Editorial: Targeting the interleukin-1β/interleukin-6/C-reactive protein pathway in clinical medicine - a road map to clinical trial design
Notice bibliographique
Résumé
monomeric CRP (mCRP), may be a better and even more specific marker of intraocular inflammatory conditions in particular and of inflammation in general. In this context, a beautiful review article by Abisjhek Roy and colleagues on the role of CRP as a potential nexus between inflammation and protein misfolding diseases may well be regarded as the highlight of this Research Topic (https://doi.org/10.3389/fimmu.2025.1612703). The review article further explores the impact of the complex interplay between CRP and its isoforms pCRP, pCRP*, and mCRP in protein misfolding diseases, with a focus on neurodegenerative disease pathogenesis.Inhibition of IL-1 and IL-6 by specific antibodies has gone far down the line in clinical medicine (1-2). Concerning chronic application, which is needed for the primary or secondary prevention of cardiovascular disease, costs and infectious complications may present limitations (2). Whereas IL-1 antibodies have been proven to lower cardiovascular events in the absence of any change in cholesterol (3), these agents have been repurposed into oncology given even larger benefits on lung cancer (4). Nonetheless, there is great hope and interest in effects downstream of IL-1 and on IL-6 itself (1-2, 5). Due to the pivotal role of IL-6 in the humane immune system, careful consideration of potential off-target effects caused by chronic IL-6 inhibition is required. The latter issues are currently being investigated in a series of randomized controlled trials (RCTs) which will have a significant impact on our understanding of the role of IL-1β/IL-6/CRP pathway in clinical medicine (1)(2)(3)(4)(5). Interestingly, low dose colchicine has recently achieved FDA approval for the prevention of cardiovascular disease and a class IIA recommendation in the American and European Guidelines (6-7). Colchicine, in addition to tubulin disruption being the primary mechanism of action, may indirectly inhibit NACHT-LRRPYD-containing 3 (NALP3) inflammasomes and IL-1β processing and release (6)(7). This may in part explain its effects on cardiovascular disease prevention and CRP levels (7). In contrast to the use of colchicine for chronic stable atherosclerosis, there is controversy related to colchicine in the setting of acute coronary ischemia where trial data to date have been neutral (8) suggesting that "timing the taming of inflammation" may have clinical relevance (9). Gastrointestinal side effects of colchicine and the higher incidence of death from non-cardiovascular causes in the original LoDoCo2 trial (5) remain a matter of concern.Finally, specific CRP inhibition has become a matter of investigation. Despite huge pharmacological efforts, attempts to specifically inhibit hepatic CRP synthesis have largely failed to reach human application (10). Promising results, mainly in the setting of acute myocardial infarction (AMI), have been achieved with CRP apheresis (11)(12). The scientific community avidly awaits data from the Innsbruck trial re-evaluating the effect of CRP apheresis on the reduction of myocardial infarction size in a randomized controlled setting (https://ichgcp.net/de/clinical-trials-registry; NCT04939805). Depending on the o u t c o m e of this trial, a further RCT investigating the effect of CRP apheresis on sound clinical endpoints in AMI is being planned (13) and thereby increasing their specificity may become a crucial pharmacological path (14)(15).In summary, this Research Topic may contribute to the understanding of future avenues towards the success of targeting the IL-1β/IL-6/CRP pathway in clinical medicine.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,006 | 0,018 |
| Méta-épidémiologie (sens strict) | 0,004 | 0,001 |
| Méta-épidémiologie (sens large) | 0,004 | 0,003 |
| Bibliométrie | 0,003 | 0,001 |
| Études des sciences et des technologies | 0,002 | 0,002 |
| Communication savante | 0,005 | 0,005 |
| Science ouverte | 0,004 | 0,001 |
| Intégrité de la recherche | 0,013 | 0,016 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,021 | 0,016 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».