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Awad SM, Elgazzar HM, Hassan EH, Allam ET, Zaid AB, Elkhadry SW, Rizk SK, Fotoh DS, Salem TAEH. Leptin gene Polymorphism and Leptin protein levels in Pediatric Autoimmune Hepatitis. J Immunoassay Immunochem 2024; 45:210-232. [PMID: 38808600 DOI: 10.1080/15321819.2024.2360083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2024]
Abstract
BACKGROUND Leptin plays a role in regulating energy balance, immunity, and inflammation. Studies suggest higher leptin levels might be associated with various autoimmune diseases. Most of them were in adult. To our knowledge, our study is one of the few that describe serum leptin level and leptin gene polymorphism in children with autoimmune hepatitis (AIH). OBJECTIVE Our study aims to explore the association between serum leptin level and genetic variations in leptin gene with the likelihood of AIH in children. PATIENTS AND METHODS Thirty-one children with AIH and 29 healthy children serving as a control group were included. Serum leptin levels were measured by ELISA assays. Leptin rs2167270 genotyping was done using the real time-PCR. The relationship of serum leptin level and leptin gene polymorphism with patients' data was studied. Patients follow up to assess treatment response. RESULTS Children with AIH had significantly higher levels of leptin compared to healthy controls. GG genotype was significantly more prevalent in the AIH group compared to controls. CONCLUSION High serum leptin levels and leptin gene polymorphism may play a role in AIH development. It is worthy to recognize if leptin can serve as diagnostic and/or therapeutic target in AIH in children.
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Affiliation(s)
- Samah M Awad
- Department of Clinical microbiology and immunology, National Liver Institute, Menoufia University, Shebin El-koom, Menoufia, Egypt
| | - Hanaa M Elgazzar
- Department of Clinical microbiology and immunology, National Liver Institute, Menoufia University, Shebin El-koom, Menoufia, Egypt
| | - Eman H Hassan
- Department of Clinical microbiology and immunology, National Liver Institute, Menoufia University, Shebin El-koom, Menoufia, Egypt
| | - Esraa T Allam
- Department of Clinical pathology, National Liver Institute, Menoufia University, Shebin El-koom, Menoufia, Egypt
| | - Ahmed B Zaid
- Immunology department, National Liver Institute, Menoufia University, Shebin El-koom, Menoufia, Egypt
| | - Sally W Elkhadry
- Department of Epidemiology and preventive medicine, National Liver Institute, Menoufia University, Shebin El-koom, Menoufia, Egypt
| | - Sara K Rizk
- Medical Biochemistry and Molecular Biology department, Faculty of Medicine, Menofia University, Shebin El-koom, Egypt
| | - Dina S Fotoh
- Physical Medicine, Rheumatology and Rehabilitation department, Faculty of Medicine, Menofia University, Shebin El-koom, Egypt
| | - Tahany Abd El Hamid Salem
- Department of Pediatric Hepatology, Gastroenterology and Nutrition, National Liver Institute, Menoufia University, Shebin El-koom, Menoufia, Egypt
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Katole NT, Kale JS, Salankar HV. Evaluation of the Antinociceptive Action of Simvastatin in Mice. Cureus 2022; 14:e26910. [PMID: 35983393 PMCID: PMC9376206 DOI: 10.7759/cureus.26910] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2022] [Accepted: 07/16/2022] [Indexed: 11/22/2022] Open
Abstract
Introduction: Statins are well-established agents for dyslipidemia and have successfully been used for the prevention of coronary artery diseases for a long time; this is attributed not only to their lipid-lowering action but also to their pleiotropic actions. Recently many pleiotropic actions of statins have been explored, but very few studies were done to explore statins' antinociceptive action; therefore, the current study was planned to evaluate the antinociceptive activity of Simvastatin in different pain models in mice. Materials and Methods: Antinociceptive activity of Simvastatin was evaluated by using Eddy's hot plate method (central analgesic model), acetic acid-induced writhing method (peripheral analgesic model), and biphasic formalin-induced paw licking method. Twenty-four mice were divided into four groups (n = 6 in each): Vehicle control group, simvastatin 5mg/kg, simvastatin 20mg/kg, and positive control group. Results: In the hot plate method, as compared to the vehicle control group, Simvastatin 20mg/kg group showed a significant rise in the reaction time to the corresponding time interval (p<0.001). While the simvastatin 5mg/kg group did not show any significant analgesic activity in the hot plate test. In the acetic acid writhing method, both test groups show a significant delay in the onset of writhing and a decrease in the number of writhes as compared to the vehicle control group (P<0.001). While in the formalin test, both groups show dose-dependent analgesic activity in both the early and late phases. Conclusion: Simvastatin exhibits analgesic activity in both central as well as peripheral models of analgesia, but central analgesia shows only at higher concentrations. Similarly, it inhibits inflammatory pain more predominantly than neurogenic, and hence simvastatin can be used in inflammatory conditions like rheumatoid arthritis and osteoarthritis particularly when there is coexisting dyslipidemia.
