Incidence of Antibodies to Il1α in Controls and in Patients with Arthritis

needed to detect patients with rheumatoid arthritis (RA) at high risk of developing a destructive form of the disease as this may influence the choice of early treatment. Among the cytokines produced by the inflammatory synovium, interleukin 1 (IL1) appears to have a predominant role in joint destruction. Specific regulation of IL1 involves natural mechanisms, including soluble IL1 receptors, IL1 receptor antagonist (IL1ra), and anti-IL antibodies. 2 Autoantibodies directed against cytokines were first described in 1989 as being mostly of the IgG isotype and binding with high affinity mainly to IL1α. It is easy to imagine that defects in this natural regulation may contribute to changes in disease incidence and severity. However, definite demonstration of this association needs confirmation from different studies. With reference to the new study published in this issue of the Annals, we will focus on the effect of autoantibodies to IL1α on disease presentation.