An international group of researchers published in the New England Journal of Medicine a study that can lead to essential reflections on the future of medicine.
It regards a treatment with monoclonal antibodies -the Canakinumab- used for some types of juvenile arthritis (Still's disease), some forms of adult rheumatoid arthritis, and several cases of periodic fevers. This specific antibody acts directly on Interleukin 1 Beta (IL1 Beta), a cytokine typical of the inflammatory response to infections.
Fever derived from infection occurs since IL1 is produced for defensive purposes, so the body responds by raising its temperature. When inflammation is widespread, and IL1 Beta "goes around the body" a little too much, chronic inflammatory and immunological diseases can arise.
The scientist wanted to verify if the action of inflammatory control of this drug had some effect on cardiovascular disease without having impacts of any kind on the levels of cholesterol or triglycerides. To do so, they studied patients with heart conditions (previously infarcted) and with precise levels of inflammation (high levels of Protein C Reactive - PCR). The survey confirmed the hypothesis. In subjects treated with the antibody, the incidence of new infarctions or other cardiovascular diseases was significantly reduced. The risk indexes were lower, too, without any change in fat plasma values.
These results concern the actual involvement of fats in the genesis of ischemic disease. The hypothesis that heart disease is an inflammatory disease much more than a metabolic disorder is becoming more and more common. The NEJM article supports the request of many experts to reject the "cholesterol hypothesis".
Given the price of Canakinumab (yearly treatment costs around 50,000 euros per patient), pharmaceutical industries are looking for new drugs and medicines to control inflammation. A condition that has proved to be the real and for a long time, unrecognised, cause of the most important chronic diseases.
Today it is possible to treat inflammation through pharmacological administration but also with modifications of diet and lifestyles. They are simple tools, feasible by anyone, that help every patient to change the relationship with the disease, a crucial aspect of caring, support and healing.
Thanks to this work, we now know that:
- Controlling inflammation reduces (without eliminating) cardiovascular disease.
- The cardiac ischemic disease may only be partially related to the problem of cholesterol and triglyceride production.
These are considerations that can and are already revolutionising the pharmacotherapy world of the most challenging chronic diseases. But above all, it confronts us with a necessary reconsideration of the hypotheses linked to cholesterol.
It has always been somewhat thought that there was an inflammatory phenomenon at the base. Today, however, the road to awareness has opened, and this part of knowledge must be clear to all, to take the necessary measures.
Measuring inflammation, implementing personalised nutritional and lifestyle changes allow in a straightforward and non-pharmacological way the management of many chronic diseases, even serious ones. Meaning that we can all help ourselves in a concrete way to maintain health and well-being.