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David MA, Reiter AJ, Dunham CL, Castile RM, Abraham JA, Iannucci LE, Shah ID, Havlioglu N, Chamberlain AM, Lake SP. Pleiotropic Effects of Simvastatin and Losartan in Preclinical Models of Post-Traumatic Elbow Contracture. Front Bioeng Biotechnol 2022; 10:803403. [PMID: 35265595 PMCID: PMC8899197 DOI: 10.3389/fbioe.2022.803403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 01/04/2022] [Indexed: 02/02/2023] Open
Abstract
Elbow trauma can lead to post-traumatic joint contracture (PTJC), which is characterized by loss of motion associated with capsule/ligament fibrosis and cartilage damage. Unfortunately, current therapies are often unsuccessful or cause complications. This study aimed to determine the effects of prophylactically administered simvastatin (SV) and losartan (LS) in two preclinical models of elbow PTJC: an in vivo elbow-specific rat injury model and an in vitro collagen gel contraction assay. The in vivo elbow rat (n = 3-10/group) injury model evaluated the effects of orally administered SV and LS at two dosing strategies [i.e., low dose/high frequency/short duration (D1) vs. high dose/low frequency/long duration (D2)] on post-mortem elbow range of motion (via biomechanical testing) as well as capsule fibrosis and cartilage damage (via histopathology). The in vitro gel contraction assay coupled with live/dead staining (n = 3-19/group) evaluated the effects of SV and LS at various concentrations (i.e., 1, 10, 100 µM) and durations (i.e., continuous, short, or delayed) on the contractibility and viability of fibroblasts/myofibroblasts [i.e., NIH3T3 fibroblasts with endogenous transforming growth factor-beta 1 (TGFβ1)]. In vivo, no drug strategy prevented elbow contracture biomechanically. Histologically, only SV-D2 modestly reduced capsule fibrosis but maintained elevated cellularity and tissue hypertrophy, and both SV strategies lessened cartilage damage. SV modest benefits were localized to the anterior region, not the posterior, of the joint. Neither LS strategy had meaningful benefits in capsule nor cartilage. In vitro, irrespective of the presence of TGFβ1, SV (≥10 μM) prevented gel contraction partly by decreasing cell viability (100 μM). In contrast, LS did not prevent gel contraction or affect cell viability. This study demonstrates that SV, but not LS, might be suitable prophylactic drug therapy in two preclinical models of elbow PTJC. Results provide initial insight to guide future preclinical studies aimed at preventing or mitigating elbow PTJC.
