IL-18BP

Interleukin-18 binding protein (IL-18BP) is a secreted, soluble regulator that constitutes the principal natural brake on IL-18 activity. It is not a truncated receptor but a distinct protein belonging to the immunoglobulin superfamily, constitutively present in human plasma at high concentrations and further induced by IFN-γ during inflammation. IL-18BP binds mature IL-18 with picomolar affinity, one order of magnitude higher than the affinity of IL-18 for its signaling receptor IL-18Rα, thereby neutralizing IL-18 and preventing IL-18Rβ recruitment and downstream MyD88-NF-κB activation. Through this mechanism, IL-18BP limits excessive IFN-γ production and protects against macrophage activation syndrome, inflammatory bowel disease, psoriasis and sepsis-associated immunopathology. Pseudomonas aeruginosa produces a viral IL-18BP homolog (PA2774) that disables this defense, and recombinant IL-18BP (tadekinig alfa) has been evaluated in clinical trials for autoinflammatory diseases.