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Hanlon MM, Smith CM, Canavan M, Neto NGB, Song Q, Lewis MJ, O’Rourke AM, Tynan O, Barker BE, Gallagher P, Mullan R, Hurson C, Moran B, Monaghan MG, Pitzalis C, Fletcher JM, Nagpal S, Veale DJ, Fearon U. Loss of synovial tissue macrophage homeostasis precedes rheumatoid arthritis clinical onset. SCIENCE ADVANCES 2024; 10:eadj1252. [PMID: 39321281 PMCID: PMC11423874 DOI: 10.1126/sciadv.adj1252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 08/20/2024] [Indexed: 09/27/2024]
Abstract
This study performed an in-depth investigation into the myeloid cellular landscape in the synovium of patients with rheumatoid arthritis (RA), "individuals at risk" of RA, and healthy controls (HC). Flow cytometric analysis demonstrated the presence of a CD40-expressing CD206+CD163+ macrophage population dominating the inflamed RA synovium, associated with disease activity and treatment response. In-depth RNA sequencing and metabolic analysis demonstrated that this macrophage population is transcriptionally distinct, displaying unique inflammatory and tissue-resident gene signatures, has a stable bioenergetic profile, and regulates stromal cell responses. Single-cell RNA sequencing profiling of 67,908 RA and HC synovial tissue cells identified nine transcriptionally distinct macrophage clusters. IL-1B+CCL20+ and SPP1+MT2A+ are the principal macrophage clusters in RA synovium, displaying heightened CD40 gene expression, capable of shaping stromal cell responses, and are importantly enriched before disease onset. Combined, these findings identify the presence of an early pathogenic myeloid signature that shapes the RA joint microenvironment and represents a unique opportunity for early diagnosis and therapeutic intervention.
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Affiliation(s)
- Megan M. Hanlon
- Molecular Rheumatology, School of Medicine, Trinity College Dublin, Dublin, Ireland
- Centre for Arthritis and Rheumatic Diseases, St. Vincent's University Hospital, University College Dublin, Dublin, Ireland
| | - Conor M. Smith
- School of Biochemistry and Immunology, Trinity College Dublin, Dublin, Ireland
| | - Mary Canavan
- Molecular Rheumatology, School of Medicine, Trinity College Dublin, Dublin, Ireland
- Centre for Arthritis and Rheumatic Diseases, St. Vincent's University Hospital, University College Dublin, Dublin, Ireland
- Translational Immunopathology, School of Biochemistry and Immunology and School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Nuno G. B. Neto
- Department of Mechanical and Manufacturing Engineering, Trinity Biomedical Sciences Institute, Dublin, Ireland
| | - Qingxuan Song
- Immunology and Discovery Sciences, Janssen Research and Development, Spring House, PA, USA
| | - Myles J. Lewis
- Centre for Experimental Medicine and Rheumatology, William Harvey Research Institute, Queen Mary University of London and Barts NIHR BRC and Barts Health NHS Trust, London, UK
| | - Aoife M. O’Rourke
- Molecular Rheumatology, School of Medicine, Trinity College Dublin, Dublin, Ireland
- Centre for Arthritis and Rheumatic Diseases, St. Vincent's University Hospital, University College Dublin, Dublin, Ireland
- Translational Immunopathology, School of Biochemistry and Immunology and School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Orla Tynan
- Molecular Rheumatology, School of Medicine, Trinity College Dublin, Dublin, Ireland
- Centre for Arthritis and Rheumatic Diseases, St. Vincent's University Hospital, University College Dublin, Dublin, Ireland
| | - Brianne E. Barker
- Molecular Rheumatology, School of Medicine, Trinity College Dublin, Dublin, Ireland
- Centre for Arthritis and Rheumatic Diseases, St. Vincent's University Hospital, University College Dublin, Dublin, Ireland
| | - Phil Gallagher
- Centre for Arthritis and Rheumatic Diseases, St. Vincent's University Hospital, University College Dublin, Dublin, Ireland
| | - Ronan Mullan
- Department of Rheumatology, Adelaide and Meath Hospital, Dublin, Ireland
| | - Conor Hurson
- Department of Orthopaedics, St. Vincent’s University Hospital, Dublin, Ireland
| | - Barry Moran
- School of Biochemistry and Immunology, Trinity College Dublin, Dublin, Ireland
| | - Michael G. Monaghan
- Department of Mechanical and Manufacturing Engineering, Trinity Biomedical Sciences Institute, Dublin, Ireland
| | - Costantino Pitzalis
- Centre for Experimental Medicine and Rheumatology, William Harvey Research Institute, Queen Mary University of London and Barts NIHR BRC and Barts Health NHS Trust, London, UK
- Department of Biomedical Sciences, Humanitas University and Humanitas Research Hospital, Milan, Italy
| | - Jean M. Fletcher
- School of Biochemistry and Immunology, Trinity College Dublin, Dublin, Ireland
- School of Medicine, Trinity Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland
| | - Sunil Nagpal
- Immunology and Discovery Sciences, Janssen Research and Development, Spring House, PA, USA
| | - Douglas J. Veale
- Centre for Arthritis and Rheumatic Diseases, St. Vincent's University Hospital, University College Dublin, Dublin, Ireland
| | - Ursula Fearon
- Molecular Rheumatology, School of Medicine, Trinity College Dublin, Dublin, Ireland
- Centre for Arthritis and Rheumatic Diseases, St. Vincent's University Hospital, University College Dublin, Dublin, Ireland
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Hanlon MM, McGarry T, Marzaioli V, Amaechi S, Song Q, Nagpal S, Veale DJ, Fearon U. Rheumatoid arthritis macrophages are primed for inflammation and display bioenergetic and functional alterations. Rheumatology (Oxford) 2023; 62:2611-2620. [PMID: 36398893 PMCID: PMC10321118 DOI: 10.1093/rheumatology/keac640] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Accepted: 10/28/2022] [Indexed: 07/20/2023] Open
Abstract
OBJECTIVES Myeloid cells with a monocyte/macrophage phenotype are present in large numbers in the RA joint, significantly contributing to disease; however, distinct macrophage functions have yet to be elucidated. This study investigates the metabolic activity of infiltrating polarized macrophages and their impact on pro-inflammatory responses in RA. METHODS CD14+ monocytes from RA and healthy control (HC) bloods were isolated and examined ex vivo or following differentiation into 'M1/M2' macrophages. Inflammatory responses and metabolic analysis ± specific inhibitors were quantified by RT-PCR, western blot, Seahorse XFe technology, phagocytosis assays and transmission electron microscopy along with RNA-sequencing (RNA-seq) transcriptomic analysis. RESULTS Circulating RA monocytes are hyper-inflammatory upon stimulation, with significantly higher expression of key cytokines compared with HC (P < 0.05) a phenotype which is maintained upon differentiation into mature ex vivo polarized macrophages. This induction in pro-inflammatory mechanisms is paralleled by cellular bioenergetic changes. RA macrophages are highly metabolic, with a robust boost in both oxidative phosphorylation and glycolysis in RA along with altered mitochondrial morphology compared with HC. RNA-seq analysis revealed divergent transcriptional variance between pro- and anti-inflammatory RA macrophages, revealing a role for STAT3 and NAMPT in driving macrophage activation states. STAT3 and NAMPT inhibition results in significant decrease in pro-inflammatory gene expression observed in RA macrophages. Interestingly, NAMPT inhibition specifically restores macrophage phagocytic function and results in reciprocal STAT3 inhibition, linking these two signalling pathways. CONCLUSION This study demonstrates a unique inflammatory and metabolic phenotype of RA monocyte-derived macrophages and identifies a key role for NAMPT and STAT3 signalling in regulating this phenotype.
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Affiliation(s)
- Megan M Hanlon
- Molecular Rheumatology Research Group, Trinity Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland
| | | | | | - Success Amaechi
- Molecular Rheumatology Research Group, Trinity Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland
| | - Qingxuan Song
- Immunology and Discovery Sciences, Janssen Research & Development, Philadelphia, PA, USA
| | - Sunil Nagpal
- Immunology and Discovery Sciences, Janssen Research & Development, Philadelphia, PA, USA
| | - Douglas J Veale
- EULAR Centre of Excellence, Centre for Arthritis and Rheumatic Diseases, St Vincent's University Hospital, Dublin, Ireland
| | - Ursula Fearon
- Correspondence to: Ursula Fearon, Molecular Rheumatology Research Group, School of Medicine, Trinity Biomedical Sciences Institute, 152-160 Pearse Street, Trinity College Dublin D02 R590, Dublin, Ireland. E-mail:
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Yang M, Zhao C, Wang M, Wang Q, Zhang R, Bai W, Liu J, Zhang S, Xu D, Liu S, Li X, Qi Z, Yang F, Zhu L, He X, Tian X, Zeng X, Li J, Jiang Y. Synovial Oxygenation at Photoacoustic Imaging to Assess Rheumatoid Arthritis Disease Activity. Radiology 2023; 306:220-228. [PMID: 35997608 DOI: 10.1148/radiol.212257] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Background Synovial hypoxia is a hallmark of rheumatoid arthritis (RA). Photoacoustic (PA) imaging, based on the use of laser-generated US, can detect the oxygenation status of tissue in individuals with RA. However, large studies are lacking, with few investigating the correlation between oxygenation status and disease activity. Purpose To measure synovial oxygenation status in participants with RA by using a multimodal PA US imaging system and to determine the correlation between PA imaging-measured oxygen saturation (SO2) and disease activity. Materials and Methods In this prospective observational cohort study, multimodal PA US imaging examinations were performed on small joints of consecutive participants with RA, who were treated at two outpatient rheumatology clinics from 2019 to 2021, and healthy controls. The SO2 values of the synovium were measured with dual-wavelength PA imaging and classified into three categories-hyperoxia, intermediate oxygenation status, or hypoxia-based on the signal coloration and clustering analysis of the SO2 values. The correlations of oxygenation status with power Doppler US (PDUS) scoring and clinical disease activity index were evaluated with one-way analysis of variance and the Kruskal-Wallis test with Bonferroni correction. Results A total of 118 participants with RA (median age, 55 years [IQR, 41-62 years]; 92 women) and 15 healthy control participants (median age, 37 years [IQR, 33-41 years]; 11 women) were included. The wrist synovium was categorized as hyperoxic in 36 participants with RA, of intermediate oxygenation status in 48 participants, and hypoxic in 34 participants. All control participants had hyperoxic synovial tissues. For participants with RA, hyperoxic synovium had more affluent Doppler US-depicted vasculature than those with hypoxia and intermediate oxygenation status (mean PDUS grade: hyperoxia, 2.7 ± 0.6 [SD]; intermediate, 1.3 ± 0.7; hypoxia, 1.1 ± 0.8; P < .001). Participants with intermediate status synovium had a lower clinical disease activity index than those with hypoxia (intermediate, 11.0 [IQR, 5.0-21.5] vs hypoxia, 26.0 [IQR, 18.0-39.0]; P = .001). Conclusion Photoacoustic imaging-detected hypoxia in thickened synovium correlated with less vascularization and higher disease activity in participants with rheumatoid arthritis. Clinical trial registration no. NCT04297475 © RSNA, 2022 Online supplemental material is available for this article.
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Affiliation(s)
- Meng Yang
- From the Departments of Ultrasound (M.Y., C.Z., M.W., R.Z., S.L., X.L., Z.Q., J. Li, Y.J.) and Rheumatology and Clinical Immunology (Q.W., W.B., S.Z., D.X., X.T., X.Z.), State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shuaifuyuan No. 1, Dongcheng District, Beijing 100730, China; National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Ministry of Science & Technology, and Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing, China (Q.W., W.B., S.Z., D.X., X.T., X.Z.,); Department of Rheumatology, Aero Space Central Hospital, Beijing, China (J. Liu); and Shenzhen Mindray Bio-Medical Electronics Co, Ltd, Shenzhen, China (F.Y., L.Z., X.H.)
| | - Chenyang Zhao
- From the Departments of Ultrasound (M.Y., C.Z., M.W., R.Z., S.L., X.L., Z.Q., J. Li, Y.J.) and Rheumatology and Clinical Immunology (Q.W., W.B., S.Z., D.X., X.T., X.Z.), State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shuaifuyuan No. 1, Dongcheng District, Beijing 100730, China; National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Ministry of Science & Technology, and Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing, China (Q.W., W.B., S.Z., D.X., X.T., X.Z.,); Department of Rheumatology, Aero Space Central Hospital, Beijing, China (J. Liu); and Shenzhen Mindray Bio-Medical Electronics Co, Ltd, Shenzhen, China (F.Y., L.Z., X.H.)
| | - Ming Wang
- From the Departments of Ultrasound (M.Y., C.Z., M.W., R.Z., S.L., X.L., Z.Q., J. Li, Y.J.) and Rheumatology and Clinical Immunology (Q.W., W.B., S.Z., D.X., X.T., X.Z.), State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shuaifuyuan No. 1, Dongcheng District, Beijing 100730, China; National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Ministry of Science & Technology, and Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing, China (Q.W., W.B., S.Z., D.X., X.T., X.Z.,); Department of Rheumatology, Aero Space Central Hospital, Beijing, China (J. Liu); and Shenzhen Mindray Bio-Medical Electronics Co, Ltd, Shenzhen, China (F.Y., L.Z., X.H.)
| | - Qian Wang
- From the Departments of Ultrasound (M.Y., C.Z., M.W., R.Z., S.L., X.L., Z.Q., J. Li, Y.J.) and Rheumatology and Clinical Immunology (Q.W., W.B., S.Z., D.X., X.T., X.Z.), State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shuaifuyuan No. 1, Dongcheng District, Beijing 100730, China; National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Ministry of Science & Technology, and Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing, China (Q.W., W.B., S.Z., D.X., X.T., X.Z.,); Department of Rheumatology, Aero Space Central Hospital, Beijing, China (J. Liu); and Shenzhen Mindray Bio-Medical Electronics Co, Ltd, Shenzhen, China (F.Y., L.Z., X.H.)
| | - Rui Zhang
- From the Departments of Ultrasound (M.Y., C.Z., M.W., R.Z., S.L., X.L., Z.Q., J. Li, Y.J.) and Rheumatology and Clinical Immunology (Q.W., W.B., S.Z., D.X., X.T., X.Z.), State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shuaifuyuan No. 1, Dongcheng District, Beijing 100730, China; National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Ministry of Science & Technology, and Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing, China (Q.W., W.B., S.Z., D.X., X.T., X.Z.,); Department of Rheumatology, Aero Space Central Hospital, Beijing, China (J. Liu); and Shenzhen Mindray Bio-Medical Electronics Co, Ltd, Shenzhen, China (F.Y., L.Z., X.H.)
| | - Wei Bai
- From the Departments of Ultrasound (M.Y., C.Z., M.W., R.Z., S.L., X.L., Z.Q., J. Li, Y.J.) and Rheumatology and Clinical Immunology (Q.W., W.B., S.Z., D.X., X.T., X.Z.), State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shuaifuyuan No. 1, Dongcheng District, Beijing 100730, China; National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Ministry of Science & Technology, and Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing, China (Q.W., W.B., S.Z., D.X., X.T., X.Z.,); Department of Rheumatology, Aero Space Central Hospital, Beijing, China (J. Liu); and Shenzhen Mindray Bio-Medical Electronics Co, Ltd, Shenzhen, China (F.Y., L.Z., X.H.)