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Affiliation(s)
- Michael A. David
- Department of Mechanical Engineering and Materials Science, Washington University in St. Louis, St. Louis, MO, United States
| | - Alex J. Reiter
- Department of Mechanical Engineering and Materials Science, Washington University in St. Louis, St. Louis, MO, United States
| | - Chelsey L. Dunham
- Department of Biomedical Engineering, Washington University in St. Louis, St. Louis, MO, United States
| | - Ryan M. Castile
- Department of Mechanical Engineering and Materials Science, Washington University in St. Louis, St. Louis, MO, United States
| | - James A. Abraham
- Department of Mechanical Engineering and Materials Science, Washington University in St. Louis, St. Louis, MO, United States
| | - Leanne E. Iannucci
- Department of Biomedical Engineering, Washington University in St. Louis, St. Louis, MO, United States
| | - Ishani D. Shah
- Department of Mechanical Engineering and Materials Science, Washington University in St. Louis, St. Louis, MO, United States
| | - Necat Havlioglu
- Department of Pathology, John Cochran VA Medical Center, St. Louis, MO, United States
| | - Aaron M. Chamberlain
- Department of Orthopaedic Surgery, Washington University in St. Louis, St. Louis, MO, United States
| | - Spencer P. Lake
- Department of Mechanical Engineering and Materials Science, Washington University in St. Louis, St. Louis, MO, United States,Department of Biomedical Engineering, Washington University in St. Louis, St. Louis, MO, United States,Department of Orthopaedic Surgery, Washington University in St. Louis, St. Louis, MO, United States,*Correspondence: Spencer P. Lake,
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Kocher J, Castellucci TB, Wen K, Li G, Yang X, Lei S, Jiang X, Yuan L. Simvastatin Reduces Protection and Intestinal T Cell Responses Induced by a Norovirus P Particle Vaccine in Gnotobiotic Pigs. Pathogens 2021; 10:pathogens10070829. [PMID: 34357979 PMCID: PMC8308729 DOI: 10.3390/pathogens10070829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 06/20/2021] [Accepted: 06/28/2021] [Indexed: 11/24/2022] Open
Abstract
Noroviruses (NoVs) are a leading cause of acute gastroenteritis worldwide. P particles are a potential vaccine candidate against NoV. Simvastatin is a cholesterol-reducing drug that is known to increase NoV infectivity. In this study, we examined simvastatin’s effects on P particle-induced protective efficacy and T-cell immunogenicity using the gnotobiotic pig model of human NoV infection and diarrhea. Pigs were intranasally inoculated with three doses (100 µg/dose) of GII.4/VA387-derived P particles together with monophosphoryl lipid A and chitosan adjuvants. Simvastatin-fed pigs received 8 mg/day orally for 11 days prior to challenge. A subset of pigs was orally challenged with 10 ID50 of a NoV GII.4/2006b variant at post-inoculation day (PID) 28 and monitored for 7 days post-challenge. Intestinal and systemic T cell responses were determined pre- and postchallenge. Simvastatin abolished the P particle’s protection and significantly increased diarrhea severity after NoV infection. Simvastatin decreased proliferation of virus-specific and non-specific CD8 T cells in duodenum and virus-specific CD4 and CD8 T cells in spleen and significantly reduced numbers of intestinal mononuclear cells in vaccinated pigs. Furthermore, simvastatin significantly decreased numbers of duodenal CD4+IFN-γ+, CD8+IFN-γ+ and regulatory T cells and total duodenal activated CD4+ and CD8+ T cells in vaccinated pigs pre-challenge at PID 28. Following challenge, simvastatin prevented the IFN-γ+ T cell response in spleen of vaccinated pigs. These results indicate that simvastatin abolished P particle vaccine-induced partial protection through, at least in part, impairing T cell immunity. The findings have specific implications for the development of preventive and therapeutic strategies against NoV gastroenteritis, especially for the elderly population who takes statin-type drugs.
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Affiliation(s)
- Jacob Kocher
- Center for Emerging, Zoonotic, and Arthropod-Borne Pathogens, Department of Biomedical Sciences and Pathobiology, Virginia-Maryland College of Veterinary Medicine, Virginia Polytechnic Institute and State University, Blacksburg, VA 24061, USA; (J.K.); (T.B.C.); (K.W.); (G.L.); (X.Y.); (S.L.)
| | - Tammy Bui Castellucci
- Center for Emerging, Zoonotic, and Arthropod-Borne Pathogens, Department of Biomedical Sciences and Pathobiology, Virginia-Maryland College of Veterinary Medicine, Virginia Polytechnic Institute and State University, Blacksburg, VA 24061, USA; (J.K.); (T.B.C.); (K.W.); (G.L.); (X.Y.); (S.L.)
