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Professor Lorenz Thurner from Saarland University and Saarland University Medical Center contributed to the study, which has now been published in the journal Jama Network Open.
The following text has been machine translated from the German with no human editing.
It is a disease that even doctors sometimes confuse with a heart attack or angina pectoris: inflammation of the pericardium, known in medical terms as pericarditis. When the tissue around our heart becomes inflamed, those affected often feel a stabbing pain in the chest area, which can also radiate to the arms, abdomen and shoulders. In rare cases, even after successful treatment of the acute disease, such pericarditis can recur after a few months as recurrent pericarditis.
Scientists from Italy and Germany have now observed a connection that could explain why some patients with the already rare condition of pericarditis (approx. 30 cases per 100,000 inhabitants per year in Germany) experience a recurrence of the disease. "At the José Carreras Centre in Homburg, we examined samples from 142 patients with pericarditis from the Italian PERIPLO study. In more than half of those who had active pericarditis, antibodies were detected that block the interleukin-1 receptor antagonist (IL-1Ra)," reports Prof. Lorenz Thurner, working group leader at the José Carreras Centre and senior physician at the Department of Internal Medicine I at Saarland University Hospital.
"Interleukin-1 is a component of the immune system that promotes inflammatory reactions, enabling the body to respond to invading enemies such as viruses and bacteria. If the antagonist of this interleukin-1 is suppressed, the pro-inflammatory messenger substance literally has free rein," explains PD Christoph Kessel from the University of Münster. "By disrupting the natural balance between inflammatory response and its inhibition, the antibody in question promotes recurrent pericarditis."
It is also important that the researchers were able to observe some patients over a longer period of time as part of the PERIPLO study. "This allowed us to track both the course of the disease and the antibody status," says Dr Maddalena Alessandra Wu, study leader of the PERIPLO study at the University of Milan. "We found that the antibodies disappeared when the inflammation subsided and the patients' anti-inflammatory defence mechanisms recovered." This suggests that the antibodies are only temporary and are associated with active disease flare-ups.
The study, which was conducted as a collaboration between the University of Milan, the University of Münster and Saarland University and Saarland University Hospital, provides a promising basis for further research to shed more light on the role of the IL-1Ra antibody and thus potentially find new therapeutic approaches to the disease.
Original publication:
Wu MA, Kessel C, Fadle N, et al. IL-1 Receptor Antagonist Antibodies in Idiopathic Recurrent Pericarditis. JAMA Netw Open.2025;8(10):e2536691. doi:10.1001/jamanetworkopen.2025.36691
Further information:
Prof. Dr. Lorenz Thurner
Email: lorenz.thurner(at)uks.eu
Funding:
The research was made possible by the NanoBioMed Young Investigator Initiative at Saarland University and funding from the Schwiete Foundation.
