An Approach to the Patients with Cryopyrin-associated Periodic Syndrome (CAPS) : a New Biologic Response Modifier, Canakinumab
Cryopyrin-associated periodic syndrome (CAPS) comprises a group of rare, but severe, autoinflammatory syndrome, and includes 3 distinct conditions, familial cold autoinflammatory syndrome (FCAS), Muckle-Wells syndrome (MWS), and neonatal-onset multisystem inflammatory disease (MONID). These syndrome...
Saved in:
| Published in | Japanese Journal of Clinical Immunology Vol. 35; no. 1; pp. 23 - 29 |
|---|---|
| Main Authors | , , , , , , , , , , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
Japan
The Japan Society for Clinical Immunology
2012
|
| Subjects | |
| Online Access | Get full text |
| ISSN | 0911-4300 1349-7413 1349-7413 |
| DOI | 10.2177/jsci.35.23 |
Cover
| Abstract | Cryopyrin-associated periodic syndrome (CAPS) comprises a group of rare, but severe, autoinflammatory syndrome, and includes 3 distinct conditions, familial cold autoinflammatory syndrome (FCAS), Muckle-Wells syndrome (MWS), and neonatal-onset multisystem inflammatory disease (MONID). These syndromes are characterized by urticarial-like rash, periodic fever, central nervous system inflammation, an arthropathy, and the risk of amyloidosis. About 20% die by age 20 years in the most severe cases. The disease is associated with mutations in the NLRP3 gene that encodes for the protein cryopyrin, a component of the inflammasome complex that regulates the production and secretion of IL-1β. Canakinumab is a human IgG monoclonal antibody targeting IL-1β. The clinical trials of canakinumab for patients with CAPS in both western countries and Japan were well-tolerated in most patients, and provided significant advantages over existing competitive therapies. Although no serious adverse effects have been reported, the frequencies of common infectious diseases including nasopharyngitis, upper respiratory tract infections, and gastroenteritis were reported presumably due to the blockade of proinflammatory cytokine, IL-1β. For us pediatrician, it will be important to be more careful for infectious diseases to provide the maximum safety of canakinumab for these patients. |
|---|---|
| AbstractList | Cryopyrin-associated periodic syndrome (CAPS) comprises a group of rare, but severe, autoinflammatory syndrome, and includes 3 distinct conditions, familial cold autoinflammatory syndrome (FCAS), Muckle-Wells syndrome (MWS), and neonatal-onset multisystem inflammatory disease (MONID). These syndromes are characterized by urticarial-like rash, periodic fever, central nervous system inflammation, an arthropathy, and the risk of amyloidosis. About 20% die by age 20 years in the most severe cases. The disease is associated with mutations in the NLRP3 gene that encodes for the protein cryopyrin, a component of the inflammasome complex that regulates the production and secretion of IL-1β. Canakinumab is a human IgG monoclonal antibody targeting IL-1β. The clinical trials of canakinumab for patients with CAPS in both western countries and Japan were well-tolerated in most patients, and provided significant advantages over existing competitive therapies. Although no serious adverse effects have been reported, the frequencies of common infectious diseases including nasopharyngitis, upper respiratory tract infections, and gastroenteritis were reported presumably due to the blockade of proinflammatory cytokine, IL-1β. For us pediatrician, it will