Acute pericarditis is characterized by pericardial inflammation which can be treated with anti-inflammatory drugs. A considerable percentage of patients develops recurrent pericarditis with several relapses. In developed countries, the idiopathic form is the most frequent and has a high risk of recurrences. Two pathophysiological mechanisms have been described for idiopathic recurrent pericarditis, autoimmune and autoinflammatory. The autoimmune mechanism is more frequently encountered in patients with rheumatologic disorders, especially systemic lupus erythematosus. The innate immune system plays a central role in the pathophysiology of pericarditis, especially in the autoinflammatory phenotype. Current evidence highlights the central role played by interleukin 1 (IL-1) and NLRP3 (NACHT, leucine-rich repeat, and pyrin domain-containing protein 3) in idiopathic recurrent pericarditis. Accordingly, IL-1 blockers have been approved for the treatment of this condition. Neutrophils are likely to be important in such setting, however their role has only been partially investigated. In the present review we have collected the current knowledge on the role of innate immune system in pericarditis pathophysiology and how this can be used to provide targeted treatments for patients with recurrent pericarditis.

中文翻译：

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治疗心包炎的新治疗见解：针对先天免疫系统。

急性心包炎的特点是心包炎症，可用抗炎药物治疗。相当比例的患者会出现复发性心包炎并多次复发。在发达国家，特发性形式最常见，并且复发风险很高。特发性复发性心包炎有两种病理生理学机制，即自身免疫和自身炎症。自身免疫机制更常见于风湿性疾病患者，尤其是系统性红斑狼疮患者。先天免疫系统在心包炎的病理生理学中起着核心作用，特别是在自身炎症表型中。目前的证据强调了白介素 1 (IL-1) 和 NLRP3（NACHT、富含亮氨酸重复序列和含有 Pyrin 结构域的蛋白 3）在特发性复发性心包炎中发挥的核心作用。因此，IL-1 阻滞剂已被批准用于治疗这种病症。中性粒细胞在这种情况下可能很重要，但其作用仅得到部分研究。在本综述中，我们收集了有关先天免疫系统在心包炎病理生理学中的作用以及如何利用其为复发性心包炎患者提供针对性治疗的最新知识。