| | - Ke Wen
- Center for Emerging, Zoonotic, and Arthropod-Borne Pathogens, Department of Biomedical Sciences and Pathobiology, Virginia-Maryland College of Veterinary Medicine, Virginia Polytechnic Institute and State University, Blacksburg, VA 24061, USA; (J.K.); (T.B.C.); (K.W.); (G.L.); (X.Y.); (S.L.)
| | - Guohua Li
- Center for Emerging, Zoonotic, and Arthropod-Borne Pathogens, Department of Biomedical Sciences and Pathobiology, Virginia-Maryland College of Veterinary Medicine, Virginia Polytechnic Institute and State University, Blacksburg, VA 24061, USA; (J.K.); (T.B.C.); (K.W.); (G.L.); (X.Y.); (S.L.)
| | - Xingdong Yang
- Center for Emerging, Zoonotic, and Arthropod-Borne Pathogens, Department of Biomedical Sciences and Pathobiology, Virginia-Maryland College of Veterinary Medicine, Virginia Polytechnic Institute and State University, Blacksburg, VA 24061, USA; (J.K.); (T.B.C.); (K.W.); (G.L.); (X.Y.); (S.L.)
| | - Shaohua Lei
- Center for Emerging, Zoonotic, and Arthropod-Borne Pathogens, Department of Biomedical Sciences and Pathobiology, Virginia-Maryland College of Veterinary Medicine, Virginia Polytechnic Institute and State University, Blacksburg, VA 24061, USA; (J.K.); (T.B.C.); (K.W.); (G.L.); (X.Y.); (S.L.)
| | - Xi Jiang
- Division of Infectious Diseases, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229, USA;
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH 45229, USA
| | - Lijuan Yuan
- Center for Emerging, Zoonotic, and Arthropod-Borne Pathogens, Department of Biomedical Sciences and Pathobiology, Virginia-Maryland College of Veterinary Medicine, Virginia Polytechnic Institute and State University, Blacksburg, VA 24061, USA; (J.K.); (T.B.C.); (K.W.); (G.L.); (X.Y.); (S.L.)
- Correspondence:
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Mostafa TM, Hegazy SK, Elshebini EM, Saif DS, Elabd AH. A comparative study on the anti-inflammatory effect of angiotensin-receptor blockers & statins on rheumatoid arthritis disease activity. Indian J Med Res 2021; 152:393-400. [PMID: 33380704 PMCID: PMC8061595 DOI: 10.4103/ijmr.ijmr_640_19] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Background & objectives : Rheumatoid artherits (RA) is a refractory disease and the imbalance between pro- and anti-inflammatory cytokines in favor of pro-inflammatory cytokines has been implicated in pathogenesis of RA. In this context, the aim of the present study was to compare the anti-inflammatory and antioxidant effects of candesartan, an angiotensin-receptor blocker, and atorvastatin in RA patients. Methods : In this single-blinded parallel randomized placebo controlled study, the patients recruited between December 2017 and May 2018 were categorized into three groups: group 1 included 15 RA patients who served as control group and received traditional therapy (+ placebo); group 2 included 15 RA patients who received traditional therapy + candesartan (8 mg/day); and group 3 included 15 patients who received traditional therapy + atorvastatin (20 mg/day) for three months. Clinical status in RA patients was evaluated by Disease Activity Score 28 (DAS28), Health Assessment Questionnaire-Disability Index (HAQ-DI) and morning stiffness before and three months after treatment. All groups were subjected to biochemical analysis of C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), tumour necrosis factor-alpha (TNF-α), interleukin-1beta (IL-1β) and malondialdehyde (MDA) before and three months after treatment. Results : Both candesartan and atorvastatin treated groups showed significant decrease in serum levels IL-1β and TNF-α, acute-phase reactants (CRP and ESR), number of swollen joint and patient global assessment. This was also associated with improvement in disease activity and quality of life regarding DAS28 and HAQ-DI as compared to baseline data and the control group. Atorvastatin group showed significant decrease in the serum level of oxidative stress marker (MDA). Interpretation & conclusions : Both candesartan and atorvastatin showed anti-inflammatory effect and immunomodulatory effects leading to improvement in clinical status and disease activity in RA patients. However, atorvastatin was superior to candesartan through its anti-oxidant effect.