| | - Jian Liu
- From the Departments of Ultrasound (M.Y., C.Z., M.W., R.Z., S.L., X.L., Z.Q., J. Li, Y.J.) and Rheumatology and Clinical Immunology (Q.W., W.B., S.Z., D.X., X.T., X.Z.), State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shuaifuyuan No. 1, Dongcheng District, Beijing 100730, China; National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Ministry of Science & Technology, and Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing, China (Q.W., W.B., S.Z., D.X., X.T., X.Z.,); Department of Rheumatology, Aero Space Central Hospital, Beijing, China (J. Liu); and Shenzhen Mindray Bio-Medical Electronics Co, Ltd, Shenzhen, China (F.Y., L.Z., X.H.)
| | - Shangzhu Zhang
- From the Departments of Ultrasound (M.Y., C.Z., M.W., R.Z., S.L., X.L., Z.Q., J. Li, Y.J.) and Rheumatology and Clinical Immunology (Q.W., W.B., S.Z., D.X., X.T., X.Z.), State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shuaifuyuan No. 1, Dongcheng District, Beijing 100730, China; National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Ministry of Science & Technology, and Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing, China (Q.W., W.B., S.Z., D.X., X.T., X.Z.,); Department of Rheumatology, Aero Space Central Hospital, Beijing, China (J. Liu); and Shenzhen Mindray Bio-Medical Electronics Co, Ltd, Shenzhen, China (F.Y., L.Z., X.H.)
| | - Dong Xu
- From the Departments of Ultrasound (M.Y., C.Z., M.W., R.Z., S.L., X.L., Z.Q., J. Li, Y.J.) and Rheumatology and Clinical Immunology (Q.W., W.B., S.Z., D.X., X.T., X.Z.), State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shuaifuyuan No. 1, Dongcheng District, Beijing 100730, China; National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Ministry of Science & Technology, and Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing, China (Q.W., W.B., S.Z., D.X., X.T., X.Z.,); Department of Rheumatology, Aero Space Central Hospital, Beijing, China (J. Liu); and Shenzhen Mindray Bio-Medical Electronics Co, Ltd, Shenzhen, China (F.Y., L.Z., X.H.)
| | - Sirui Liu
- From the Departments of Ultrasound (M.Y., C.Z., M.W., R.Z., S.L., X.L., Z.Q., J. Li, Y.J.) and Rheumatology and Clinical Immunology (Q.W., W.B., S.Z., D.X., X.T., X.Z.), State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shuaifuyuan No. 1, Dongcheng District, Beijing 100730, China; National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Ministry of Science & Technology, and Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing, China (Q.W., W.B., S.Z., D.X., X.T., X.Z.,); Department of Rheumatology, Aero Space Central Hospital, Beijing, China (J. Liu); and Shenzhen Mindray Bio-Medical Electronics Co, Ltd, Shenzhen, China (F.Y., L.Z., X.H.)
| | - Xuelan Li
- From the Departments of Ultrasound (M.Y., C.Z., M.W., R.Z., S.L., X.L., Z.Q., J. Li, Y.J.) and Rheumatology and Clinical Immunology (Q.W., W.B., S.Z., D.X., X.T., X.Z.), State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shuaifuyuan No. 1, Dongcheng District, Beijing 100730, China; National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Ministry of Science & Technology, and Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing, China (Q.W., W.B., S.Z., D.X., X.T., X.Z.,); Department of Rheumatology, Aero Space Central Hospital, Beijing, China (J. Liu); and Shenzhen Mindray Bio-Medical Electronics Co, Ltd, Shenzhen, China (F.Y., L.Z., X.H.)
| | - Zhenhong Qi
- From the Departments of Ultrasound (M.Y., C.Z., M.W., R.Z., S.L., X.L., Z.Q., J. Li, Y.J.) and Rheumatology and Clinical Immunology (Q.W., W.B., S.Z., D.X., X.T., X.Z.), State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shuaifuyuan No. 1, Dongcheng District, Beijing 100730, China; National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Ministry of Science & Technology, and Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing, China (Q.W., W.B., S.Z., D.X., X.T., X.Z.,); Department of Rheumatology, Aero Space Central Hospital, Beijing, China (J. Liu); and Shenzhen Mindray Bio-Medical Electronics Co, Ltd, Shenzhen, China (F.Y., L.Z., X.H.)
| | - Fang Yang
- From the Departments of Ultrasound (M.Y., C.Z., M.W., R.Z., S.L., X.L., Z.Q., J. Li, Y.J.) and Rheumatology and Clinical Immunology (Q.W., W.B., S.Z., D.X., X.T., X.Z.), State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shuaifuyuan No. 1, Dongcheng District, Beijing 100730, China; National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Ministry of Science & Technology, and Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing, China (Q.W., W.B., S.Z., D.X., X.T., X.Z.,); Department of Rheumatology, Aero Space Central Hospital, Beijing, China (J. Liu); and Shenzhen Mindray Bio-Medical Electronics Co, Ltd, Shenzhen, China (F.Y., L.Z., X.H.)
| | - Lei Zhu
- From the Departments of Ultrasound (M.Y., C.Z., M.W., R.Z., S.L., X.L., Z.Q., J. Li, Y.J.) and Rheumatology and Clinical Immunology (Q.W., W.B., S.Z., D.X., X.T., X.Z.), State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shuaifuyuan No. 1, Dongcheng District, Beijing 100730, China; National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Ministry of Science & Technology, and Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing, China (Q.W., W.B., S.Z., D.X., X.T., X.Z.,); Department of Rheumatology, Aero Space Central Hospital, Beijing, China (J. Liu); and Shenzhen Mindray Bio-Medical Electronics Co, Ltd, Shenzhen, China (F.Y., L.Z., X.H.)
| | - Xujin He
- From the Departments of Ultrasound (M.Y., C.Z., M.W., R.Z., S.L., X.L., Z.Q., J. Li, Y.J.) and Rheumatology and Clinical Immunology (Q.W., W.B., S.Z., D.X., X.T., X.Z.), State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shuaifuyuan No. 1, Dongcheng District, Beijing 100730, China; National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Ministry of Science & Technology, and Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing, China (Q.W., W.B., S.Z., D.X., X.T., X.Z.,); Department of Rheumatology, Aero Space Central Hospital, Beijing, China (J. Liu); and Shenzhen Mindray Bio-Medical Electronics Co, Ltd, Shenzhen, China (F.Y., L.Z., X.H.)
| | - Xinping Tian
- From the Departments of Ultrasound (M.Y., C.Z., M.W., R.Z., S.L., X.L., Z.Q., J. Li, Y.J.) and Rheumatology and Clinical Immunology (Q.W., W.B., S.Z., D.X., X.T., X.Z.), State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shuaifuyuan No. 1, Dongcheng District, Beijing 100730, China; National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Ministry of Science & Technology, and Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing, China (Q.W., W.B., S.Z., D.X., X.T., X.Z.,); Department of Rheumatology, Aero Space Central Hospital, Beijing, China (J. Liu); and Shenzhen Mindray Bio-Medical Electronics Co, Ltd, Shenzhen, China (F.Y., L.Z., X.H.)
| | - Xiaofeng Zeng
- From the Departments of Ultrasound (M.Y., C.Z., M.W., R.Z., S.L., X.L., Z.Q., J. Li, Y.J.) and Rheumatology and Clinical Immunology (Q.W., W.B., S.Z., D.X., X.T., X.Z.), State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shuaifuyuan No. 1, Dongcheng District, Beijing 100730, China; National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Ministry of Science & Technology, and Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing, China (Q.W., W.B., S.Z., D.X., X.T., X.Z.,); Department of Rheumatology, Aero Space Central Hospital, Beijing, China (J. Liu); and Shenzhen Mindray Bio-Medical Electronics Co, Ltd, Shenzhen, China (F.Y., L.Z., X.H.)
| | - Jianchu Li
- From the Departments of Ultrasound (M.Y., C.Z., M.W., R.Z., S.L., X.L., Z.Q., J. Li, Y.J.) and Rheumatology and Clinical Immunology (Q.W., W.B., S.Z., D.X., X.T., X.Z.), State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shuaifuyuan No. 1, Dongcheng District, Beijing 100730, China; National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Ministry of Science & Technology, and Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing, China (Q.W., W.B., S.Z., D.X., X.T., X.Z.,); Department of Rheumatology, Aero Space Central Hospital, Beijing, China (J. Liu); and Shenzhen Mindray Bio-Medical Electronics Co, Ltd, Shenzhen, China (F.Y., L.Z., X.H.)
| | - Yuxin Jiang
- From the Departments of Ultrasound (M.Y., C.Z., M.W., R.Z., S.L., X.L., Z.Q., J. Li, Y.J.) and Rheumatology and Clinical Immunology (Q.W., W.B., S.Z., D.X., X.T., X.Z.), State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shuaifuyuan No. 1, Dongcheng District, Beijing 100730, China; National Clinical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID), Ministry of Science & Technology, and Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education, Beijing, China (Q.W., W.B., S.Z., D.X., X.T., X.Z.,); Department of Rheumatology, Aero Space Central Hospital, Beijing, China (J. Liu); and Shenzhen Mindray Bio-Medical Electronics Co, Ltd, Shenzhen, China (F.Y., L.Z., X.H.)
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Hypoxia Inhibits Osteogenesis and Promotes Adipogenesis of Fibroblast-like Synoviocytes via Upregulation of Leptin in Patients with Rheumatoid Arthritis. J Immunol Res 2022; 2022:1431399. [PMID: 36530571 DOI: 10.1155/2022/1431399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 11/21/2022] [Accepted: 11/22/2022] [Indexed: 12/12/2022] Open
Abstract
Hypoxia is associated with the pathogenesis of rheumatoid arthritis (RA). RA fibroblast-like synoviocytes (FLSs) are able to differentiate into osteoblasts and adipocytes. In this study, we aimed to investigate the role of hypoxia in the osteogenesis or adipogenesis of RA-FLSs. Bioinformatics analysis was performed to profile gene expression in the datasets of GSE21959, GSE32006, and GSE55875, and flow cytometry was performed for FLS characterization, while Alizarin Redand Oil Red O staining for osteogenic or adipogenic differentiation of FLSs, respectively. RNA interference leptin knockdown was used to determine the role of leptin in the osteogenesis and adipogenesis of RA-FLSs, and the expression of osteogenic and adipogenic markers was quantified by RT-qPCR and Western blotting. FLSs exhibited a mesenchymal stem cell (MSC)-like phenotype and we observed a limited self-renewal capacity in RA-FLSs compared to that in MSCs, but it was still greater than osteoarthritis (OA)-FLSs. Hypoxia did not change the RA-FLS MSC-like phenotype but inhibited the osteogenic differentiation and promoted the adipogenic differentiation of RA-FLSs. From the bioinformatics analysis ofGSE21959, GSE32006, and GSE55875 datasets, we found leptin, the only perturbed hypoxia-mediated upregulated gene across the three profiled datasets. Leptin knockdown in RA-FLSs reversed the hypoxia-mediated reduction of osteogenesis and hypoxia-mediated enhancement of adipogenesis by elevated expression of osteogenic markers and reduced expression of adipogenic markers, respectively. Therefore, hypoxia-leptin regulation of the osteogenic and adipogenic differentiation of RA-FLSs advances our understanding of RA pathogenesis, meanwhile also provides opportunities for future therapeutic intervention of RA.
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Systematic Review: Targeted Molecular Imaging of Angiogenesis and Its Mediators in Rheumatoid Arthritis. Int J Mol Sci 2022; 23:ijms23137071. [PMID: 35806074 PMCID: PMC9267012 DOI: 10.3390/ijms23137071] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 06/23/2022] [Accepted: 06/23/2022] [Indexed: 12/14/2022] Open
Abstract
Extensive angiogenesis is a characteristic feature in the synovial tissue of rheumatoid arthritis (RA) from a very early stage of the disease onward and constitutes a crucial event for the development of the proliferative synovium. This process is markedly intensified in patients with prolonged disease duration, high disease activity, disease severity, and significant inflammatory cell infiltration. Angiogenesis is therefore an interesting target for the development of new therapeutic approaches as well as disease monitoring strategies in RA. To this end, nuclear imaging modalities represent valuable non-invasive tools that can selectively target molecular markers of angiogenesis and accurately and quantitatively track molecular changes in multiple joints simultaneously. This systematic review summarizes the imaging markers used for single photon emission computed tomography (SPECT) and/or positron emission tomography (PET) approaches, targeting pathways and mediators involved in synovial neo-angiogenesis in RA.
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López-Armada MJ, Fernández-Rodríguez JA, Blanco FJ. Mitochondrial Dysfunction and Oxidative Stress in Rheumatoid Arthritis. Antioxidants (Basel) 2022; 11:antiox11061151. [PMID: 35740048 PMCID: PMC9220001 DOI: 10.3390/antiox11061151] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 06/08/2022] [Accepted: 06/09/2022] [Indexed: 02/04/2023] Open
Abstract
Control of excessive mitochondrial oxidative stress could provide new targets for both preventive and therapeutic interventions in the treatment of chronic inflammation or any pathology that develops under an inflammatory scenario, such as rheumatoid arthritis (RA). Increasing evidence has demonstrated the role of mitochondrial alterations in autoimmune diseases mainly due to the interplay between metabolism and innate immunity, but also in the modulation of inflammatory response of resident cells, such as synoviocytes. Thus, mitochondrial dysfunction derived from several danger signals could activate tricarboxylic acid (TCA) disruption, thereby favoring a vicious cycle of oxidative/mitochondrial stress. Mitochondrial dysfunction can act through modulating innate immunity via redox-sensitive inflammatory pathways or direct activation of the inflammasome. Besides, mitochondria also have a central role in regulating cell death, which is deeply altered in RA. Additionally, multiple evidence suggests that pathological processes in RA can be shaped by epigenetic mechanisms and that in turn, mitochondria are involved in epigenetic regulation. Finally, we will discuss about the involvement of some dietary components in the onset and progression of RA.
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Affiliation(s)
- María José López-Armada
- Grupo de Investigación en Envejecimiento e Inflamación (ENVEINF), Instituto de Investigación Biomédica de A Coruña (INIBIC), Complexo Hospitalario Universitario de A Coruña (CHUAC), Sergas, 15006 A Coruña, Spain;
- Correspondence: (M.J.L.-A.); (F.J.B.); Tel./Fax: +34-981-178272-73 (M.J.L.-A.)
| | - Jennifer Adriana Fernández-Rodríguez
- Grupo de Investigación en Envejecimiento e Inflamación (ENVEINF), Instituto de Investigación Biomédica de A Coruña (INIBIC), Complexo Hospitalario Universitario de A Coruña (CHUAC), Sergas, 15006 A Coruña, Spain;
| | - Francisco Javier Blanco
- Grupo de Investigación de Reumatología (GIR), Instituto de Investigación Biomédica de A Coruña (INIBIC), Complexo Hospitalario Universitario de A Coruña (CHUAC), Sergas, 15006 A Coruña, Spain
- Grupo de Investigación de Reumatología y Salud (GIR-S), Departamento de Fisioterapia, Medicina y Ciencias Biomédicas, Facultad de Fisioterapia, Campus de Oza, Universidade da Coruña, 15001 A Coruña, Spain
- Correspondence: (M.J.L.-A.); (F.J.B.); Tel./Fax: +34-981-178272-73 (M.J.L.-A.)
