Protracted IKKb inhibition is dangerous

Many pro-inflammatory molecules share the intracellular signaling pathway with Nuclear Factor – kappa Binding (NF-kB) for their induction and activity. Cytoplasmic NF-kB is released and transported into the nucleus, where it drives transcription of specific genes, when an inhibitor (IkB) is phosphorylated by the inhibitor-kappa kinase beta (IKKb) The importance of this pathway suggests that IKKb would be a promising target for new anti-inflammatory drugs. Here, Greten and colleages tested this idea using mice in which IKKb was deleted in myeloid cells: macrophages and neutrophils (IKKb-del-myo). [A total IKKb deficiency is an embryonic lethal]. IKKb-del-myo mice were viable and had no obvious changes even within tissues that are rich in myeloid cells, such as lymphoid organs and the gastrointestinal tract. They observed that IKKb-del-myo mice were actually more susceptible to endotoxin- (LPS-) induced toxic shock, which is mediated by TNF and interleukin-1beta (IL-1b). IKKb-deficient cells are more susceptible to apoptosis because some NF-kB-induced genes are protective (e.g., A20).

The authors also studied another conditional knockout mouse, in which IKKb is deleted in all “interferon-inducible” cells (IKKb-del), though this model is complicated by a requisite induction with the pleiotropic agent poly-I:C and deletion probably occurs in many more cell types. These mice develop many more granulocytes and, like the IKKb-del-myo mice, also produced much higher levels of IL-1b after LPS treatment. However, mRNA encoding IL-1 was actually decreased, suggesting a change in IL-1 processing.

Indeed, the authors determined that NF-kB inhibits caspase-1 and serine proteases that are required in macrophages and neutrophils, respectively, to cleave pro-IL-1b and release the active cytokine. Consistent with this interpretation, a serine protease inhibitor protected mice against IL-1b-induced death. Mice exposed to LPS die more quickly and more often when fed ML120B, an inhibitor of IKKb for a protracted period with multiple doses, correlating with an increased processing and release of IL-1b (figure, extracted from Figure 7). Definitely not a lead compound for a daily regimen.
Greten et al. Cell. 2007 Sep 7;130(5):918-31. "NF-kappaB is a negative regulator of IL-1beta secretion as revealed by genetic and pharmacological inhibition of IKKbeta"