be important to be more careful for infectious diseases to provide the maximum safety of canakinumab for these patients.Cryopyrin-associated periodic syndrome (CAPS) comprises a group of rare, but severe, autoinflammatory syndrome, and includes 3 distinct conditions, familial cold autoinflammatory syndrome (FCAS), Muckle-Wells syndrome (MWS), and neonatal-onset multisystem inflammatory disease (MONID). These syndromes are characterized by urticarial-like rash, periodic fever, central nervous system inflammation, an arthropathy, and the risk of amyloidosis. About 20% die by age 20 years in the most severe cases. The disease is associated with mutations in the NLRP3 gene that encodes for the protein cryopyrin, a component of the inflammasome complex that regulates the production and secretion of IL-1β. Canakinumab is a human IgG monoclonal antibody targeting IL-1β. The clinical trials of canakinumab for patients with CAPS in both western countries and Japan were well-tolerated in most patients, and provided significant advantages over existing competitive therapies. Although no serious adverse effects have been reported, the frequencies of common infectious diseases including nasopharyngitis, upper respiratory tract infections, and gastroenteritis were reported presumably due to the blockade of proinflammatory cytokine, IL-1β. For us pediatrician, it will be important to be more careful for infectious diseases to provide the maximum safety of canakinumab for these patients. Cryopyrin-associated periodic syndrome (CAPS) comprises a group of rare, but severe, autoinflammatory syndrome, and includes 3 distinct conditions, familial cold autoinflammatory syndrome (FCAS), Muckle-Wells syndrome (MWS), and neonatal-onset multisystem inflammatory disease (MONID). These syndromes are characterized by urticarial-like rash, periodic fever, central nervous system inflammation, an arthropathy, and the risk of amyloidosis. About 20% die by age 20 years in the most severe cases. The disease is associated with mutations in the NLRP3 gene that encodes for the protein cryopyrin, a component of the inflammasome complex that regulates the production and secretion of IL-1β. Canakinumab is a human IgG monoclonal antibody targeting IL-1β. The clinical trials of canakinumab for patients with CAPS in both western countries and Japan were well-tolerated in most patients, and provided significant advantages over existing competitive therapies. Although no serious adverse effects have been reported, the frequencies of common infectious diseases including nasopharyngitis, upper respiratory tract infections, and gastroenteritis were reported presumably due to the blockade of proinflammatory cytokine, IL-1β. For us pediatrician, it will be important to be more careful for infectious diseases to provide the maximum safety of canakinumab for these patients. |
| Author | MORI, Masa-aki NOZAWA, Tomo YOKOTA, Shumpei KIZAWA, Toshiatsu HARA, Toshiro MIYAMAE, Takako IMAGAWA, Tomoyuki KANETAKA, Taichi HEIKE, Toshio TAKATA, Hidetoshi KIKUCHI, Masako NISHIKOMORI, Ryohta |