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7
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Fearon U, Hanlon MM, Floudas A, Veale DJ. Cellular metabolic adaptations in rheumatoid arthritis and their therapeutic implications. Nat Rev Rheumatol 2022; 18:398-414. [PMID: 35440762 DOI: 10.1038/s41584-022-00771-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/04/2022] [Indexed: 12/16/2022]
Abstract
Activation of endothelium and immune cells is fundamental to the initiation of autoimmune diseases such as rheumatoid arthritis (RA), and it results in trans-endothelial cell migration and synovial fibroblast proliferation, leading to joint destruction. In RA, the synovial microvasculature is highly dysregulated, resulting in inefficient oxygen perfusion to the synovium, which, along with the high metabolic demands of activated immune and stromal cells, leads to a profoundly hypoxic microenvironment. In inflamed joints, infiltrating immune cells and synovial resident cells have great requirements for energy and nutrients, and they adapt their metabolic profiles to generate sufficient energy to support their highly activated inflammatory states. This shift in metabolic capacity of synovial cells enables them to produce the essential building blocks to support their proliferation, activation and invasiveness. Furthermore, it results in the accumulation of metabolic intermediates and alteration of redox-sensitive pathways, affecting signalling pathways that further potentiate the inflammatory response. Importantly, the inflamed synovium is a multicellular tissue, with cells differing in their metabolic requirements depending on complex cell-cell interactions, nutrient supply, metabolic intermediates and transcriptional regulation. Therefore, understanding the complex interplay between metabolic and inflammatory pathways in synovial cells in RA will provide insight into the underlying mechanisms of disease pathogenesis.
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Affiliation(s)
- Ursula Fearon
- Molecular Rheumatology, Trinity Biomedical Sciences Institute, TCD, Dublin, Ireland. .,EULAR Centre of Excellence, Centre for Arthritis and Rheumatic Diseases, St Vincent's University Hospital, Dublin, Ireland.
| | - Megan M Hanlon
- Molecular Rheumatology, Trinity Biomedical Sciences Institute, TCD, Dublin, Ireland.,EULAR Centre of Excellence, Centre for Arthritis and Rheumatic Diseases, St Vincent's University Hospital, Dublin, Ireland
| | - Achilleas Floudas
- Molecular Rheumatology, Trinity Biomedical Sciences Institute, TCD, Dublin, Ireland.,EULAR Centre of Excellence, Centre for Arthritis and Rheumatic Diseases, St Vincent's University Hospital, Dublin, Ireland
| | - Douglas J Veale
- EULAR Centre of Excellence, Centre for Arthritis and Rheumatic Diseases, St Vincent's University Hospital, Dublin, Ireland
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Abstract
Rheumatoid Arthritis (RA) is a chronic systemic autoimmune disease. RA mainly affects synovial joints, with inflammation of the synovial membrane (synovitis), characterised by neo-angiogenesis, hyperplasia of lining layer, and immune cell infiltration that drive local inflammation and, if untreated, can lead to joint destruction and disability. In parallel to the well-known clinical heterogeneity, the underlying synovitis can also be significantly heterogeneous, both at cellular and molecular level, which can at least in part explain why despite the availability of highly effective treatment options, a large proportion of patients are resistant to some individual treatments. The assimilation of recent high-throughput data from analysis at the single-cell level with rigorous and high-quality clinical outcomes obtained from large randomised clinical trials support the definition of disease and treatment response endotypes. Looking ahead, the integration of histological and molecular signatures from the diseased tissue into clinical algorithms may help decision making in the management of patients with Rheumatoid Arthritis in clinical practice.
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Hanlon MM, Canavan M, Barker BE, Fearon U. Metabolites as drivers and targets in Rheumatoid Arthritis. Clin Exp Immunol 2021; 208:167-180. [PMID: 35020864 PMCID: PMC9188347 DOI: 10.1093/cei/uxab021] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 11/03/2021] [Accepted: 12/14/2021] [Indexed: 12/15/2022] Open
Abstract
Rheumatoid arthritis (RA) is a chronic autoimmune disease characterized by neovascularization, immune cell infiltration, and synovial hyperplasia, which leads to degradation of articular cartilage and bone, and subsequent functional disability. Dysregulated angiogenesis, synovial hypoxia, and immune cell infiltration result in a ‘bioenergetic crisis’ in the inflamed joint which further exacerbates synovial invasiveness. Several studies have examined this vicious cycle between metabolism, immunity, and inflammation and the role metabolites play in these interactions. To add to this complexity, the inflamed synovium is a multicellular tissue with many cellular subsets having different metabolic requirements. Metabolites can shape the inflammatory phenotype of immune cell subsets during disease and act as central signalling hubs. In the RA joint, the increased energy demand of stromal and immune cells leads to the accumulation of metabolites such as lactate, citrate, and succinate as well as adipocytokines which can regulate downstream signalling pathways. Transcription factors such as HIF1ɑ and mTOR can act as metabolic sensors to activate synovial cells and drive pro-inflammatory effector function, thus perpetuating chronic inflammation further. These metabolic intermediates may be potential therapeutic targets and so understanding the complex interplay between metabolites and synovial cells in RA may allow for identification of novel therapeutic strategies but also may provide significant insight into the underlying mechanisms of disease pathogenesis.
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Affiliation(s)
- Megan M Hanlon
- Molecular Rheumatology, Trinity Biomedical Sciences Institute, Trinity College Dublin.,EULAR Centre of Excellence for Rheumatology, Centre for Arthritis and Rheumatic Diseases, St. Vincent's University Hospital, Dublin, Ireland
| | - Mary Canavan
- Molecular Rheumatology, Trinity Biomedical Sciences Institute, Trinity College Dublin.,EULAR Centre of Excellence for Rheumatology, Centre for Arthritis and Rheumatic Diseases, St. Vincent's University Hospital, Dublin, Ireland
| | - Brianne E Barker
- Molecular Rheumatology, Trinity Biomedical Sciences Institute, Trinity College Dublin.,EULAR Centre of Excellence for Rheumatology, Centre for Arthritis and Rheumatic Diseases, St. Vincent's University Hospital, Dublin, Ireland
| | - Ursula Fearon
- Molecular Rheumatology, Trinity Biomedical Sciences Institute, Trinity College Dublin.,EULAR Centre of Excellence for Rheumatology, Centre for Arthritis and Rheumatic Diseases, St. Vincent's University Hospital, Dublin, Ireland
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10
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Ike RW, Kalunian KC. Will rheumatologists ever pick up the arthroscope again? Int J Rheum Dis 2021; 24:1235-1246. [PMID: 34323382 DOI: 10.1111/1756-185x.14184] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 06/26/2021] [Accepted: 07/12/2021] [Indexed: 02/04/2023]
Abstract
Conditions prompting physicians and surgeons first adapting endoscopes to peer into joints were mainly the sort of synovial conditions that would concern today's rheumatologists. Rheumatologists were among the pre-World War II pioneers developing and documenting arthroscopy. The post-War father of modern arthroscopy, Watanabe, found rheumatologists among his early students, who took back the technique to their home countries, teaching orthopedists and rheumatologists alike. Rheumatologists described and analyzed the intra-articular features of their common diseases in the '60s and '70s. A groundswell of interest from academic rheumatologists in adapting arthroscopy grew considerably in the '90s with development of "needle scopes" that could be used in an office setting. Rheumatologists helped conduct the very trials the findings of which reduced demand for their arthroscopic services by questioning the efficacy of arthroscopic debridement in osteoarthritis (OA) and also developing biological compounds that greatly reduced the call for any resective intervention in inflammatory arthropathies. The arthroscope has proven an excellent tool for viewing and sampling synovium and continues to serve this purpose at several international research centers. While cartilage is now imaged mainly by magnetic resonance imaging, some OA features - such as a high prevalence of visible calcinosis - beg further arthroscopy-directed investigation. A new generation of "needle scopes" with far superior optics awaits future investigators, should they develop interest.
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Affiliation(s)
- Robert W Ike
- Department of Internal Medicine, Division of Rheumatology, University of Michigan Health System, Ann Arbor, MI, USA
| | - Kenneth C Kalunian
- Department of Medicine, Division of Rheumatology, Allergy and Immunology, University of California at San Diego, San Diego, CA, USA
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Murray K, Floudas A, Murray C, Fabre A, Crown J, Fearon U, Veale D. First use of tofacitinib to treat an immune checkpoint inhibitor-induced arthritis. BMJ Case Rep 2021; 14:14/2/e238851. [PMID: 33541985 PMCID: PMC7868229 DOI: 10.1136/bcr-2020-238851] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Immune checkpoint inhibitors have revolutionised cancer treatment; however, immune-related adverse events do occur, with up to 7% developing inflammatory arthritis. Common rheumatoid arthritis therapies such as methotrexate, prednisolone and biologics have been used to treat this arthritis in small, uncontrolled case series with varying success. In this case of personalised medicine, we report the first use of tofacitinib, a small molecular inhibitor of the Janus kinase-signal transducer and activator of transcription pathway, to treat checkpoint inhibitor-related inflammatory arthritis. This resulted in a rapid clinical response and complete, sustained remission of the arthritis with associated marked reduction in synovial molecular and cellular immune response.
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Affiliation(s)
- Kieran Murray
- EULAR Centre for Arthritis and Rheumatic Disease, St. Vincent's University Hospital, Dublin, Ireland
| | - Achilleas Floudas
- EULAR Centre for Arthritis and Rheumatic Disease, St. Vincent's University Hospital, Dublin, Ireland,Molecular Rheumatology, Trinity Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland
| | - Ciara Murray
- Pathology, Oncology and Medicine, University College Dublin, Dublin, Ireland
| | - Aurelie Fabre
- Pathology, Oncology and Medicine, University College Dublin, Dublin, Ireland
| | - John Crown
- Pathology, Oncology and Medicine, University College Dublin, Dublin, Ireland
| | - Ursula Fearon
- EULAR Centre for Arthritis and Rheumatic Disease, St. Vincent's University Hospital, Dublin, Ireland,Molecular Rheumatology, Trinity Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland
| | - Douglas Veale
- EULAR Centre for Arthritis and Rheumatic Disease, St. Vincent's University Hospital, Dublin, Ireland,Pathology, Oncology and Medicine, University College Dublin, Dublin, Ireland
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12
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McGarry T, Hanlon MM, Marzaioli V, Cunningham CC, Krishna V, Murray K, Hurson C, Gallagher P, Nagpal S, Veale DJ, Fearon U. Rheumatoid arthritis CD14 + monocytes display metabolic and inflammatory dysfunction, a phenotype that precedes clinical manifestation of disease. Clin Transl Immunology 2021; 10:e1237. [PMID: 33510894 PMCID: PMC7815439 DOI: 10.1002/cti2.1237] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Revised: 10/27/2020] [Accepted: 12/18/2020] [Indexed: 12/11/2022] Open
Abstract
Introduction This study investigates the metabolic activity of circulating monocytes and their impact on pro‐inflammatory responses in RA and explores whether this phenotype is already primed for inflammation before clinical manifestations of disease. Methods Blood was collected and CD14+ monocytes isolated from healthy control donors (HC), individuals at‐risk (IAR) and RA patients. Monocyte frequency in blood and synovial tissue was assessed by flow cytometry. Inflammatory responses and metabolic analysis ± specific inhibitors were quantified by RT‐PCR, Western blot, migration assays, Seahorse‐XFe‐technology, mitotracker assays and transmission electron microscopy. Transcriptomic analysis was performed on HC, IAR and RA synovial tissue. Results CD14+ monocytes from RA patients are hyper‐inflammatory following stimulation, with significantly higher expression of cytokines/chemokines than those from HC. LPS‐induced RA monocyte migratory capacity is consistent with increased monocyte frequency in RA synovial tissue. RA CD14+ monocytes show enhanced mitochondrial respiration, biogenesis and alterations in mitochondrial morphology. Furthermore, RA monocytes display increased levels of key glycolytic enzymes HIF1α, HK2 and PFKFB3 and demonstrate a reliance on glucose consumption, blockade of which abrogates pro‐inflammatory mediator responses. Blockade of STAT3 activation inhibits this forced glycolytic flux resulting in metabolic reprogramming and resolution of inflammation. Interestingly, this highly activated monocytic phenotype is evident in IAR of developing disease, in addition to an enhanced monocyte gene signature observed in synovial tissue from IAR. Conclusion RA CD14+ monocytes are metabolically re‐programmed for sustained induction of pro‐inflammatory responses, with STAT3 identified as a molecular regulator of metabolic dysfunction. This phenotype precedes clinical disease onset and may represent a potential pathway for therapeutic targeting early in disease.
