Central |
| ISSN: | 1873-0183 |
| Popis: | Autoimmunity and autoinflammation are generally considered as mutually exclusive mechanisms of diseases but may concur to specific syndromes. Idiopathic recurrent acute pericarditis (IRAP) is defined as the recurrence of pericardial symptoms at any point following the prior cessation of acute pericarditis, and the latency is generally 6 weeks. Manifestations of pericarditis such as pericardial friction rub, electrocardiographic changes, and pericardial effusion are less frequent in the subsequent episodes compared to the index attack, and in some cases the only clinical sign is represented by a suggestive chest pain. Several autoimmune diseases may manifest with pericarditis which is often related to viral infections, while postviral pericarditis may in turn display a nonspecific autoimmune background. Similarly, autoinflammatory syndromes such as familial Mediterranean fever and tumor necrosis factor receptor-associated periodic syndrome are characterized by self-limiting pericardial symptoms. Corticosteroids are generally effective, thus supporting the autoimmune nature of IRAP, but dramatic results are obtained with interleukin-1 blocking agents in corticosteroid-dependent cases, pointing to a pathogenic role for the inflammasome. Based on these observations, we submit that IRAP represents a paradigmatic example of the putative coexistence of autoimmunity and autoinflammation: the main aim of this review is to critically discuss the hypothesis as well as the current understanding of this enigmatic clinical condition. |
| Databáze: | OpenAIRE |
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