| Author_xml | – sequence: 1 fullname: YOKOTA, Shumpei organization: Department of Pediatrics, Yokohama City University School of Medicine – sequence: 1 fullname: KANETAKA, Taichi organization: Department of Pediatrics, Yokohama City University School of Medicine – sequence: 1 fullname: MORI, Masa-aki organization: Department of Pediatrics, Yokohama City University School of Medicine – sequence: 1 fullname: HEIKE, Toshio organization: Department of Pediatrics Graduate School of Medicine, Kyoto University – sequence: 1 fullname: IMAGAWA, Tomoyuki organization: Department of Pediatrics, Yokohama City University School of Medicine – sequence: 1 fullname: NOZAWA, Tomo organization: Department of Pediatrics, Yokohama City University School of Medicine – sequence: 1 fullname: KIKUCHI, Masako organization: Department of Pediatrics, Yokohama City University School of Medicine – sequence: 1 fullname: KIZAWA, Toshiatsu organization: Department of Pediatrics, Yokohama City University School of Medicine – sequence: 1 fullname: MIYAMAE, Takako organization: Department of Pediatrics, Yokohama City University School of Medicine – sequence: 1 fullname: NISHIKOMORI, Ryohta organization: Department of Pediatrics Graduate School of Medicine, Kyoto University – sequence: 1 fullname: TAKATA, Hidetoshi organization: Department of Pediatrics, Graduate School of Medical Science Kyushu University – sequence: 1 fullname: HARA, Toshiro organization: Department of Pediatrics, Graduate School of Medical Science Kyushu University |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/22374439$$D View this record in MEDLINE/PubMed |
| BookMark | eNo90U1v1DAQBmALFdGl9MIPQL4BElnij8QxF7REfEkFVhTO0cSedL0kdrC9qvbCbydoSy8zh3k00rzzmJz54JGQp6xcc6bU630ybi2qNRcPyIoJqQslmTgjq1IzVkhRlufkMiXXlyWXjai1fkTOORdKSqFX5M_G0808xwBmR3OgeYd0C9mhz4neuryjbTyG-RidLyClYBxktHSL0QXrDL0-ehvDhPRFu9lev6RvKNCveEvfuTCGmwV8xzQHn5B-WfzgML6iLXj45fxhgv4JeTjAmPDyrl-Qnx_e_2g_FVffPn5uN1fFntWNLmQtbNljZWSlsekbxXoYaqWh1FZzK2qrawaSY6WkEWjrQcgBVKOFtnxoQFyQ56e9y6W_D5hyN7lkcBzBYzikTvNKsSUbschnd_LQT2i7OboJ4rH7H9kC3p7APmW4wXsAMTszYvfvIZ2oOnYqXNxPzA5ih178BeiThuU |
| ContentType | Journal Article |
| Copyright | 2012 The Japan Society for Clinical Immunology |
| Copyright_xml | – notice: 2012 The Japan Society for Clinical Immunology |
| DBID | CGR CUY CVF ECM EIF NPM 7X8 |
| DOI | 10.2177/jsci.35.23 |
| DatabaseName | Medline MEDLINE MEDLINE (Ovid) MEDLINE MEDLINE PubMed MEDLINE - Academic |
| DatabaseTitle | MEDLINE Medline Complete MEDLINE with Full Text PubMed MEDLINE (Ovid) MEDLINE - Academic |
| DatabaseTitleList | MEDLINE - Academic MEDLINE |
| Database_xml | – sequence: 1 dbid: NPM name: PubMed url: https://proxy.k.utb.cz/login?url=http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed sourceTypes: Index Database – sequence: 2 dbid: EIF name: MEDLINE url: https://proxy.k.utb.cz/login?url=https://www.webofscience.com/wos/medline/basic-search sourceTypes: Index Database |
| DeliveryMethod | fulltext_linktorsrc |
| Discipline | Biology |
| EISSN | 1349-7413 |
| EndPage | 29 |
| ExternalDocumentID | 22374439 article_jsci_35_1_35_1_23_article_char_en |
| Genre | Journal Article Review |
| GroupedDBID | 2WC ALMA_UNASSIGNED_HOLDINGS CS3 E3Z EBS EJD F5P JSF KQ8 MOJWN OK1 RJT CGR CUY CVF ECM EIF NPM 7X8 |
| ID | FETCH-LOGICAL-j1689-463d0be5c459e8b871baf679a09d92d36d961a42e574c3ed6f34fa78939d2f8a3 |
| ISSN | 0911-4300 1349-7413 |
| IngestDate | Fri Jul 11 03:35:59 EDT 2025 Thu May 23 23:15:49 EDT 2024 Wed Sep 03 06:29:09 EDT 2025 |
| IsDoiOpenAccess | true |
| IsOpenAccess | true |
| IsPeerReviewed | false |
| IsScholarly | false |
| Issue | 1 |
| Language | Japanese |
| LinkModel | OpenURL |
| MergedId | FETCHMERGED-LOGICAL-j1689-463d0be5c459e8b871baf679a09d92d36d961a42e574c3ed6f34fa78939d2f8a3 |
| Notes | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 ObjectType-Review-3 content type line 23 |