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Affiliation(s)
- Trudy McGarry
- Molecular Rheumatology Trinity Biomedical Sciences Institute Trinity College Dublin Dublin Ireland.,EULAR Centre of Excellence for Rheumatology Centre for Arthritis and Rheumatic Diseases St Vincent's University Hospital University College Dublin Dublin Ireland
| | - Megan M Hanlon
- Molecular Rheumatology Trinity Biomedical Sciences Institute Trinity College Dublin Dublin Ireland.,EULAR Centre of Excellence for Rheumatology Centre for Arthritis and Rheumatic Diseases St Vincent's University Hospital University College Dublin Dublin Ireland
| | - Viviana Marzaioli
- Molecular Rheumatology Trinity Biomedical Sciences Institute Trinity College Dublin Dublin Ireland.,EULAR Centre of Excellence for Rheumatology Centre for Arthritis and Rheumatic Diseases St Vincent's University Hospital University College Dublin Dublin Ireland
| | - Clare C Cunningham
- Molecular Rheumatology Trinity Biomedical Sciences Institute Trinity College Dublin Dublin Ireland.,EULAR Centre of Excellence for Rheumatology Centre for Arthritis and Rheumatic Diseases St Vincent's University Hospital University College Dublin Dublin Ireland
| | - Vinod Krishna
- Janssen Research & Development, Immunology Spring House, PA Titusville New Jersey USA
| | - Kieran Murray
- EULAR Centre of Excellence for Rheumatology Centre for Arthritis and Rheumatic Diseases St Vincent's University Hospital University College Dublin Dublin Ireland
| | - Conor Hurson
- Department of Orthopaedics St Vincent's University Hospital UCD Dublin Ireland
| | - Phil Gallagher
- EULAR Centre of Excellence for Rheumatology Centre for Arthritis and Rheumatic Diseases St Vincent's University Hospital University College Dublin Dublin Ireland
| | - Sunil Nagpal
- Janssen Research & Development, Immunology Spring House, PA Titusville New Jersey USA
| | - Douglas J Veale
- EULAR Centre of Excellence for Rheumatology Centre for Arthritis and Rheumatic Diseases St Vincent's University Hospital University College Dublin Dublin Ireland
| | - Ursula Fearon
- Molecular Rheumatology Trinity Biomedical Sciences Institute Trinity College Dublin Dublin Ireland.,EULAR Centre of Excellence for Rheumatology Centre for Arthritis and Rheumatic Diseases St Vincent's University Hospital University College Dublin Dublin Ireland
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Liu C, He L, Wang J, Wang Q, Sun C, Li Y, Jia K, Wang J, Xu T, Ming R, Wang Q, Lin N. Anti-angiogenic effect of Shikonin in rheumatoid arthritis by downregulating PI3K/AKT and MAPKs signaling pathways. JOURNAL OF ETHNOPHARMACOLOGY 2020; 260:113039. [PMID: 32497675 DOI: 10.1016/j.jep.2020.113039] [Citation(s) in RCA: 62] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/07/2020] [Revised: 05/10/2020] [Accepted: 05/27/2020] [Indexed: 05/15/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Zicao is the dried root of Lithospermum erythrorhizon Sieb, et Zucc, Arnebia euchroma (Royle) Johnst, or Arnebia guttata Bunge and commonly used to treat viral infection, inflammation, arthritis and cancer in China.Shikonin (SKN) is a major active chemical component isolated from zicao. Previous research showed that SKN has anti-inflammatory, immunomodulatory and analgesic effects, and inhibits the development of arthritis and the condition of collagen arthritis (CIA) mice; nevertheless, its role in the angiogenesis of rheumatoid arthritis (RA) has not been elucidated. AIM OF THE STUDY The purpose of this study was to investigate the antiangiogenic activity of SKN in CIA rats and various angiogenesis models. MATERIAL AND METHODS The anti-arthritic effect of SKN on CIA rats was tested by arthritis score, arthritis incidence, radiological observation and histopathology evaluation of inflamed joints. Vessel density evaluated with CD31 immunohistochemistry/immunofluorescence in joint synovial membrane tissues of CIA rats, chick chorioallantoic membrane assay, rat aortic ring assay, and the migration, invasion, adhesion and tube formation of human umbilical vein endothelial (HUVEC) cells induced by tumor necrosis factor (TNF)-α were used to measured the antiangiogenenic activity of SKN. Moreover, the effect of SKN on the expression of angiogenic mediators, such as vascular endothelial growth factor (VEGF), VEGFR2, TNF-α, interleukin (IL)-1β, platelet derived growth factor (PDGF) and transforming growth factor (TGF)-β in sera and joint synovia of rats, and in TNF-α-induced MH7A/HUVEC cells were measured by immunohistochemistry, enzyme linked immunosorbent assay, Western blot and/or real-time polymerase chain reaction (PCR). Through the analysis of protein and mRNA levels of phosphoinositide 3-kinase (PI3K), Akt and PTEN, and the autophosphorylation of ERK1/2, JNK and p38 in joint synovia of rats and in TNF-α-induced HUVEC cells, the molecular mechanism of its inhibition was elucidated by using Western blot and/or real-time PCR. RESULTS SKN significantly reduced the arthritis score and arthritis incidence, and inhibited inflammation, pannus formation, cartilage and bone destruction of inflamed joints in CIA rats. Partially, SKN remarkably decreased the immature blood vessels in synovial membrane tissues of inflamed joints from CIA rats. It also suppressed in vivo angiogenesis in chick embryo and VEGF165-induced microvessel sprout formation ex vivo. Meanwhile, SKN inhibited TNF-α-induced migration, invasion, adhesion and tube formation of HUVEC cells. Moreover, SKN significantly decreased the expression of angiogenic activators including VEGF, VEGFR2, TNF-α, IL-1β, PDGF and TGF-β in synovia of CIA rats and/or in MH7A/HUVEC cells. More interestingly, SKN downregulated PI3K and Akt, and simultaneously upregulated PTEN both at protein and mRNA levels in synovia tissues and/or in TNF-α-induced HUVEC cells. It also suppressed the phosphorylation and gene level of TNF-α-induced signaling molecules, as ERK1/2, JNK, and p38 in synovium and/or in TNF-α-induced HUVEC cells. CONCLUSION These findings indicate for the first time that SKN has the anti-angiogenic effect in RA in vivo, ex vivo and in vitro by interrupting the PI3K/AKT and MAPKs signaling pathways.
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Affiliation(s)
- Chunfang Liu
- Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences, Beijing, 100700, China.
| | - Lianhua He
- Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences, Beijing, 100700, China; Department of Rheumatism and Immunology, Peking University Shenzhen Hospital, Shenzhen, China.
| | - Jingxia Wang
- Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences, Beijing, 100700, China.
| | - Qianqian Wang
- Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences, Beijing, 100700, China.
| | - Congcong Sun
- Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences, Beijing, 100700, China.
| | - Yiqun Li
- Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences, Beijing, 100700, China.
| | - Kexin Jia
- Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences, Beijing, 100700, China.
| | - Jinxia Wang
- Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences, Beijing, 100700, China.
| | - Tengteng Xu
- Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences, Beijing, 100700, China.
| | - Ruirui Ming
- Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences, Beijing, 100700, China.
| | - Qingwen Wang
- Department of Rheumatism and Immunology, Peking University Shenzhen Hospital, Shenzhen, China.
| | - Na Lin
- Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences, Beijing, 100700, China.
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14
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Yu Y, Cai W, Zhou J, Lu H, Wang Y, Song Y, He R, Pei F, Wang X, Zhang R, Liu H, Wei F. Anti-arthritis effect of berberine associated with regulating energy metabolism of macrophages through AMPK/ HIF-1α pathway. Int Immunopharmacol 2020; 87:106830. [PMID: 32738596 DOI: 10.1016/j.intimp.2020.106830] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 07/18/2020] [Accepted: 07/21/2020] [Indexed: 12/20/2022]
Abstract
Berberine (BBR) is the effective constituent of Cortex phellodendri and was characterized as an excellent anti-microbial agent with significant anti-inflammatory effects. Previously, we had demonstrated that BBR alleviated the inflammatory response in adjuvant-induced arthritis (AA) rats by regulating polarization of macrophages. However, the exact mechanics by which BBR regulates macrophage polarization remained unclear. Here, we showed that BBR treatment had little influence on total number of macrophages in joints of AA rats, but increased the proportion of M2 macrophages and decreased the proportion of M1 macrophages. Meanwhile, we found BBR up-regulated the expression of AMP-activated protein kinase phosphorylation (p-AMPK) and down-regulated the expression of Hypoxia inducible factor 1α (HIF-1α) in synovial macrophages of AA rats. In vitro, using LPS-stimulated peritoneal macrophages from normal rats, we also verified that pretreatment with BBR promoted transition from M1 to M2 by up-regulating the expression of p-AMPK and suppressing the expression of HIF-1α. Compound C (an AMPK inhibitor) could abrogate the inhibition of BBR on migration of macrophages. Glycolysis of M1 suppressed by BBR through decreasing lactate export, glucose consumption, and increasing intracellular ATP content, which was remarkably reversed by Compound C. These findings indicated that anti-arthritis effect of BBR is associated with regulating energy metabolism of macrophages through AMPK/HIF-1α pathway.
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Affiliation(s)
- Yun Yu
- School of Pharmacy, Bengbu Medical College, No.2600, Donghai Avenue, Bengbu 233000, Anhui, China
| | - Weiwei Cai
- School of Pharmacy, Bengbu Medical College, No.2600, Donghai Avenue, Bengbu 233000, Anhui, China
| | - Jing Zhou
- School of Pharmacy, Bengbu Medical College, No.2600, Donghai Avenue, Bengbu 233000, Anhui, China
| | - Huaqiu Lu
- School of Pharmacy, Bengbu Medical College, No.2600, Donghai Avenue, Bengbu 233000, Anhui, China
| | - Ying Wang
- School of Pharmacy, Bengbu Medical College, No.2600, Donghai Avenue, Bengbu 233000, Anhui, China
| | - Yining Song
- School of Pharmacy, Bengbu Medical College, No.2600, Donghai Avenue, Bengbu 233000, Anhui, China
| | - Rui He
- School of Pharmacy, Bengbu Medical College, No.2600, Donghai Avenue, Bengbu 233000, Anhui, China
| | - Feilong Pei
- School of Pharmacy, Bengbu Medical College, No.2600, Donghai Avenue, Bengbu 233000, Anhui, China
| | - Xiaodie Wang
- School of Pharmacy, Bengbu Medical College, No.2600, Donghai Avenue, Bengbu 233000, Anhui, China
| | - Renhao Zhang
- School of Pharmacy, Bengbu Medical College, No.2600, Donghai Avenue, Bengbu 233000, Anhui, China
| | - Hao Liu
- School of Pharmacy, Bengbu Medical College, No.2600, Donghai Avenue, Bengbu 233000, Anhui, China; Anhui BBCA Pharmaceuticals Co., Ltd, No.6288, Donghai Avenue, Bengbu 233000, Anhui, China
| | - Fang Wei
- School of Pharmacy, Bengbu Medical College, No.2600, Donghai Avenue, Bengbu 233000, Anhui, China; Anhui BBCA Pharmaceuticals Co., Ltd, No.6288, Donghai Avenue, Bengbu 233000, Anhui, China; School of Chemistry and Chemical Engineering, Anhui University, No.3, Feixi Rode, Hefei 230039, Anhui, China.
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Monitoring with In Vivo Electrochemical Sensors: Navigating the Complexities of Blood and Tissue Reactivity. SENSORS 2020; 20:s20113149. [PMID: 32498360 PMCID: PMC7308849 DOI: 10.3390/s20113149] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 05/29/2020] [Accepted: 05/31/2020] [Indexed: 12/18/2022]
Abstract
The disruptive action of an acute or critical illness is frequently manifest through rapid biochemical changes that may require continuous monitoring. Within these changes, resides trend information of predictive value, including responsiveness to therapy. In contrast to physical variables, biochemical parameters monitored on a continuous basis are a largely untapped resource because of the lack of clinically usable monitoring systems. This is despite the huge testing repertoire opening up in recent years in relation to discrete biochemical measurements. Electrochemical sensors offer one of the few routes to obtaining continuous readout and, moreover, as implantable devices information referable to specific tissue locations. This review focuses on new biological insights that have been secured through in vivo electrochemical sensors. In addition, the challenges of operating in a reactive, biological, sample matrix are highlighted. Specific attention is given to the choreographed host rejection response, as evidenced in blood and tissue, and how this limits both sensor life time and reliability of operation. Examples will be based around ion, O2, glucose, and lactate sensors, because of the fundamental importance of this group to acute health care.
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Sperry MM, Yu YH, Kartha S, Ghimire P, Welch RL, Winkelstein BA, Granquist EJ. Intra-articular etanercept attenuates pain and hypoxia from TMJ loading in the rat. J Orthop Res 2020; 38:1316-1326. [PMID: 31903618 PMCID: PMC9118642 DOI: 10.1002/jor.24581] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Accepted: 12/28/2019] [Indexed: 02/04/2023]
Abstract
Mechanical overloading of the temporomandibular joint (TMJ) and biochemical changes, like inflammation and hypoxia, contribute to cartilage degeneration and pain associated with osteoarthritis (OA). Yet, how overloading contributes to early dysregulation of chondrocytes is not understood, limiting the development of diagnostics and treatments for TMJ OA. Hypoxia-inducible factors (HIF)-1α/2α in chondrocytes were evaluated at Days 8 and 15 in a rat TMJ pain model induced by jaw loading (1 h/day for 7 days) using immunohistochemistry and compared between cases that induce persistent (3.5 N), acute (2 N), or no (0 N) sensitivity. Hypoxia was measured on Day 8 by immunolabeling of the tracer EF5 and 18 F-EF5 PET imaging. To assess the role of tumor necrosis factor (TNF) in painful TMJ loading, intra-articular etanercept was given before loading. Orofacial sensitivity was evaluated during and after loading. Facial grimace, TNF-α, HIF-2α, and hypoxia levels in the TMJ were measured after loading. HIF-2α was elevated (P = .03) after 3.5 N loading at Day 8, but HIF-1α was unchanged. EF5 uptake increased on Day 8 in the 3.5 N group (P < .048) by tissue assay and 18 F-EF5 PET. At Day 8, both HIF-2α (P = .01) and EF5 uptake (P = .005) were correlated with loading magnitude. Etanercept attenuated sensitivity (P < .01) and the facial grimace on Day 7 (P = .01). It also reduced (P < .01) HIF-2α and EF5 uptake on Day 8; but TNF-α levels were not different from controls at that time. Findings suggest that TMJ loading that induces persistent sensitivity upregulates the catabolic factor HIF-2α and reduces oxygen levels in the cartilage, which may be TNF-driven.
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Affiliation(s)
| | - Ya-Hsin Yu
- Department of Endodontics, University of Pennsylvania School of Dental Medicine
| | - Sonia Kartha
- Department of Bioengineering, University of Pennsylvania
| | | | | | - Beth A. Winkelstein
- Department of Bioengineering, University of Pennsylvania
- Department of Neurosurgery, University of Pennsylvania
| | - Eric J. Granquist
- Oral & Maxillofacial Surgery, University of Pennsylvania School of Medicine
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ErMiao San Inhibits Angiogenesis in Rheumatoid Arthritis by Suppressing JAK/STAT Signaling Pathways. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2020. [DOI: 10.1155/2020/4381212] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
ErMiao San (EMS) is composed of the Cortex Phellodendri chinensis and Atractylodes lancea, and it has the function of eliminating heat and excreting dampness in terms of traditional Chinese medicine to damp heat syndrome. Previous reports indicate that EMS possesses anti-inflammatory activity; however, its action on angiogenesis of rheumatoid arthritis (RA) has not been clarified. The present study aims to determine the antiangiogenic activity of EMS in collagen-induced arthritis (CIA) mice and in various angiogenesis models. Our data showed that EMS (5 g/kg) markedly reduced the immature blood vessels in synovial membrane tissues of inflamed joints from CIA mice. It also inhibited vascular endothelial growth factor (VEGF)-induced microvessel sprout formation ex vivo. Meanwhile, EMS suppressed VEGF-induced migration, invasion, adhesion, and tube formation of human umbilical vein endothelial cells (HUVECs). Moreover, EMS significantly reduced the expression of angiogenic activators including interleukin (IL)-1β, IL-6, and tumor necrosis factor-alpha (TNF-α) in synovium of CIA mice. More interestingly, EMS blocked the autophosphorylation of VEGF-induced JAK1, STAT1, and STAT6 in CIA mice and VEGF-induced HUVECs. These findings suggest for the first time that EMS possesses the antiangiogenic effect in RA in vivo, ex vivo, and in vitro by interrupting the targeting of JAK/STAT activation.
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Fromm S, Cunningham CC, Dunne MR, Veale DJ, Fearon U, Wade SM. Enhanced angiogenic function in response to fibroblasts from psoriatic arthritis synovium compared to rheumatoid arthritis. Arthritis Res Ther 2019; 21:297. [PMID: 31864394 PMCID: PMC6925847 DOI: 10.1186/s13075-019-2088-3] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Accepted: 12/12/2019] [Indexed: 12/12/2022] Open
Abstract
Introduction Angiogenesis is an early event in the pathogenesis of both psoriatic arthritis (PsA) and rheumatoid arthritis (RA); however, there are striking differences in blood vessel morphology and activation between the two arthropathies. The aim of this study was to assess if the PsA and RA joint microenvironments differentially regulate endothelial cell function. Methods PsA and RA primary synovial fibroblasts (SFC) were isolated from synovial biopsies, grown to confluence, and supernatants harvested and termed ‘conditioned media’ (CM). Human umbilical vein endothelial cells (HUVEC) were cultured with PsA SFC or RA SFC-CM (20%). HUVEC tube formation, migration, and PBMC adhesion were assessed by matrigel tube formation, wound repair, and PBMC adhesion assays. HUVEC cell surface expression of ICAM, VCAM, and E-Selectin was assessed by flow cytometry. Transcriptome analysis of genes promoting angiogenesis was performed by real-time PCR. Finally, a MSD multiplex angiogenic assay was performed on PsA SFC and RA SFC supernatants. Results Macroscopic synovitis and vascularity were similar in PsA and RA patients; however, significant differences in vascular morphological pattern were recorded with tortuous, elongated vessels observed in PsA compared to straight regular branching vessels observed in RA. Transcriptome analysis showed strong upregulation of the pro-angiogenic signature in HUVEC primed with PsA SFC-CM compared to RA SFC-CM and basal control. In parallel, paired PsA SFC-CM significantly induced HUVEC tube formation compared to that of RA SFC-CM. Furthermore, PsA SFC-CM induced HUVEC migration was paralleled by a significant induction in VEGFA, PFKFB3, ICAM-1, and MMP3 mRNA expression. A significant increase in PBMC adhesion and cell surface expression of VCAM-1, ICAM-1, and E-Selectin expression was also demonstrated in PsA SFC-CM-primed HUVEC compared to RA SFC-CM. Finally, VEGF, TSLP, Flt-1, and Tie-2 expression was elevated in PsA SFC-CM compared to RA SFC-CM, with no significant difference in other pro-angiogenic mediators including MIP-3, bFGF, PIGF, and MCP-1. Conclusion PsA SFC and RA SFC secreted factors differentially regulate endothelial cell function, with soluble mediators in the PsA joint microenvironment inducing a more pro-angiogenic phenotype compared to the RA.
