Effect of Interleukin-1 Blockade With Anakinra on Leukocyte Count in Patients With ST-Segment Elevation Acute Myocardial Infarction

Authors

Marco Giuseppe Del Buono, Virginia Commonwealth University, Catholic University of the Sacred Heart
Juan I. Damonte, Virginia Commonwealth University, Hospital Italiano de Buenos Aires
Cory R. Trankle, Virginia Commonwealth UniversityFollow
Dinesh Kadariya, Virginia Commonwealth UniversityFollow
Salvatore Carbone, Virginia Commonwealth University, Sapienza University of RomeFollow
Georgia Thomas, Virginia Commonwealth UniversityFollow
Jeremy Turlington, Virginia Commonwealth UniversityFollow
Roshanak Markley, Virginia Commonwealth UniversityFollow
Justin M. Canada, Virginia Commonwealth UniversityFollow
Giuseppe G. Biondi‐Zoccai, Sapienza University of Rome
Michael C. Kontos, Virginia Commonwealth UniversityFollow
Benjamin W. Van Tassell, Virginia Commonwealth UniversityFollow
Antonio Abbate, Virginia Commonwealth UniversityFollow

Document Type

Article

Original Publication Date

2022

Journal/Book/Conference Title

Scientific Reports

Volume

12

Issue

1254

DOI of Original Publication

10.1038/s41598-022-05374-w

Comments

Originally published at https://doi.org/10.1038/s41598-022-05374-w

Date of Submission

October 2023

Abstract

Leukocytosis is a common finding in patients with ST elevation myocardial infarction (STEMI) and portends a poor prognosis. Interleukin 1-β regulates leukopoiesis and pre-clinical studies suggest that anakinra (recombinant human interleukin-1 [IL-1] receptor antagonist) suppresses leukocytosis in myocardial infarction. However, the effect of IL-1 blockade with anakinra on leukocyte count in patients with STEMI is unknown. We reviewed the white blood cell (WBC) and differential count of 99 patients enrolled in a clinical trial of anakinra (n = 64) versus placebo (n = 35) for 14 days after STEMI. A complete blood cell count with differential count were obtained at admission, and after 72 h, 14 days and 3 months. After 72 h from treatment, anakinra compared to placebo led to a statistically significant greater percent reduction in total WBC count (− 35% [− 48 to − 24] vs. − 21% [− 34 to − 10], P = 0.008), absolute neutrophil count (− 48% [− 60 to − 22] vs. − 27% [− 46 to − 5], P = 0.004) and to an increase in absolute eosinophil count (+ 50% [0 to + 100] vs. 0% [− 50 to + 62], P = 0.022). These changes persisted while on treatment at 14 days and were no longer apparent at 3 months after treatment discontinuation. We found that in patients with STEMI IL-1 blockade with anakinra accelerates resolution of leukocytosis and neutrophilia. This modulation may represent one of the mechanisms by which IL-1 blockade improves clinical outcomes.

Rights

Copyright © 2022, The Author(s). This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder.

Is Part Of

VCU Internal Medicine Publications