key: cord-288931-d4fyitnk
authors: Parisi, Valentina; Leosco, Dario
title: Precision medicine in COVID-19: IL-1β a potential target
date: 2020-04-18
journal: JACC Basic Transl Sci
DOI: 10.1016/j.jacbts.2020.04.006
sha: 
doc_id: 288931
cord_uid: d4fyitnk

nan

On April 4, 2020, coronavirus disease 2019 (COVID-19) has been confirmed in 1.395 .136 people worldwide with a mortality of approximately 5.8 %.

Since the COVID 19 dramatic outbreak, there is an urgent need for effective treatments. A wide spectrum of disease severity has been described, ranging from asymptomatic, mildly symptomatic, severe symptomatic requiring hospitalization, to respiratory failure from acute respiratory distress syndrome (ARDS). Furthermore, it has been widely reported that the prevalence of the disease is almost three times higher in males. Overall, these evidences suggest that the prognosis appears to be more conditioned by the host's response than by the infection itself, thus a precision medicine approach is highly desirable. In cardiovascular diseases, an important source of inflammatory mediators, including IL-1β, is the visceral adipose tissue (4) . Of note, activation of NLRP3 inflammasome in macrophages attenuates uncoupling protein 1 (UCP1) induction and mitochondrial respiration in cultures of primary adipocytes and the NLRP3 inflammasome activation appears to link obesity and dysfunctional thermogenesis (5).

In conclusion, there are many open questions that merit to be explored: i) to verify the role of NLRP3 in the clinical variability of COVID-19; ii) to test the potential therapeutic effect in COVID-19 of IL-1β inhibition (canakinumab, anakinra); iii) to explore the role of visceral adipose tissue in the inflammatory response to SARS-CoV-2 infection.

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