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Affiliation(s)
- S Fromm
- Department of Molecular Rheumatology, Trinity Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland
| | - C C Cunningham
- Department of Molecular Rheumatology, Trinity Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland
| | - M R Dunne
- Department of Surgery, Trinity Translational Medicine Institute, St. James's Hospital, Trinity College Dublin, Dublin, Ireland
| | - D J Veale
- Rheumatology EULAR Centre of Excellence, Centre for Arthritis & Rheumatic Diseases, University College Dublin, Dublin, Ireland
| | - U Fearon
- Department of Molecular Rheumatology, Trinity Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland.
| | - S M Wade
- Department of Molecular Rheumatology, Trinity Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland.,Rheumatology EULAR Centre of Excellence, Centre for Arthritis & Rheumatic Diseases, University College Dublin, Dublin, Ireland
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Panga V, Kallor AA, Nair A, Harshan S, Raghunathan S. Mitochondrial dysfunction in rheumatoid arthritis: A comprehensive analysis by integrating gene expression, protein-protein interactions and gene ontology data. PLoS One 2019; 14:e0224632. [PMID: 31703070 PMCID: PMC6839853 DOI: 10.1371/journal.pone.0224632] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Accepted: 10/17/2019] [Indexed: 02/07/2023] Open
Abstract
Several studies have reported mitochondrial dysfunction in rheumatoid arthritis (RA). Many nuclear DNA (nDNA) encoded proteins translocate to mitochondria, but their participation in the dysfunction of this cell organelle during RA is quite unclear. In this study, we have carried out an integrative analysis of gene expression, protein-protein interactions (PPI) and gene ontology data. The analysis has identified potential implications of the nDNA encoded proteins in RA mitochondrial dysfunction. Firstly, by analysing six synovial microarray datasets of RA patients and healthy controls obtained from the gene expression omnibus (GEO) database, we found differentially expressed nDNA genes that encode mitochondrial proteins. We uncovered some of the roles of these genes in RA mitochondrial dysfunction using literature search and gene ontology analysis. Secondly, by employing gene co-expression from microarrays and collating reliable PPI from seven databases, we created the first mitochondrial PPI network that is specific to the RA synovial joint tissue. Further, we identified hubs of this network, and moreover, by integrating gene expression and network analysis, we found differentially expressed neighbours of the hub proteins. The results demonstrate that nDNA encoded proteins are (i) crucial for the elevation of mitochondrial reactive oxygen species (ROS) and (ii) involved in membrane potential, transport processes, metabolism and intrinsic apoptosis during RA. Additionally, we proposed a model relating to mitochondrial dysfunction and inflammation in the disease. Our analysis presents a novel perspective on the roles of nDNA encoded proteins in mitochondrial dysfunction, especially in apoptosis, oxidative stress-related processes and their relation to inflammation in RA. These findings provide a plethora of information for further research.
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Affiliation(s)
- Venugopal Panga
- Institute of Bioinformatics and Applied Biotechnology (IBAB), Bengaluru, Karnataka, India
- Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Ashwin Adrian Kallor
- Institute of Bioinformatics and Applied Biotechnology (IBAB), Bengaluru, Karnataka, India
| | - Arunima Nair
- Institute of Bioinformatics and Applied Biotechnology (IBAB), Bengaluru, Karnataka, India
| | - Shilpa Harshan
- Institute of Bioinformatics and Applied Biotechnology (IBAB), Bengaluru, Karnataka, India
- Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Srivatsan Raghunathan
- Institute of Bioinformatics and Applied Biotechnology (IBAB), Bengaluru, Karnataka, India
- * E-mail:
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20
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Wade SM, Ohnesorge N, McLoughlin H, Biniecka M, Carter SP, Trenkman M, Cunningham CC, McGarry T, Canavan M, Kennedy BN, Veale DJ, Fearon U. Dysregulated miR-125a promotes angiogenesis through enhanced glycolysis. EBioMedicine 2019; 47:402-413. [PMID: 31466915 PMCID: PMC6796559 DOI: 10.1016/j.ebiom.2019.08.043] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Revised: 08/20/2019] [Accepted: 08/20/2019] [Indexed: 12/24/2022] Open
Abstract
Background Although neoangiogenesis is a hallmark of chronic inflammatory diseases such as inflammatory arthritis and many cancers, therapeutic agents targeting the vasculature remain elusive. Here we identified miR-125a as an important regulator of angiogenesis. Methods MiRNA levels were quantified in Psoriatic Arthritis (PsA) synovial-tissue by RT-PCR and compared to macroscopic synovial vascularity. HMVEC were transfected with anti-miR-125a and angiogenic mechanisms quantified using tube formation assays, transwell invasion chambers, wound repair, RT-PCR and western blot. Real-time analysis of EC metabolism was assessed using the XF-24 Extracellular-Flux Analyzer. Synovial expression of metabolic markers was assessed by immunohistochemistry and immunofluorescent staining. MiR-125a CRISPR/Cas9-based knock-out zebrafish were generated and vascular development assessed. Finally, glycolytic blockade using 3PO, which inhibits Phosphofructokinase-fructose-2,6-bisphophatase 3 (PFKFB3), was assessed in miR-125a−/− ECs and zebrafish embryos. Findings MiR-125a is significantly decreased in PsA synovium and inversely associated with macroscopic vascularity. In-vivo, CRISPR/cas9 miR-125a−/− zebrafish displayed a hyper-branching phenotype. In-vitro, miR-125a inhibition promoted EC tube formation, branching, migration and invasion, effects paralleled by a shift in their metabolic profile towards glycolysis. This metabolic shift was also observed in the PsA synovial vasculature where increased expression of glucose transporter 1 (GLUT1), PFKFB3 and Pyruvate kinase muscle isozyme M2 (PKM2) were demonstrated. Finally, blockade of PFKFB3 significantly inhibited anti-miR-125a-induced angiogenic mechanisms in-vitro, paralleled by normalisation of vascular development of CRISPR/cas9 miR-125a−/− zebrafish embryos. Intepretation Our results provide evidence that miR-125a deficiency enhances angiogenic processes through metabolic reprogramming of endothelial cells. Fund Irish Research Council, Arthritis Ireland, EU Seventh Framework Programme (612218/3D-NET).
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Affiliation(s)
- Sarah M Wade
- Molecular Rheumatology, School of Medicine, Trinity Biomedical Sciences Institute, Trinity College Dublin, Dublin 2, Ireland; EULAR Centre for Arthritis and Rheumatic Diseases, Vincent's University Hospital, Dublin Academic Health Care, University College Dublin, Dublin 4, Ireland
| | - Nils Ohnesorge
- EULAR Centre for Arthritis and Rheumatic Diseases, Vincent's University Hospital, Dublin Academic Health Care, University College Dublin, Dublin 4, Ireland
| | - Hayley McLoughlin
- Molecular Rheumatology, School of Medicine, Trinity Biomedical Sciences Institute, Trinity College Dublin, Dublin 2, Ireland
| | - Monika Biniecka
- EULAR Centre for Arthritis and Rheumatic Diseases, Vincent's University Hospital, Dublin Academic Health Care, University College Dublin, Dublin 4, Ireland
| | - Steven P Carter
- UCD School of Biomolecular & Biomedical Science, UCD Conway Institute, University College Dublin, Belfield, Dublin 4, Ireland
| | - Michelle Trenkman
- EULAR Centre for Arthritis and Rheumatic Diseases, Vincent's University Hospital, Dublin Academic Health Care, University College Dublin, Dublin 4, Ireland
| | - Clare C Cunningham
- Molecular Rheumatology, School of Medicine, Trinity Biomedical Sciences Institute, Trinity College Dublin, Dublin 2, Ireland; EULAR Centre for Arthritis and Rheumatic Diseases, Vincent's University Hospital, Dublin Academic Health Care, University College Dublin, Dublin 4, Ireland
| | - Trudy McGarry
- Molecular Rheumatology, School of Medicine, Trinity Biomedical Sciences Institute, Trinity College Dublin, Dublin 2, Ireland; EULAR Centre for Arthritis and Rheumatic Diseases, Vincent's University Hospital, Dublin Academic Health Care, University College Dublin, Dublin 4, Ireland
| | - Mary Canavan
- Molecular Rheumatology, School of Medicine, Trinity Biomedical Sciences Institute, Trinity College Dublin, Dublin 2, Ireland; EULAR Centre for Arthritis and Rheumatic Diseases, Vincent's University Hospital, Dublin Academic Health Care, University College Dublin, Dublin 4, Ireland
| | - Breandán N Kennedy
- UCD School of Biomolecular & Biomedical Science, UCD Conway Institute, University College Dublin, Belfield, Dublin 4, Ireland
| | - Douglas J Veale
- EULAR Centre for Arthritis and Rheumatic Diseases, Vincent's University Hospital, Dublin Academic Health Care, University College Dublin, Dublin 4, Ireland
| | - Ursula Fearon
- Molecular Rheumatology, School of Medicine, Trinity Biomedical Sciences Institute, Trinity College Dublin, Dublin 2, Ireland; EULAR Centre for Arthritis and Rheumatic Diseases, Vincent's University Hospital, Dublin Academic Health Care, University College Dublin, Dublin 4, Ireland.
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21
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Burke CJ, Alizai H, Beltran LS, Regatte RR. MRI of synovitis and joint fluid. J Magn Reson Imaging 2019; 49:1512-1527. [PMID: 30618151 DOI: 10.1002/jmri.26618] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Revised: 12/03/2018] [Accepted: 12/03/2018] [Indexed: 12/20/2022] Open
Abstract
Synovitis and joint effusion are common manifestations of rheumatic disease and play an important role in the disease pathophysiology. Earlier detection and accurate assessment of synovial pathology, therefore, can facilitate appropriate clinical management and hence improve prognosis. Magnetic resonance imaging (MRI) allows unparalleled assessment of all joint structures and associated pathology. It has emerged as a powerful tool, which enables not only detection of synovitis and effusion, but also allows quantification, detailed characterization, and noninvasive monitoring of synovial processes. The purpose of this article is to summarize the pathophysiology of synovitis and to review the role of qualitative, semiquantitative, and quantitative MRI in the assessment of synovitis and joint fluid. We also discuss the utility of MRI as an outcome measure to assess treatment response, particularly with respect to osteoarthritis and rheumatoid arthritis. Emerging applications such as hybrid positron emission tomography / MRI and molecular imaging are also briefly discussed. Level of Evidence: 5 Technical Efficacy: Stage 3 J. Magn. Reson. Imaging 2019.
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Affiliation(s)
| | - Hamza Alizai
- Department of Radiology, NYU Langone Health, New York, New York, USA
| | - Luis S Beltran
- Department of Radiology, NYU Langone Health, New York, New York, USA
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22
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Canavan M, Walsh AM, Bhargava V, Wade SM, McGarry T, Marzaioli V, Moran B, Biniecka M, Convery H, Wade S, Orr C, Mullan R, Fletcher JM, Nagpal S, Veale DJ, Fearon U. Enriched Cd141+ DCs in the joint are transcriptionally distinct, activated, and contribute to joint pathogenesis. JCI Insight 2018; 3:95228. [PMID: 30518680 DOI: 10.1172/jci.insight.95228] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2017] [Accepted: 10/29/2018] [Indexed: 12/13/2022] Open
Abstract
CD141+ DC are implicated in antiviral and antitumor immunity. However, mechanistic studies in autoimmune disease are limited. This is the first study to our knowledge examining CD141+ DC in autoimmune disease, specifically inflammatory arthritis (IA). We identified significant enrichment of CD141+ DC in the inflamed synovial joint, which were transcriptionally distinct from IA and healthy control (HC) blood CD141+ DC and significantly more activated, and they exhibited increased responsiveness to TLR3. Synovial CD141+ DC represent a bone fide CD141+ DC population that is distinct from CD1c+ DC. Synovial CD141+ DC induced higher levels of CD4+ and CD8+ T cell activation compared with their peripheral blood counterparts, as made evident by expression of IFN-γ, TNF-α, and granulocyte-macrophage CSF (GMCSF). Autologous synovial CD141+ DC cocultures also induce higher levels of these cytokines, further highlighting their contribution to synovial inflammation. Synovial CD141+ DC-T cell interactions had the ability to further activate synovial fibroblasts, inducing adhesive and invasive pathogenic mechanisms. Furthermore, we identify a mechanism in which synovial CD141+ DC are activated, via ligation of the hypoxia-inducible immune-amplification receptor TREM-1, which increased synovial CD141+ DC activation, migratory capacity, and proinflammatory cytokines. Thus, synovial CD141+ DC display unique mechanistic and transcriptomic signatures, which are distinguishable from blood CD141+ DC and can contribute to synovial joint inflammation.