| OpenAccessLink | https://www.jstage.jst.go.jp/article/jsci/35/1/35_1_23/_article/-char/en |
| PMID | 22374439 |
| PQID | 925716993 |
| PQPubID | 23479 |
| PageCount | 7 |
| ParticipantIDs | proquest_miscellaneous_925716993 pubmed_primary_22374439 jstage_primary_article_jsci_35_1_35_1_23_article_char_en |
| PublicationCentury | 2000 |
| PublicationDate | 2012 2012-00-00 20120101 |
| PublicationDateYYYYMMDD | 2012-01-01 |
| PublicationDate_xml | – year: 2012 text: 2012 |
| PublicationDecade | 2010 |
| PublicationPlace | Japan |
| PublicationPlace_xml | – name: Japan |
| PublicationTitle | Japanese Journal of Clinical Immunology |
| PublicationTitleAlternate | Jpn. J. Clin. Immunol. |
| PublicationYear | 2012 |
| Publisher | The Japan Society for Clinical Immunology |
| Publisher_xml | – name: The Japan Society for Clinical Immunology |
| References | 24) Lachmann HJ, Kone-Paut I, Kuemmerle-Deschener JB, et al. : Use of canakinumab in the cryopyrin-associated periodic syndrome. New Engl J Med 360 : 2416-2425, 2009. 3) Dhimolea E. Canakinumab. : mAbs 2 : 3-13, 2010. 1) Lachmann HJ. : Clinical immunology review series : an approach to the patients with a periodic fever syndrome. Clin Exp Immunol 165 : 301-309, 2011. 21) Kaufman RA, Lovell DJ. : Infantile-onset multisystem inflammatory disease : radiologic findings. Radiology 160 : 741-746, 1986. 7) Ridker PM, Fonseca FAH, Genest Jm et al. : Baseline characteristics of participants in the JUPITER trial, a randomized placebo-controlled primary prevention trial of statin therapy among individuals with low low-density lipoprotein cholesterol and elevated high-sensitivy C-reactive protein. Am J Cardiol 100 : 1659-1664, 2007. 13) Feldmann J, Prieur A-M, Quartier P, et al. : Chronic infantile neurological cutaneous and articular syndrome is caused by mutations in CIAS-1, a gene highly expressed in polymorphonuclear cells and chondrocytes. Am J Hum Genet 71 : 198-203, 2002. 6) Hillier SL, Martius J, Krohn M, et al. : A case-controlled study of chorioamnionic infection and histologic chorioamnionitis in prematurity. N Engl J Med 319 : 972-978, 1988. 10) Di Virgilio F. : Liaisons dangereuses : P2X7 and the inflammasome. Trends Pharmacol Sci 28 : 465-472, 2007. 8) Bianchi ME. : DAMPs, PAMPs and alarmins : all we need to know about danger. J Leukoc Biol 81 : 1-5, 2007. 11) Lovell DJ, Ruperto N, Goodman S, et al. : Adalinumab with or without methotrexate in juvenile rheumatoid arthritis. New Engl J Med 359 : 810-820, 2008. 2) Hoffman HM, Wanderer AA. : Inflammasome and IL-1β-mediated disorders. Curr Allergy Rep 10 : 229-235, 2010. 16) Yu JR, Leslie KS. : Cryopyrin-associated periodic syndrome : an update on diagnosis and treatment response. Curr Allergy Asthma Rep 11 : 12-20, 2011. 5) Murdoch JR, Lioyd CM. : Chronic inflammation and asthma. Mutat Res 690 : 24-39, 2010. 14) Franchi L, Eigenbrod T, Munoz-Planillo R, et al. : The inflammasome : a caspase-1 activation platform regulating immune responses and disease pathogenesis. Nat Immunol 10 : 241-247, 2009. 19) Hoffman H, Mueller J, Brodie D, et al. : Mutation of a new gene encoding a putative pyrin-like protein causes familial cold autoinflammatory syndrome and Muckle-Wells syndrome. Nat Genet 29 : 301-305, 2001. 22) Neven B, Marvillet I, Terrada C, et al. : Long-term efficacy of the interleukin-1 receptor antagonist anakinra in ten patients with neonatal-onset multisystem inflammatory disease/chronic infantile neurologic, cutaneous, articular syndrome. Arthritis Rheum 62 : 258-267, 2010. 