Reclassification of Cytokine-Based Immune- Mediated Inflammatory Diseases: Mechanisms and Therapeutic Advances of IL-1-Driven Inflammatory Diseases

² Center for Immune-Related Diseases at Shanghai Institute of Immunology, Department of Immunology and Microbiology, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China,

³ Changchun GeneScience Pharmaceutical Co., Ltd. Changchun 130000, Jilin, China,

JCNR 2025 , 9(9), 22–31; https://doi.org/10.26689/jcnr.v9i9.12338

© 2025 by the Authors. Licensee Whioce Publishing, Singapore. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution 4.0 International License ( https://creativecommons.org/licenses/by/4.0/ )

Abstract

Immune-mediated inflammatory diseases (IMIDs) represent a heterogeneous group of disorders driven by immune dysregulation, involving multiple organ systems and characterized by substantial clinical diversity. Traditional classification based on affected organs fails to capture shared pathogenic mechanisms and impedes the development of unified therapeutic strategies. In recent years, reclassification of IMIDs according to the dominance of key cytokine hubs has emerged as a focus of research. Interleukin-1 (IL-1), crucial in triggering and maintaining innate immune reactions, is key to the onset and continuation of inflammation. Aberrant activation of the IL-1 axis serves as a pathogenic driver in several prototypical auto-inflammatory diseases (AIDs) and plays a role in the development of inflammatory diseases like gout, hidradenitis suppurativa, recurrent pericarditis, and chronic recurrent multifocal osteomyelitis (CRMO), demonstrating a high degree of mechanistic convergence. Therapeutic strategies targeting IL-1 have shown favorable efficacy and safety in multiple clinical studies, with several agents approved for corresponding indications. As molecular mechanisms are further elucidated and biologic therapies continue to evolve, the IL-1 axis is increasingly recognized as a common inflammatory nexus within IMIDs. The reclassification framework centered on IL-1 provides a conceptual basis for the implementation of shared-treatment strategies across distinct diseases and establishes a theoretical and practical foundation for precision-targeted interventions.

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