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Affiliation(s)
- Mary Canavan
- Molecular Rheumatology, School of Medicine, Trinity College Dublin, Ireland
| | | | - Vipul Bhargava
- Discovery Sciences, Janssen Research & Development, Spring House, Pennsylvania, USA
| | - Sarah M Wade
- Molecular Rheumatology, School of Medicine, Trinity College Dublin, Ireland
| | - Trudy McGarry
- Molecular Rheumatology, School of Medicine, Trinity College Dublin, Ireland
| | - Viviana Marzaioli
- Molecular Rheumatology, School of Medicine, Trinity College Dublin, Ireland
| | - Barry Moran
- School of Biochemistry and Immunology, Trinity College Dublin, Ireland
| | - Monika Biniecka
- Centre for Arthritis & Rheumatic Diseases, St. Vincent's University Hospital, University College Dublin, Ireland
| | - Hannah Convery
- Centre for Arthritis & Rheumatic Diseases, St. Vincent's University Hospital, University College Dublin, Ireland
| | - Siobhan Wade
- Molecular Rheumatology, School of Medicine, Trinity College Dublin, Ireland
| | - Carl Orr
- Centre for Arthritis & Rheumatic Diseases, St. Vincent's University Hospital, University College Dublin, Ireland
| | - Ronan Mullan
- Department of Rheumatology, Adelaide and Meath Hospital, Dublin, Ireland
| | - Jean M Fletcher
- Translational Immunology, Schools of Biochemistry and Immunology and Medicine, Trinity College Dublin, Ireland
| | | | - Douglas J Veale
- Centre for Arthritis & Rheumatic Diseases, St. Vincent's University Hospital, University College Dublin, Ireland
| | - Ursula Fearon
- Molecular Rheumatology, School of Medicine, Trinity College Dublin, Ireland
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Fearon U, Hanlon MM, Wade SM, Fletcher JM. Altered metabolic pathways regulate synovial inflammation in rheumatoid arthritis. Clin Exp Immunol 2018; 197:170-180. [PMID: 30357805 DOI: 10.1111/cei.13228] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/17/2018] [Indexed: 12/25/2022] Open
Abstract
Rheumatoid arthritis is characterized by synovial proliferation, neovascularization and leucocyte extravasation leading to joint destruction and functional disability. The blood vessels in the inflamed synovium are highly dysregulated, resulting in poor delivery of oxygen; this, along with the increased metabolic demand of infiltrating immune cells and inflamed resident cells, results in the lack of key nutrients at the site of inflammation. In these adverse conditions synovial cells must adapt to generate sufficient energy to support their proliferation and activation status, and thus switch their cell metabolism from a resting regulatory state to a highly metabolically active state. This alters redox-sensitive signalling pathways and also results in the accumulation of metabolic intermediates which, in turn, can act as signalling molecules that further exacerbate the inflammatory response. The RA synovium is a multi-cellular tissue, and while many cell types interact to promote the inflammatory response, their metabolic requirements differ. Thus, understanding the complex interplay between hypoxia-induced signalling pathways, metabolic pathways and the inflammatory response will provide better insight into the underlying mechanisms of disease pathogenesis.
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Affiliation(s)
- U Fearon
- Molecular Rheumatology, Trinity Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland
| | - M M Hanlon
- Molecular Rheumatology, Trinity Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland
| | - S M Wade
- Molecular Rheumatology, Trinity Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland
| | - J M Fletcher
- Translational Immunology, Trinity Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland
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McGarry T, Biniecka M, Veale DJ, Fearon U. Hypoxia, oxidative stress and inflammation. Free Radic Biol Med 2018; 125:15-24. [PMID: 29601945 DOI: 10.1016/j.freeradbiomed.2018.03.042] [Citation(s) in RCA: 333] [Impact Index Per Article: 55.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Revised: 03/20/2018] [Accepted: 03/24/2018] [Indexed: 12/20/2022]
Abstract
Inflammatory Arthritis is characterized by synovial proliferation, neovascularization and leukocyte extravasation leading to joint destruction and functional disability. Efficiency of oxygen supply to the synovium is poor due to the highly dysregulated synovial microvasculature. This along with the increased energy demands of activated infiltrating immune cells and inflamed resident cells leads to an hypoxic microenvironment and mitochondrial dysfunction. This favors an increase of reactive oxygen species, leading to oxidative damage which further promotes inflammation. In this adverse microenvironment synovial cells adapt to generate energy and switch their cell metabolism from a resting regulatory state to a highly metabolically active state which allows them to produce essential building blocks to support their proliferation. This metabolic shift results in the accumulation of metabolic intermediates which act as signaling molecules that further dictate the inflammatory response. Understanding the complex interplay between hypoxia-induced signaling pathways, oxidative stress and mitochondrial function will provide better insight into the underlying mechanisms of disease pathogenesis.
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Affiliation(s)
- Trudy McGarry
- The Department of Molecular Rheumatology, Trinity College Dublin, Ireland
| | - Monika Biniecka
- The Centre for Arthritis and Rheumatic Disease, Dublin Academic Medical Centre, St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland
| | - Douglas J Veale
- The Centre for Arthritis and Rheumatic Disease, Dublin Academic Medical Centre, St. Vincent's University Hospital, Elm Park, Dublin 4, Ireland
| | - Ursula Fearon
- The Department of Molecular Rheumatology, Trinity College Dublin, Ireland.
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25
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Orr CK, Najm A, Young F, McGarry T, Biniecka M, Fearon U, Veale DJ. The Utility and Limitations of CRP, ESR and DAS28-CRP in Appraising Disease Activity in Rheumatoid Arthritis. Front Med (Lausanne) 2018; 5:185. [PMID: 30123796 PMCID: PMC6085449 DOI: 10.3389/fmed.2018.00185] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Accepted: 06/06/2018] [Indexed: 12/29/2022] Open
Abstract
Introduction: Identifying and quantifying inflammatory disease activity in rheumatoid arthritis remains a challenge. Many studies have suggested that a large proportion of patients may have active inflammation, but normal inflammatory markers. Although various disease activity scores have been validated, most rely to a large degree on biomarkers such as CRP and ESR. In this study, we examine the utility and limitations of these biomarkers, as well as the DAS28-CRP in appraising disease activity in RA. Methods: Two hundred and twenty three consecutive rheumatoid arthritis reporting knee arthralgia underwent synovial sampling of the affected knee via needle arthroscopy. The synovium was examined by microscopy with H+E staining as well as immunohistochemistry, and related to the ESR, CRP and DAS28-CRP on blood samples taken immediately before arthroscopy. Results: Although a statistically significant positive correlation was observed between CRP and the level of inflammation in the biopsy retrieved (n = 197, rho = 0.43, CI 0.30–0.54, p < 0.0001), there was histological evidence of inflammation in the synovium in 49.4% of the patients who had a normal CRP. A positive correlation was also observed between ESR and the level of inflammation in the biopsy retrieved (n = 188, rho = 0.29, CI 0.15–0.42 p < 0.0001). A statistically significant but weak positive correlation was observed between the DAS28-CRP and synovial inflammation (n = 189, rho = 0.23, CI 0.09–0.37, p = 0.0011). Only the CD19 infiltrate in the synovium correlated with serum CRP (n = 70, rho = 0.32, CI 0.08–0.52, p = 0.0068). Conclusion: CRP has a moderately strong relationship with disease activity, but there are significant pitfalls in the use of this biomarker in RA, and therefore a need interpret CRP results judiciously. The results of this study underline the heterogeneity of RA, and the need to develop improved panels of biomarkers, to better stratify RA, and to identify the cohort for whom inflammatory activity cannot be measured accurately with CRP.
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Affiliation(s)
- Carl K Orr
- Dublin Academic Medical Centre, Centre for Arthritis and Rheumatic Diseases, University College Dublin, Dublin, Ireland
| | - Aurelie Najm
- Dublin Academic Medical Centre, Centre for Arthritis and Rheumatic Diseases, University College Dublin, Dublin, Ireland
| | - Francis Young
- Dublin Academic Medical Centre, Centre for Arthritis and Rheumatic Diseases, University College Dublin, Dublin, Ireland
| | - Trudy McGarry
- Molecular Rheumatology Research Group, Trinity Biomedical Sciences Institute, Trinity College, Dublin, Ireland
| | - Monika Biniecka
- Dublin Academic Medical Centre, Centre for Arthritis and Rheumatic Diseases, University College Dublin, Dublin, Ireland
| | - Ursula Fearon
- Molecular Rheumatology Research Group, Trinity Biomedical Sciences Institute, Trinity College, Dublin, Ireland
| | - Douglas J Veale
- Dublin Academic Medical Centre, Centre for Arthritis and Rheumatic Diseases, University College Dublin, Dublin, Ireland
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Xue L, Li X, Chen Q, He J, Dong Y, Wang J, Shen S, Jia R, Zang QJ, Zhang T, Li M, Geng Y. Associations between D3R expression in synovial mast cells and disease activity and oxidant status in patients with rheumatoid arthritis. Clin Rheumatol 2018; 37:2621-2632. [PMID: 29934747 DOI: 10.1007/s10067-018-4168-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2018] [Revised: 05/12/2018] [Accepted: 05/31/2018] [Indexed: 02/07/2023]
Abstract
Dopamine D3 receptor (D3R) on immune cells is involved in the pathogenesis of rheumatoid arthritis (RA). Mast cells (MCs) are currently identified as important effector cells in synovial inflammation of RA, but little is known about the role of D3R on synovial MCs in the pathogenesis of RA. Several inflammatory cells in the synovium induce reactive oxygen species (ROS) formation which are involved in the progression of RA. However, it is unclear whether D3R on synovial MCs is related to the levels of ROS in RA patients. In this study, a total of 73 patients with RA were divided into three groups according to disease activity DAS28 scores. The number of cases in group 1, group 2, and group 3 was 19, 26, and 28, respectively. We examined D3R-positive MC numbers in the synovial fluid and ROS levels in each group of RA patients, and we also analyzed the association of D3R-positive MC numbers with RA disease activity and ROS levels. MDA and protein carbonylation in the serum and synovial fluid were measured to reflect the level of lipid peroxidation and protein oxidation, respectively. Additionally, superoxide dismutase (SOD) and catalase (CAT) in the serum and synovial fluid were used to be markers of antioxidant levels. Our results showed that D3R-positive MCs in the synovial fluid showed a declining trend with the increased disease activity DAS28 score in RA patients. There was negative correlation between D3R-positive MC numbers in the synovial fluid and disease severity DAS28 score of RA patients. Moreover, D3R-positive MC numbers in the synovial fluid were negatively correlated with the level of MDA and protein carbonylation while were positively correlated with antioxidant levels such as SOD and CAT in RA patients. Our results suggested that D3R on MCs may be involved in ROS-mediated pathogenesis of RA.
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Affiliation(s)
- Li Xue
- Department of Laboratory, The Second Affiliated Hospital of Medical College of Xi'an Jiaotong University, Xi'an, 710004, Shaanxi, People's Republic of China
| | - Xueyi Li
- Department of Rheumatology, The Second Affiliated Hospital of Medical College of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Qingping Chen
- The First Department of Rheumatology, Xi'an Fifth Hospital, Xi'an, Shaanxi, China
| | - Juntao He
- Department of Laboratory, The Second Affiliated Hospital of Medical College of Xi'an Jiaotong University, Xi'an, 710004, Shaanxi, People's Republic of China
| | - Yanying Dong
- Department of Laboratory, The Second Affiliated Hospital of Medical College of Xi'an Jiaotong University, Xi'an, 710004, Shaanxi, People's Republic of China
| | - Jing Wang
- Department of Rheumatology, The First Affiliated Hospital of Medical College of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Siyao Shen
- The First Department of Rheumatology, Xi'an Fifth Hospital, Xi'an, Shaanxi, China
| | - Rui Jia
- Department of Neurology, The First Affiliated Hospital of Medical College of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Quan Jin Zang
- The Second Department of Orthopaedics, The Second Affiliated Hospital of Medical College of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Ting Zhang
- Department of Laboratory, Wuxi Maternity and Child Health Hospital, Nanjing Medical University, Wuxi, Jiangsu, China
| | - Ming Li
- Department of Cardiovascular Surgery, The First Affiliated Hospital of Medical College of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Yan Geng
- Department of Laboratory, The Second Affiliated Hospital of Medical College of Xi'an Jiaotong University, Xi'an, 710004, Shaanxi, People's Republic of China.
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He L, Liu C, Sun C, Wang J, Zhi K, Sun D, Wang H, Wang Q, Lin N. Wu-Tou Decoction Inhibits Angiogenesis in Experimental Arthritis by Targeting VEGFR2 Signaling Pathway. Rejuvenation Res 2018; 21:442-455. [PMID: 29385909 DOI: 10.1089/rej.2017.2011] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Wu-tou decoction (WTD) is a classic traditional Chinese medicine formula and has been extensively used for the treatment of rheumatoid arthritis (RA). Previous reports indicate that WTD possesses anti-inflammatory and antinociceptive activities, and inhibits the development of arthritic joints and disease severity of collagen-induced arthritis (CIA) or adjuvant-induced rats; however, its action on angiogenesis of RA has not been clarified. This study aims to determine the anti-angiogenic activity of WTD in CIA rats and in various angiogenesis models. Our data showed that WTD (0.95, 1.9, and 3.8 g/kg) markedly reduced the immature blood vessels in synovial membrane tissues of inflamed joints from CIA rats. It also inhibited in vivo angiogenesis in chick embryo and VEGF165-induced microvessel sprout formation ex vivo. Meanwhile, WTD suppressed VEGF165-/MH7A-induced migration, invasion, adhesion, and tube formation of human umbilical vein endothelial cells (HUVECs). Moreover, WTD significantly reduced the expression of angiogenic activators, including vascular endothelial growth factor (VEGF), VEGFR2, interleukin (IL)-1β, IL-17, transforming growth factor-β, platelet-derived growth factor, placenta growth factor, angiopoietin (Ang) I and Ang II in synovium of CIA rats, and/or in HUVECs. More interestingly, WTD blocked the autophosphorylation of VEGF165-induced VEGFR2 and consequently downregulated the signaling pathways of activated AKT, ERK1/2, JNK, and p38 in VEGF165-induced HUVECs. These findings suggest for the first time that WTD possesses the anti-angiogenic effect in RA in vivo, ex vivo, and in vitro by interrupting the targeting of VEGFR2 activation.
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Affiliation(s)
- Lianhua He
- 1 Guangzhou University of Chinese Medicine , Guangzhou, China .,2 Institute of Chinese Materia Medica , China Academy of Chinese Medical Sciences, Beijing, China
| | - Chunfang Liu
- 2 Institute of Chinese Materia Medica , China Academy of Chinese Medical Sciences, Beijing, China
| | - Congcong Sun
- 2 Institute of Chinese Materia Medica , China Academy of Chinese Medical Sciences, Beijing, China
| | - Jingxia Wang
- 2 Institute of Chinese Materia Medica , China Academy of Chinese Medical Sciences, Beijing, China
| | - Kai Zhi
- 2 Institute of Chinese Materia Medica , China Academy of Chinese Medical Sciences, Beijing, China
| | - Danni Sun
- 2 Institute of Chinese Materia Medica , China Academy of Chinese Medical Sciences, Beijing, China
| | - Hui Wang
- 2 Institute of Chinese Materia Medica , China Academy of Chinese Medical Sciences, Beijing, China
| | - Qianqian Wang
- 2 Institute of Chinese Materia Medica , China Academy of Chinese Medical Sciences, Beijing, China
| | - Na Lin
- 1 Guangzhou University of Chinese Medicine , Guangzhou, China .,2 Institute of Chinese Materia Medica , China Academy of Chinese Medical Sciences, Beijing, China
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Orr C, Najm A, Biniecka M, McGarry T, Ng CT, Young F, Fearon U, Veale DJ. Synovial Immunophenotype and Anti-Citrullinated Peptide Antibodies in Rheumatoid Arthritis Patients. Arthritis Rheumatol 2017; 69:2114-2123. [DOI: 10.1002/art.40218] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2016] [Accepted: 07/18/2017] [Indexed: 01/20/2023]
Affiliation(s)
- Carl Orr
- University College Dublin; Dublin Ireland
| | | | | | | | - Chin-Teck Ng
- Singapore General Hospital and Duke-NUS Medical School; Singapore
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Humby F, Mahto A, Ahmed M, Barr A, Kelly S, Buch M, Pitzalis C, Conaghan PG. The Relationship Between Synovial Pathobiology and Magnetic Resonance Imaging Abnormalities in Rheumatoid Arthritis: A Systematic Review. J Rheumatol 2017; 44:1311-1324. [DOI: 10.3899/jrheum.161314] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/11/2017] [Indexed: 01/16/2023]
Abstract
Objective.Magnetic resonance imaging (MRI) has been increasingly recognized as a critical tool for the assessment of patients with rheumatoid arthritis (RA) and is able to reliably identify synovitis, bone marrow edema, bone erosion, and joint space narrowing (JSN)/cartilage loss. Understanding the exact relationship between each MRI feature and local synovial pathobiology is critical to dissect disease pathogenesis as well as develop future predictive models.Methods.A systematic review was performed of the current published literature examining the relationship between MRI abnormalities and synovial pathobiology in patients with RA.Results.Eighteen studies were identified; most focused on validation of MRI as a tool to detect and quantify synovitis, with a significant relationship demonstrated. Additionally, from the limited data available, a critical role seems likely for synovial pathways, at least in driving joint damage. However, there was a lack of data examining the relationship between synovial pathobiology and bone marrow abnormalities and JSN.Conclusion.Although understanding the interrelationship of these disease biomarkers offers the potential to enhance the predictive validity of modern imaging with concomitant synovial pathobiological analysis, further studies integrating MRI with synovial tissue analysis in well-controlled cohorts at distinct disease stages before and after therapeutic intervention are required to achieve this.