9) Akira S. : Innate immunity and adjuvants. Phi Trans R Soc 366 : 2748-2755, 2011. 20) Aksentijevich I, Nomak M, Mallah M, et al. : De novo CIAS1 mutations, cytokine activation, and evidence for genetic heterogeneity in patients with neonatal-onset multisystem inflammatory disease (NOMID) : a new member of the expanding family of pyrin-associated autoinflammatory diseases. Arthritis Rheum 46 : 3340-3348, 2002. 15) Aksentijevich I, Putnam CD, Remmers EF, et al. : The clinical continuum of cryopyrinopathies : novel CIAS-1 mutations in North America patients and a new cryopyrin model. Arthritis Rheum 56 : 1273-1285, 2007. 17) Arostegui JI, Saldana MaDL, Pascal M, et al. : A somatic NLRP3 mutation as a cause of a sporadic case of chronic infantile neurologic cutaneous articular syndrome/neonatal-onset multisystem inflammatory disease. Arthritis Rheum 62 : 1158-1166, 2010. 12) Yokota S, Imagawa T, Mori M, et al. : Efficacy and safety of tocilizumab in patients with systemic-onset juvenile idiopathic arthritis : a randomized, double-blind, placebo-controlled, withdrawal phase III trial. Lancet 371 : 998-1006, 2008. 4) Imagawa T, Nishikomori R, Takada H, et al. : Safety and efficacy of canakinumab in patients with cryopyrin-associated periodic syndrome : 24-week results from an open-label, phase-3 pivotal study. Clin Exp Rheumatol (in press 25) Schroder K, Zhou R, Tschopp J. : The NLRP3 inflammasome : a sensor for metabolic danger? Science 327 : 296-300, 2010. 18) Saito M, Fijisawa A, Nishikomori R, et al. : Somatic mosaicism of CIAS1 in a patient with chronic infantile neurologic cutaneous articular syndrome. Arthritis Rheum 52 : 3579-3585, 2005. 23) Hoffman HM, Throne ML, Amar NJ, et al. : Efficacy and safety of rilonacept (interleukin-1 trap) in patients with cryopyrin-associated periodic syndromes. Results from two sequential placebo-controlled studires. Arthritis Rheum 58 : 2443-2452, 2008. |
| References_xml | – reference: 25) Schroder K, Zhou R, Tschopp J. : The NLRP3 inflammasome : a sensor for metabolic danger? Science 327 : 296-300, 2010. – reference: 13) Feldmann J, Prieur A-M, Quartier P, et al. : Chronic infantile neurological cutaneous and articular syndrome is caused by mutations in CIAS-1, a gene highly expressed in polymorphonuclear cells and chondrocytes. Am J Hum Genet 71 : 198-203, 2002. – reference: 15) Aksentijevich I, Putnam CD, Remmers EF, et al. : The clinical continuum of cryopyrinopathies : novel CIAS-1 mutations in North America patients and a new cryopyrin model. Arthritis Rheum 56 : 1273-1285, 2007. – reference: 2) Hoffman HM, Wanderer AA. : Inflammasome and IL-1β-mediated disorders. Curr Allergy Rep 10 : 229-235, 2010. – reference: 7) Ridker PM, Fonseca FAH, Genest Jm et al. : Baseline characteristics of participants in the JUPITER trial, a randomized placebo-controlled primary prevention trial of statin therapy among individuals with low low-density lipoprotein cholesterol and elevated high-sensitivy C-reactive protein. Am J Cardiol 100 : 1659-1664, 2007. – reference: 14) Franchi L, Eigenbrod T, Munoz-Planillo R, et al. : The inflammasome : a caspase-1 activation platform regulating immune responses and disease pathogenesis. Nat Immunol 10 : 241-247, 2009. – reference: 19) Hoffman H, Mueller J, Brodie D, et al. : Mutation of a new gene encoding a putative pyrin-like protein causes familial cold autoinflammatory syndrome