Interleukin 1β: A Proinflammatory Target for Preventing Atherosclerotic Heart Disease

Interleukin 1β (IL-1β) is a proinflammatory cytokine that has been implicated in a number of rheumatologic and inflammatory conditions. The production and secretion of IL-1β from inflammatory cells is a tightly regulated process that has been extensively described and studied. In recent years, IL-1β has been associated with several steps in the development of atherosclerotic plaques, as well as other cardiovascular disease modifiers, such as cigarette smoking and type II diabetes mellitus. More recently, IL-1β has become the target of therapy in refractory rheumatologic conditions and is under investigation as a potential target of therapy in cardiovascular disease. The Canakinumab Anti-inflammatory Thrombosis Outcomes Study is currently underway and strives to use canakinumab, a monoclonal antibody directed against IL-1β, to evaluate the inflammatory hypothesis of cardiovascular disease. If the trial meets its primary end points (eg, significant reductions in nonfatal myocardial infarction, nonfatal stroke, and cardiovascular death), the Canakinumab Anti-inflammatory Thrombosis Outcomes Study will confirm the critical role of IL-1β–mediated inflammation in the development of cardiovascular disease and will introduce cytokine-directed therapy as a potential avenue for the treatment of atherosclerotic disease.