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Takahashi S, Saegusa J, Sendo S, Okano T, Akashi K, Irino Y, Morinobu A. Glutaminase 1 plays a key role in the cell growth of fibroblast-like synoviocytes in rheumatoid arthritis. Arthritis Res Ther 2017; 19:76. [PMID: 28399896 PMCID: PMC5387190 DOI: 10.1186/s13075-017-1283-3] [Citation(s) in RCA: 78] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2016] [Accepted: 03/24/2017] [Indexed: 01/08/2023] Open
Abstract
Background The recent findings of cancer-specific metabolic changes, including increased glucose and glutamine consumption, have provided new therapeutic targets for consideration. Fibroblast-like synoviocytes (FLS) from rheumatoid arthritis (RA) patients exhibit several tumor cell-like characteristics; however, the role of glucose and glutamine metabolism in the aberrant proliferation of these cells is unclear. Here, we evaluated the role of these metabolic pathways in RA-FLS proliferation and in autoimmune arthritis in SKG mice. Methods The expression of glycolysis- or glutaminolysis-related enzymes was evaluated by real-time polymerase chain reaction (PCR) and Western blotting, and the intracellular metabolites were evaluated by metabolomic analyses. The effects of glucose or glutamine on RA-FLS cell growth were investigated using glucose- or glutamine-free medium. Glutaminase (GLS)1 small interfering RNA (siRNA) and the GLS1 inhibitor compound 968 were used to inhibit GLS1 in RA-FLS, and compound 968 was used to study the effect of GLS1 inhibition in zymosan A-injected SKG mice. Results GLS1 expression was increased in RA-FLS, and metabolomic analyses revealed that glutamine metabolism was increased in RA-FLS. RA-FLS proliferation was reduced under glutamine-deprived, but not glucose-deprived, conditions. Cell growth of RA-FLS was inhibited by GLS1 siRNA transfection or GLS1 inhibitor treatment. Treating RA-FLS with either interleukin-17 or platelet-derived growth factor resulted in increased GLS1 levels. Compound 968 ameliorated the autoimmune arthritis and decreased the number of Ki-67-positive synovial cells in SKG mice. Conclusions Our results suggested that glutamine metabolism is involved in the pathogenesis of RA and that GLS1 plays an important role in regulating RA-FLS proliferation, and may be a novel therapeutic target for RA. Electronic supplementary material The online version of this article (doi:10.1186/s13075-017-1283-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Soshi Takahashi
- Department of Rheumatology and Clinical Immunology, Kobe University Graduate School of Medicine, 7-5-1, Kusunoki-Cho, Chuo-Ku, Kobe, 650-0017, Japan
| | - Jun Saegusa
- Department of Rheumatology and Clinical Immunology, Kobe University Graduate School of Medicine, 7-5-1, Kusunoki-Cho, Chuo-Ku, Kobe, 650-0017, Japan. .,Department of Clinical Laboratory, Kobe University Hospital, 7-5-1, Kusunoki-Cho, Chuo-Ku, Kobe, 650-0017, Japan.
| | - Sho Sendo
- Department of Rheumatology and Clinical Immunology, Kobe University Graduate School of Medicine, 7-5-1, Kusunoki-Cho, Chuo-Ku, Kobe, 650-0017, Japan
| | - Takaichi Okano
- Department of Rheumatology and Clinical Immunology, Kobe University Graduate School of Medicine, 7-5-1, Kusunoki-Cho, Chuo-Ku, Kobe, 650-0017, Japan
| | - Kengo Akashi
- Department of Rheumatology and Clinical Immunology, Kobe University Graduate School of Medicine, 7-5-1, Kusunoki-Cho, Chuo-Ku, Kobe, 650-0017, Japan
| | - Yasuhiro Irino
- Division of Evidence-Based Laboratory Medicine, Kobe University Graduate School of Medicine, 7-5-1, Kusunoki-Cho, Chuo-Ku, Kobe, 650-0017, Japan
| | - Akio Morinobu
- Department of Rheumatology and Clinical Immunology, Kobe University Graduate School of Medicine, 7-5-1, Kusunoki-Cho, Chuo-Ku, Kobe, 650-0017, Japan
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Opposing regulation of the late phase TNF response by mTORC1-IL-10 signaling and hypoxia in human macrophages. Sci Rep 2016; 6:31959. [PMID: 27558590 PMCID: PMC4997257 DOI: 10.1038/srep31959] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2016] [Accepted: 08/01/2016] [Indexed: 12/17/2022] Open
Abstract
Tumor necrosis factor (TNF) is best known for inducing a rapid but transient NF-κB-mediated inflammatory response. We investigated later phases of TNF signaling, after the initial transient induction of inflammatory genes has subsided, in primary human macrophages. TNF signaling induced expression of late response genes, including inhibitors of NF-κB and TLR signaling, with delayed and sustained kinetics 6–24 hr after TNF stimulation. A subset of late phase genes was expressed in rheumatoid arthritis synovial macrophages, confirming their expression under chronic inflammatory conditions in vivo. Expression of a subset of late phase genes was mediated by autocrine IL-10, which activated STAT3 with delayed kinetics. Hypoxia, which occurs at sites of infection or inflammation where TNF is expressed, suppressed this IL-10-STAT3 autocrine loop and expression of late phase genes. TNF-induced expression of IL-10 and downstream genes was also dependent on signaling by mTORC1, which senses the metabolic state of cells and is modulated by hypoxia. These results reveal an mTORC1-dependent IL-10-mediated late phase response to TNF by primary human macrophages, and identify suppression of IL-10 responses as a new mechanism by which hypoxia can promote inflammation. Thus, hypoxic and metabolic pathways may modulate TNF responses during chronic inflammation.
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Hypoxia, mitochondrial dysfunction and synovial invasiveness in rheumatoid arthritis. Nat Rev Rheumatol 2016; 12:385-97. [DOI: 10.1038/nrrheum.2016.69] [Citation(s) in RCA: 173] [Impact Index Per Article: 21.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Blaser H, Dostert C, Mak TW, Brenner D. TNF and ROS Crosstalk in Inflammation. Trends Cell Biol 2016; 26:249-261. [PMID: 26791157 DOI: 10.1016/j.tcb.2015.12.002] [Citation(s) in RCA: 680] [Impact Index Per Article: 85.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2015] [Revised: 12/03/2015] [Accepted: 12/04/2015] [Indexed: 01/06/2023]
Abstract
Tumor necrosis factor (TNF) is tremendously important for mammalian immunity and cellular homeostasis. The role of TNF as a master regulator in balancing cell survival, apoptosis and necroptosis has been extensively studied in various cell types and tissues. Although these findings have revealed much about the direct impact of TNF on the regulation of NF-κB and JNK, there is now rising interest in understanding the emerging function of TNF as a regulator of the generation of reactive oxygen species (ROS) and reactive nitrogen species (RNS). In this review we summarize work aimed at defining the role of TNF in the control of ROS/RNS signaling that influences innate immune cells under both physiological and inflammatory conditions.
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Affiliation(s)
- Heiko Blaser
- The Campbell Family Cancer Research Institute, Ontario Cancer Institute, University Health Network, Toronto, Ontario, Canada
| | - Catherine Dostert
- Department of Infection and Immunity, Experimental and Molecular Immunology, Luxembourg Institute of Health, 29, rue Henri Koch, 4354 Esch-sur-Alzette, Luxembourg
| | - Tak W Mak
- The Campbell Family Cancer Research Institute, Ontario Cancer Institute, University Health Network, Toronto, Ontario, Canada; Department of Immunology, University of Toronto, Toronto, Ontario, Canada; Department of Medical Biophysics, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Dirk Brenner
- Department of Infection and Immunity, Experimental and Molecular Immunology, Luxembourg Institute of Health, 29, rue Henri Koch, 4354 Esch-sur-Alzette, Luxembourg; Odense Research Center for Anaphylaxis (ORCA), Department of Dermatology and Allergy Center, Odense University Hospital, University of Southern Denmark, Odense, Denmark.
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Redox-Mediated Angiogenesis in the Hypoxic Joint of Inflammatory Arthritis. Arthritis Rheumatol 2014; 66:3300-10. [DOI: 10.1002/art.38822] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2013] [Accepted: 08/07/2014] [Indexed: 01/15/2023]
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Fiocco U, Sfriso P, Oliviero F, Lunardi F, Calabrese F, Scagliori E, Cozzi L, Di Maggio A, Nardacchione R, Molena B, Felicetti M, Gazzola K, Stramare R, Rubaltelli L, Accordi B, Costa L, Roux-Lombard P, Punzi L, Dayer JM. Blockade of intra-articular TNF in peripheral spondyloarthritis: Its relevance to clinical scores, quantitative imaging and synovial fluid and synovial tissue biomarkers. Joint Bone Spine 2013; 80:165-70. [DOI: 10.1016/j.jbspin.2012.06.016] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2012] [Accepted: 06/27/2012] [Indexed: 11/16/2022]
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Gao W, Sweeney C, Walsh C, Rooney P, McCormick J, Veale DJ, Fearon U. Notch signalling pathways mediate synovial angiogenesis in response to vascular endothelial growth factor and angiopoietin 2. Ann Rheum Dis 2012; 72:1080-8. [PMID: 23161900 PMCID: PMC3664379 DOI: 10.1136/annrheumdis-2012-201978] [Citation(s) in RCA: 84] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Objective Notch signalling pathways are critical for angiogenesis and endothelial cell (EC) fate; however the mechanisms regulating these processes in the inflamed joint remain to be elucidated. Here, we examine whether Notch signalling mediates vascular endothelial growth factor (VEGF) and angiopoietin 2 (Ang2)-induced vascular function. Methods Notch-1 intracellular domain (Notch-1 IC), Notch-4 IC, Delta-like-ligand 4, Hes-related transcriptional repressors-1 and 2 (Hrt-1, Hrt-2) mRNA and/or protein expression was measured by Real-time PCR and/or western blot. VEGF/Ang2 induced EC function was assessed using transwell invasion chambers, matrigel tube formation assays and wound repair scratch assays ± Notch-1 siRNA or an γ-secretase inhibitor N-(N-(3,5-Difluorophenacetyl-L-alanly))-S-phenylglycine-t-Butyl Ester (DAPT) in RA synovial explants or human microvascular EC. Interleukin (IL)-6 and IL-8 were measured by ELISA and MMP2 and 9 by gelatine zymography. Results Notch-1 IC and Notch-4 IC protein expressions were demonstrated in RA and psoriatic arthritis synovial biopsies, with minimal expression observed in Osteoarthritis (OA). VEGF and Ang2 induced Notch-1 IC/ Notch-4 IC protein expression in synovial explant cultures and human microvascular EC levels were further potentiated by VEGF/Ang2 stimulation in combination. Notch-1, Delta-like-ligand 4, and Hrt-2 mRNA expression were significantly induced by VEGF and Ang2 alone and in combination. Furthermore VEGF/Ang2-induced EC invasion, angiogenesis and migration were inhibited by Notch-1 siRNA or DAPT. Conditioned media from VEGF/Ang2 stimulated RA synovial explants induced EC tube formation, an effect that was inhibited by DAPT. Finally, DAPT significantly decreased VEGF/Ang2 induced IL-6, IL-8, MMP2 and 9 expressions in RA synovial explants. Conclusions Notch-1 mediates VEGF/Ang2-induced angiogenesis and EC invasion in inflammatory arthritis.
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Affiliation(s)
- Wei Gao
- Department of Rheumatology, Translational Research Group, Dublin Academic Medical Centre, St Vincent's University Hospital, Dublin, Ireland
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Gao W, Sweeney C, Connolly M, Kennedy A, Ng CT, McCormick J, Veale DJ, Fearon U. Notch-1 mediates hypoxia-induced angiogenesis in rheumatoid arthritis. ACTA ACUST UNITED AC 2012; 64:2104-13. [PMID: 22275240 DOI: 10.1002/art.34397] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE To examine the effect of hypoxia on Notch-1 signaling pathway components and angiogenesis in inflammatory arthritis. METHODS The expression and regulation of Notch-1, its ligand delta-like protein 4 (DLL-4) and downstream signaling components (hairy-related transcription factor 1 [HRT-1], HRT-2), and hypoxia-inducible factor 1α (HIF-1α) under normoxic and hypoxic conditions (1-3%) were assessed in synovial tissue specimens from patients with inflammatory arthritis and controls and in human dermal microvascular endothelial cells (HDMECs) by immunohistology, dual immunofluorescence staining (Notch-1/factor VIII), Western blotting, and real-time polymerase chain reaction. In vivo synovial tissue oxygen levels (tissue PO2) were measured under direct visualization at arthroscopy. HDMEC activation under hypoxic conditions in the presence of Notch-1 small interfering RNA (siRNA), the γ-secretase inhibitor DAPT, or dimethyloxalylglycine (DMOG) was assessed by Matrigel tube formation assay, migration assay, invasion assay, and matrix metalloproteinase 2 (MMP-2)/MMP-9 zymography. RESULTS Expression of Notch-1, its ligand DLL-4, and HRT-1 was demonstrated in synovial tissue, with the strongest expression localized to perivascular/vascular regions. Localization of Notch-1 to synovial endothelium was confirmed by dual immunofluorescence staining. Notch-1 intracellular domain (NICD) expression was significantly higher in synovial tissue from patients with tissue PO2 of <20 mm Hg (<3% O2) than in those with tissue PO2 of >20 mm Hg (>3% O2). Exposure of HDMECs to 3% hypoxia induced HIF-1α and NICD protein expression and DLL-4, HRT-1, and HRT-2 messenger RNA expression. DMOG directly induced NICD expression, while Notch-1 siRNA inhibited hypoxia-induced HIF-1α expression, suggesting that Notch-1/HIF-1α signaling is bidirectional. Finally, 3% hypoxia-induced angiogenesis, endothelial cell migration, endothelial cell invasion, and proMMP-2 and proMMP-9 activities were inhibited by Notch-1 siRNA and/or the γ-secretase inhibitor DAPT. CONCLUSION Our findings indicate that Notch-1 is expressed in synovial tissue and that increased NICD expression is associated with low in vivo tissue PO2. Furthermore, Notch-1/HIF-1α interactions mediate hypoxia-induced angiogenesis and invasion in inflammatory arthritis.