and Muckle-Wells syndrome. Nat Genet 29 : 301-305, 2001. – reference: 5) Murdoch JR, Lioyd CM. : Chronic inflammation and asthma. Mutat Res 690 : 24-39, 2010. – reference: 1) Lachmann HJ. : Clinical immunology review series : an approach to the patients with a periodic fever syndrome. Clin Exp Immunol 165 : 301-309, 2011. – reference: 22) Neven B, Marvillet I, Terrada C, et al. : Long-term efficacy of the interleukin-1 receptor antagonist anakinra in ten patients with neonatal-onset multisystem inflammatory disease/chronic infantile neurologic, cutaneous, articular syndrome. Arthritis Rheum 62 : 258-267, 2010. – reference: 20) Aksentijevich I, Nomak M, Mallah M, et al. : De novo CIAS1 mutations, cytokine activation, and evidence for genetic heterogeneity in patients with neonatal-onset multisystem inflammatory disease (NOMID) : a new member of the expanding family of pyrin-associated autoinflammatory diseases. Arthritis Rheum 46 : 3340-3348, 2002. – reference: 16) Yu JR, Leslie KS. : Cryopyrin-associated periodic syndrome : an update on diagnosis and treatment response. Curr Allergy Asthma Rep 11 : 12-20, 2011. – reference: 9) Akira S. : Innate immunity and adjuvants. Phi Trans R Soc 366 : 2748-2755, 2011. – reference: 21) Kaufman RA, Lovell DJ. : Infantile-onset multisystem inflammatory disease : radiologic findings. Radiology 160 : 741-746, 1986. – reference: 10) Di Virgilio F. : Liaisons dangereuses : P2X7 and the inflammasome. Trends Pharmacol Sci 28 : 465-472, 2007. – reference: 3) Dhimolea E. Canakinumab. : mAbs 2 : 3-13, 2010. – reference: 12) Yokota S, Imagawa T, Mori M, et al. : Efficacy and safety of tocilizumab in patients with systemic-onset juvenile idiopathic arthritis : a randomized, double-blind, placebo-controlled, withdrawal phase III trial. Lancet 371 : 998-1006, 2008. – reference: 6) Hillier SL, Martius J, Krohn M, et al. : A case-controlled study of chorioamnionic infection and histologic chorioamnionitis in prematurity. N Engl J Med 319 : 972-978, 1988. – reference: 18) Saito M, Fijisawa A, Nishikomori R, et al. : Somatic mosaicism of CIAS1 in a patient with chronic infantile neurologic cutaneous articular syndrome. Arthritis Rheum 52 : 3579-3585, 2005. – reference: 4) Imagawa T, Nishikomori R, Takada H, et al. : Safety and efficacy of canakinumab in patients with cryopyrin-associated periodic syndrome : 24-week results from an open-label, phase-3 pivotal study. Clin Exp Rheumatol (in press) – reference: 11) Lovell DJ, Ruperto N, Goodman S, et al. : Adalinumab with or without methotrexate in juvenile rheumatoid arthritis. New Engl J Med 359 : 810-820, 2008. – reference: 17) Arostegui JI, Saldana MaDL, Pascal M, et al. : A somatic NLRP3 mutation as a cause of a sporadic case of chronic infantile neurologic cutaneous articular syndrome/neonatal-onset multisystem inflammatory disease. Arthritis Rheum 62 : 1158-1166, 2010. – reference: 24) Lachmann HJ, Kone-Paut I, Kuemmerle-Deschener JB, et al. : Use of canakinumab in the cryopyrin-associated periodic syndrome. New Engl J Med 360 : 2416-2425, 2009. – reference: 8) Bianchi ME. : DAMPs, PAMPs and alarmins : all we need to know about danger. J Leukoc Biol 81 : 1-5, 2007. – reference: 23) Hoffman HM, Throne ML, Amar NJ, et al. : Efficacy and safety of rilonacept (interleukin-1 trap) in patients with cryopyrin-associated periodic syndromes. Results from two sequential placebo-controlled studires. Arthritis Rheum 58 : 2443-2452, 2008. |
