Interleukin-1β blockade reduces intestinal inflammation in a murine model of Tumor Necrosis Factor-independent ulcerative colitis

Background & aimsInflammatory bowel diseases (IBDs) are multifactorial diseases commonly treated with either immunomodulatory drugs or anti-tumor necrosis factor (TNF). Currently, failure to respond to anti-TNF therapy (assessed not prior to 8-12 weeks after starting treatment) occurs in 20-40% of patients enrolled in clinical trials and 10-20% in clinical practice. Murine models of IBD provide important tools to better understand disease mechanism(s). In this context and among the numerous models available, Winnie-TNF-KO mice were recently reported to display characteristics of ulcerative colitis (UC) that are independent of TNF, and with increased IL-1β production.MethodsHerein, the efficacy of recombinant (r) IL-1 receptor antagonist (IL-1Ra, Anakinra) administration was evaluated in Winnie-TNF-KO mice, utilized as an UC model of primary anti-TNF non-responders.ResultsWe analyzed gut mucosal biopsies and circulating cytokine profiles of a cohort of 30 UC patients; approximately 75% of primary non-responders were characterized by abundant IL-1β in both the serum and local intestinal tissues. In Winnie-TNF-KO mice, administration of Anakinra efficiently reduced the histological score of the distal colon, which represents the most common site of inflammation in Winnie mice. Furthermore, among lamina propria and mesenteric lymph node-derived T cells, IFNγ-expressing CD8+ T cells were significantly reduced following Anakinra administration.ConclusionsOur study provides new insight and alternative approaches to treat UC patients, and point to anti-IL-1 strategies (i.e., Anakinra) that may be a more effective therapeutic option for primary non-responders to anti-TNF therapy