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Affiliation(s)
- Wei Gao
- Dublin Academic Medical Centre, St. Vincent's University Hospital, and University College Dublin, Dublin, Ireland
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Pfitzner T, Geissler S, Duda G, Perka C, Matziolis G. Increased BMP expression in arthrofibrosis after TKA. Knee Surg Sports Traumatol Arthrosc 2012; 20:1803-8. [PMID: 22089372 DOI: 10.1007/s00167-011-1774-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2011] [Accepted: 11/08/2011] [Indexed: 01/13/2023]
Abstract
PURPOSE Because of the multiple possible aetiologies of painful total knee arthroplasty (TKA), the diagnosis and treatment of such patients are challenging. In a considerable number of patients, an intraarticular pathology is present, although not verifiable with clinical and diagnostic imaging techniques as in cases of primary arthrofibrosis. In these patients, the differentiation between intra- and extraarticular causes of pain remains difficult. Until now, little attention has been paid to changes of the synovial fluid and tissue in these knees. The objective of this study was to analyse the changes of the synovial environment in patients suffering from arthrofibrosis after TKA in comparison with knees with referred pain suffering from hip arthritis. The changes of the synovial environment probably provide additional diagnostic information to verify an intraarticular pathology. METHODS The synovial fluid of 10 consecutive knees in 10 patients presenting with a primary arthrofibrosis after TKA without signs of infection, instability, malalignment, or loosening was analysed and compared to the synovial fluid of 10 knees with referred pain serving as controls. The BMP-2 concentration was measured in the synovial fluid, and the presence of cytokines leading to an overexpression of BMP-2 was detected by measuring the change of BMP-2 expression in a synoviocyte cell line following exposing to the synovial fluid of the patients. RESULTS The concentration of BMP-2 in the synovial fluid was significantly higher in arthrofibrotic TKA knees (24.3 ± 6.9 pg/mL), compared with the control group 5.9 ± 4.8 pg/mL (P < 0.001). Corresponding to this finding, BMP-2 expression in synoviocytes was upregulated 11.5-fold (P < 0.05) by synovial fluid of patients suffering from arthrofibrosis after TKA, compared with the control group with referred pain. CONCLUSION BMP-2 is overexpressed and its concentrations are consequently higher in patients suffering from arthrofibrosis after TKA. The synovial BMP-2 concentration may be a potential marker for differentiating between intra- and extraarticular causes of pain. LEVEL OF EVIDENCE II.
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Affiliation(s)
- Tilman Pfitzner
- Orthopaedic Department, Center for Musculoskeletal Surgery, Charité-University Medicine Berlin, Chariteplatz 1, 10117 Berlin, Germany.
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Fangradt M, Hahne M, Gaber T, Strehl C, Rauch R, Hoff P, Löhning M, Burmester GR, Buttgereit F. Human monocytes and macrophages differ in their mechanisms of adaptation to hypoxia. Arthritis Res Ther 2012; 14:R181. [PMID: 22870988 PMCID: PMC3580576 DOI: 10.1186/ar4011] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2012] [Accepted: 08/07/2012] [Indexed: 12/23/2022] Open
Abstract
Introduction Inflammatory arthritis is a progressive disease with chronic inflammation of joints, which is mainly characterized by the infiltration of immune cells and synovial hyperproliferation. Monocytes migrate towards inflamed areas and differentiate into macrophages. In inflamed tissues, much lower oxygen levels (hypoxia) are present in comparison to the peripheral blood. Hence, a metabolic adaptation process must take place. Other studies suggest that Hypoxia Inducible Factor 1-alpha (HIF-1α) may regulate this process, but the mechanism involved for human monocytes is not yet clear. To address this issue, we analyzed the expression and function of HIF-1α in monocytes and macrophages, but also considered alternative pathways involving nuclear factor of kappa light polypeptide gene enhancer in B-cells (NFκB). Methods Isolated human CD14+ monocytes were incubated under normoxia and hypoxia conditions with or without phorbol 12-myristate 13-acetate (PMA) stimulation, respectively. Nuclear and cytosolic fractions were prepared in order to detect HIF-1α and NFκB by immunoblot. For the experiments with macrophages, primary human monocytes were differentiated into human monocyte derived macrophages (hMDM) using human macrophage colony-stimulating factor (hM-CSF). The effects of normoxia and hypoxia on gene expression were compared between monocytes and hMDMs using quantitative PCR (quantitative polymerase chain reaction). Results We demonstrate, using primary human monocytes and hMDM, that the localization of transcription factor HIF-1α during the differentiation process is shifted from the cytosol (in monocytes) into the nucleus (in macrophages), apparently as an adaptation to a low oxygen environment. For this localization change, protein kinase C alpha/beta 1 (PKC-α/β1 ) plays an important role. In monocytes, it is NFκB1, and not HIF-1α, which is of central importance for the expression of hypoxia-adjusted genes. Conclusions These data demonstrate that during differentiation of monocytes into macrophages, crucial cellular adaptation mechanisms are decisively changed.
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Spies CM, Straub RH, Buttgereit F. Energy metabolism and rheumatic diseases: from cell to organism. Arthritis Res Ther 2012; 14:216. [PMID: 22747923 PMCID: PMC3446535 DOI: 10.1186/ar3885] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
In rheumatic and other chronic inflammatory diseases, high amounts of energy for the activated immune system have to be provided and allocated by energy metabolism. In recent time many new insights have been gained into the control of the immune response through metabolic signals. Activation of immune cells as well as reduced nutrient supply and hypoxia in inflamed tissues cause stimulation of glycolysis and other cellular metabolic pathways. However, persistent cellular metabolic signals can promote ongoing chronic inflammation and loss of immune tolerance. On the organism level, the neuroendocrine immune response of the hypothalamic-pituitary adrenal axis and sympathetic nervous system, which is meant to overcome a transient inflammatory episode, can lead to metabolic disease sequelae if chronically activated. We conclude that, on cellular and organism levels, a prolonged energy appeal reaction is an important factor of chronic inflammatory disease etiology.
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Affiliation(s)
- Cornelia M Spies
- Department of Rheumatology and Clinical Immunology, Charité University Medicine Berlin, Charitéplatz 1, 10117 Berlin, Germany.
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Lowin T, Weidler C, Jenei-Lanzl Z, Capellino S, Baerwald CGO, Buttgereit F, Straub RH. Relationship between placenta growth factor 1 and vascularization, dehydroepiandrosterone sulfate to dehydroepiandrosterone conversion, or aromatase expression in patients with rheumatoid arthritis and patients with osteoarthritis. ACTA ACUST UNITED AC 2012; 64:1799-808. [DOI: 10.1002/art.34338] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Goronzy JJ, Li G, Yu M, Weyand CM. Signaling pathways in aged T cells - a reflection of T cell differentiation, cell senescence and host environment. Semin Immunol 2012; 24:365-72. [PMID: 22560928 DOI: 10.1016/j.smim.2012.04.003] [Citation(s) in RCA: 85] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2012] [Revised: 04/01/2012] [Accepted: 04/09/2012] [Indexed: 01/04/2023]
Abstract
With increasing age, the ability of the immune system to protect against new antigenic challenges or to control chronic infections erodes. Decline in thymic function and cumulating antigenic experiences of acute and chronic infections threaten T cell homeostasis, but insufficiently explain the failing immune competence and the increased susceptibility for autoimmunity. Alterations in signaling pathways in the aging T cells account for many of the age-related defects. Signaling threshold calibrations seen with aging frequently built on mechanisms that are operational in T cell development and T cell differentiation or are adaptations to the changing environment in the aging host. Age-related changes in transcription of receptors and signaling molecules shift the balance towards inhibitory pathways, most dominantly seen in CD8 T cells and to a lesser degree in CD4 T cells. Prominent examples are the expression of negative regulatory receptors of the CD28 and the TNF receptor superfamilies as well the expression of various cytoplasmic and nuclear dual-specific phosphatases.
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Affiliation(s)
- Jörg J Goronzy
- Department of Medicine, Stanford University School of Medicine, Stanford, CA 94305, United States.
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Chenevier-Gobeaux C, Simonneau C, Lemarechal H, Bonnefont-Rousselot D, Poiraudeau S, Rannou F, Anract P, Borderie D. Hypoxia induces nitric oxide synthase in rheumatoid synoviocytes: consequences on NADPH oxidase regulation. Free Radic Res 2012; 46:628-36. [DOI: 10.3109/10715762.2012.662276] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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Hypoxia--a key regulator of angiogenesis and inflammation in rheumatoid arthritis. Nat Rev Rheumatol 2012; 8:153-62. [PMID: 22293762 DOI: 10.1038/nrrheum.2011.205] [Citation(s) in RCA: 237] [Impact Index Per Article: 19.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The importance of inflammation in rheumatoid arthritis (RA) is well understood. This knowledge has resulted in the development of anti-inflammatory therapies--either broadly acting (such as steroids) or more specific approaches (such as antibodies against TNF)--with biologic therapies (including TNF inhibitors) revolutionizing the treatment of RA. However, what is less well appreciated in RA are the links between inflammation, blood-vessel formation (angiogenesis) and cellular responses to changes in oxygen tension. Inadequate oxygenation, termed hypoxia, is thought to drive the increase in synovial angiogenesis that occurs in RA, through expression of hypoxia-inducible molecules, including vascular endothelial growth factor (VEGF). This process promotes further infiltration of inflammatory cells and production of inflammatory mediators, perpetuating synovitis. This Review highlights the molecular pathways activated by hypoxia, and how these pathways might interact with inflammatory signaling to promote and maintain synovitis in RA, with a particular focus on the response of macrophages to hypoxia in the context of RA. Successful treatment of RA, for example with anti-TNF antibodies, reduces levels of proangiogenic factors, including VEGF, and leads to normalization of the vasculature. These processes emphasise the close links between hypoxia, angiogenesis and inflammation in this disease and supports the concept that angiogenesis blockade could be of therapeutic benefit in RA.
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Current World Literature. Curr Opin Rheumatol 2012; 24:119-22. [DOI: 10.1097/bor.0b013e32834f0d5d] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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IL-17A expression is localised to both mononuclear and polymorphonuclear synovial cell infiltrates. PLoS One 2011; 6:e24048. [PMID: 21887369 PMCID: PMC3161104 DOI: 10.1371/journal.pone.0024048] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2011] [Accepted: 07/31/2011] [Indexed: 01/05/2023] Open
Abstract
INTRODUCTION This study examines the expression of IL-17A-secreting cells within the inflamed synovium and the relationship to in vivo joint hypoxia measurements. METHODS IL-17A expression was quantified in synovial tissue (ST), serum and synovial fluid (SF) by immunohistochemistry and MSD-plex assays. IL-6 SF and serum levels were measured by MSD-plex assays. Dual immunofluorescence for IL-17A was quantified in ST CD15+ cells (neutrophils), Tryptase+ (mast cells) and CD4+ (T cells). Synovial tissue oxygen (tpO(2)) levels were measured under direct visualisation at arthroscopy. Synovial infiltration was assessed using immunohistochemistry for cell specific markers. Peripheral blood mononuclear and polymorphonuclear cells were isolated and exposed to normoxic or 3% hypoxic conditions. IL-17A and IL-6 were quantified as above in culture supernatants. RESULTS IL-17A expression was localised to mononuclear and polymorphonuclear (PMN) cells in inflamed ST. Dual immunoflourescent staining co-localised IL-17A expression with CD15+ neutrophils Tryptase+ mast cells and CD4+T cells. % IL-17A positivity was highest on CD15+ neutrophils, followed by mast cells and then CD4+T-cells. The number of IL-17A-secreting PMN cells significantly correlated with sublining CD68 expression (r = 0.618, p<0.01). IL-17A SF levels correlated with IL-6 SF levels (r = 0.675, p<0.01). Patients categorized according to tp0(2)< or >20 mmHg, showed those with low tp0(2)<20 mmHg had significantly higher IL-17A+ mononuclear cells with no difference observed for PMNs. Exposure of mononuclear and polymorphonuclear cells to 3% hypoxia, significantly induced IL-6 in mononuclear cells, but had no effect on IL-17A expression in mononuclear and polymorphonuclear cells. CONCLUSION This study demonstrates IL-17A expression is localised to several immune cell subtypes within the inflamed synovial tissue, further supporting the concept that IL-17A is a key mediator in inflammatory arthritis. The association of hypoxia with Il-17A expression appears to be indirect, probably through hypoxia-induced pro-inflammatory pathways and leukocyte influx within the joint microenvironment.
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Biniecka M, Kennedy A, Ng CT, Chang TC, Balogh E, Fox E, Veale DJ, Fearon U, O'Sullivan JN. Successful tumour necrosis factor (TNF) blocking therapy suppresses oxidative stress and hypoxia-induced mitochondrial mutagenesis in inflammatory arthritis. Arthritis Res Ther 2011; 13:R121. [PMID: 21787418 PMCID: PMC3239359 DOI: 10.1186/ar3424] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2011] [Revised: 06/02/2011] [Accepted: 07/25/2011] [Indexed: 11/23/2022] Open
Abstract
Introduction To examine the effects of tumour necrosis factor (TNF) blocking therapy on the levels of early mitochondrial genome alterations and oxidative stress. Methods Eighteen inflammatory arthritis patients underwent synovial tissue oxygen (tpO2) measurements and clinical assessment of disease activity (DAS28-CRP) at baseline (T0) and three months (T3) after starting biologic therapy. Synovial tissue lipid peroxidation (4-HNE), T and B cell specific markers and synovial vascular endothelial growth factor (VEGF) were quantified by immunohistochemistry. Synovial levels of random mitochondrial DNA (mtDNA) mutations were assessed using Random Mutation Capture (RMC) assay. Results 4-HNE levels pre/post anti TNF-α therapy were inversely correlated with in vivo tpO2 (P < 0.008; r = -0.60). Biologic therapy responders showed a significantly reduced 4-HNE expression (P < 0.05). High 4-HNE expression correlated with high DAS28-CRP (P = 0.02; r = 0.53), tender joint count for 28 joints (TJC-28) (P = 0.03; r = 0.49), swollen joint count for 28 joints (SJC-28) (P = 0.03; r = 0.50) and visual analogue scale (VAS) (P = 0.04; r = 0.48). Strong positive association was found between the number of 4-HNE positive cells and CD4+ cells (P = 0.04; r = 0.60), CD8+ cells (P = 0.001; r = 0.70), CD20+ cells (P = 0.04; r = 0.68), CD68+ cells (P = 0.04; r = 0.47) and synovial VEGF expression (P = 0.01; r = 063). In patients whose in vivo tpO2 levels improved post treatment, significant reduction in mtDNA mutations and DAS28-CRP was observed (P < 0.05). In contrast in those patients whose tpO2 levels remained the same or reduced at T3, no significant changes for mtDNA mutations and DAS28-CRP were found. Conclusions High levels of synovial oxidative stress and mitochondrial mutation burden are strongly associated with low in vivo oxygen tension and synovial inflammation. Furthermore these significant mitochondrial genome alterations are rescued following successful anti TNF-α treatment.
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Affiliation(s)
- Monika Biniecka
- Translation Rheumatology Research Group, Dublin Academic Medical Centre, The Conway Institute of Biomolecular and Biomedical Research, St. Vincent’s University Hospital, Elm Park, Dublin 4, Ireland
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Successful biologic therapy leads to an improvement in synovial tissue hypoxia. Nat Rev Rheumatol 2011; 7:131. [DOI: 10.1038/nrrheum.2011.5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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