| SSID | ssib002483699 ssib004486027 ssib005901866 ssib004368810 ssib058493880 ssj0035374 ssib023167663 ssib002484376 ssib000940325 ssib002484377 |
| Score | 1.5795729 |
| SecondaryResourceType | review_article |
| Snippet | Cryopyrin-associated periodic syndrome (CAPS) comprises a group of rare, but severe, autoinflammatory syndrome, and includes 3 distinct conditions, familial... |
| SourceID | proquest pubmed jstage |
| SourceType | Aggregation Database Index Database Publisher |
| StartPage | 23 |
| SubjectTerms | Antibodies, Monoclonal - adverse effects Antibodies, Monoclonal - therapeutic use Autoimmune Diseases - immunology autoinflammatory syndrome biologic response modifiers cryopyrin-associated periodic syndrome Cryopyrin-Associated Periodic Syndromes - drug therapy Cryopyrin-Associated Periodic Syndromes - immunology Humans Interleukin-1beta - antagonists & inhibitors interleukin-1β NLRP3-inflammasome |
| Title | An Approach to the Patients with Cryopyrin-associated Periodic Syndrome (CAPS) : a New Biologic Response Modifier, Canakinumab |
| URI | https://www.jstage.jst.go.jp/article/jsci/35/1/35_1_23/_article/-char/en https://www.ncbi.nlm.nih.gov/pubmed/22374439 https://www.proquest.com/docview/925716993 |
| Volume | 35 |
| hasFullText | 1 |
| inHoldings | 1 |
| isFullTextHit | |
| isPrint | |
| ispartofPNX | Japanese Journal of Clinical Immunology, 2012, Vol.35(1), pp.23-29 |
| link | http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwnV1Lj9MwELbKIiQuiPeWl3zgAFpSkthxYm5RVbSl2m1hu9JyipwXTSWSVR-HcuDn8jsY23GaoF1p2UvU5ml55rO_GXtmEHqb-tROc55ZNItjiyYCxkFBXCtLck_AjOI7qvLcySk7PqdfLryLXu9Pa9fSdhMPkl9XxpXcRqpwDuQqo2T_Q7LNS-EE_Ab5whEkDMcbyTgsJYtsYqIkh5zpPKl10Npwtasud6uitEQtBuCXM2halRbJ0VmdrUCt5IazM-MhEGrXo65SqfbZq220Ev9pkRcmcrCUday2P0Xc4bcw98qalkctojs0wZdjGYvSceN_n06m81B5YBegV1nRjP_h6WgeTtSluSiSRXPlZPptrIOM1sKCJjR6ORpP1M7OebVe6M1lxpvh7K1eFQkn29jZrnpdC2sXpgP2L7H1uk6mB3BCuQUsibRHeJ0QpaPJ9XBNWhO_9rz8O6W4elF7CYRkQLyBeaKTortWgEjeFBEvcvTBJZG5IkPoQGPvoLuuz5istDH52qLBnNrE7aSZI6xtJtKAkhZt1P9bq9WEBe20clRVFuvGFwd72u7K7Adsn3YNOCjXOYE0gyEe0dnLTf_qtL6yJz7u-wEo2xIMmB_Z9baZ4mjzh-hBrXM41N3xCPWW4jG6pxV59wT9Dkts8II3FQa8YIMXLPGCr8ILNnjBBi_4nUTLe_wJCwxIwQYp2CAFG6R8wC2cPEXnn0fz4bFV1x-xlg4LuEUZSe048xLq8SyIA9-JRc58LmyecjclLOXMEdTNPJ8mJEtZTmgufLAAeOrmMOQ9QwdlVWaHCCfwlEcpt-Emme6JM3hL4nlB7vLYoXYfBbozo0udZCa6sU71ETbdH8HUINf7AOjVdh1xmI4d0CPSR8-1WJq3g1HgU7BFXtz-uy_RfQlg7Y58hQ42q232Ggj6Jn6jtPsvjW3eww |
| linkProvider | Colorado Alliance of Research Libraries |
| openUrl | ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info%3Asid%2Fsummon.serialssolutions.com&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=An+Approach+to+the+Patients+with+Cryopyrin-associated+Periodic+Syndrome+%28CAPS%29+%3A+a+New+Biologic+Response+Modifier%2C+Canakinumab&rft.jtitle=Japanese+Journal+of+Clinical+Immunology&rft.au=YOKOTA%2C+Shumpei&rft.au=KANETAKA%2C+Taichi&rft.au=MORI%2C+Masa-aki&rft.au=HEIKE%2C+Toshio&rft.date=2012&rft.pub=The+Japan+Society+for+Clinical+Immunology&rft.issn=0911-4300&rft.eissn=1349-7413&rft.volume=35&rft.issue=1&rft.spage=23&rft.epage=29&rft_id=info:doi/10.2177%2Fjsci.35.23&rft.externalDocID=article_jsci_35_1_35_1_23_article_char_en |
| thumbnail_l | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/lc.gif&issn=0911-4300&client=summon |
| thumbnail_m | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/mc.gif&issn=0911-4300&client=summon |
| thumbnail_s | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/sc.gif&issn=0911-4300&client=summon |