The cytokine interleukin-1 (IL-1) is primarily to blame for a severe type of juvenile arthritis, according to Pascual and colleagues on page 1479. Blocking IL-1 activity in children with systemic onset juvenile idiopathic arthritis (SoJIA) completely resolved disease symptoms in a majority of children who had failed to respond to conventional treatments.
SoJIA is a systemic inflammatory disease of unknown etiology that can cause long-term arthritis in children. The pathogenesis of the disease is unclear, although increases in the inflammatory cytokine IL-6 have been reported in the blood of these patients. Currently the most effective therapy for SoJIA is long-term treatment with steroids, which carries with it the risk of growth retardation, osteoporosis, and obesity.
Pascual and colleagues now reveal a central role for IL-1—a cytokine that plays a major role in many inflammatory and autoimmune diseases—in the pathology of SoJIA. They show that...