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Affiliation(s)
- Tarek Mohamed Mostafa
- Department of Clinical Pharmacy, Faculty of Pharmacy, Tanta University, Tanta, Egypt
| | - Sahar Kamal Hegazy
- Department of Clinical Pharmacy, Faculty of Pharmacy, Tanta University, Tanta, Egypt
| | - Emad M Elshebini
- Division of Medicine Rheumatology & Immunology, Faculty of Medicine, Menoufia University, Menofia Governorate, Egypt
| | - Dalia S Saif
- Department of Rheumatology & Rehabilitation, Faculty of Medicine, Menoufia University, Menofia Governorate, Egypt
| | - Ahmed H Elabd
- Department of Clinical Pharmacy, Faculty of Pharmacy, Tanta University, Tanta, Egypt
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Aranow C, Cush J, Bolster MB, Striebich CC, Dall'era M, Mackay M, Olech E, Frech T, Box J, Keating R, Wasko MC, St Clair W, Kivitz A, Huang W, Ricketts P, Welch B, Callahan S, Spychala M, Boyle K, York K, Keyes-Elstein L, Goldmuntz E, Diamond B, Davidson A. A double-blind, placebo-controlled, phase II, randomized study of lovastatin therapy in the treatment of mildly active rheumatoid arthritis. Rheumatology (Oxford) 2020; 59:1505-1513. [PMID: 31628482 DOI: 10.1093/rheumatology/kez471] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2019] [Revised: 08/19/2019] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES 3-hydroxy-3-methylglutaryl coenzyme-A (HMG Co-A) reductase inhibitors (statins) are standard treatment for hyperlipidaemia. In addition to lipid-lowering abilities, statins exhibit multiple anti-inflammatory effects. The objectives of this study were to determine whether treatment of patients with RA with lovastatin decreased CRP or reduced disease activity. METHODS We conducted a randomized double-blind placebo-controlled 12 week trial of lovastatin vs placebo in 64 RA patients with mild clinical disease activity but an elevated CRP. The primary efficacy end point was the reduction in mean log CRP. Secondary end points included disease activity, RF and anti-CCP antibody titres. Mechanistic end points included levels of serum cytokines. Safety was assessed; hepatic and muscle toxicities were of particular interest. RESULTS Baseline features were similar between groups. No significant difference in mean log CRP reduction between the two groups was observed, and disease activity did not change from baseline in either treatment group. Mechanistic analyses did not reveal significant changes in any biomarkers. A post hoc analysis of subjects not using biologic therapy demonstrated a significantly greater proportion achieving ⩾20% reduction in CRP from baseline in the lovastatin group compared with placebo (P-value = 0.007). No difference was observed in subjects receiving biologics. Lovastatin was well tolerated with no serious safety concerns. CONCLUSION This study showed no anti-inflammatory or clinical effects on RA disease activity after 12 weeks of treatment with lovastatin. Lovastatin had a modest effect on CRP in subjects not using biologics, suggesting statins may be anti-inflammatory in selected patients. TRIAL REGISTRATION ClinicalTrials.gov, http://clinicaltrials.gov, NCT00302952.
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Affiliation(s)
- Cynthia Aranow
- The Feinstein Institute for Medical Research, Manhasset, USA
| | - John Cush
- Division of Rheumatology, Baylor University Medical Center, Dallas, USA
| | - Marcy B Bolster
- Division of Rheumatology, Massachusetts General Hospital, Boston, USA
| | | | - Maria Dall'era
- Division of Rheumatology, University of California, San Francisco, USA
| | - Meggan Mackay
- The Feinstein Institute for Medical Research, Manhasset, USA
| | - Ewa Olech
- Department of Internal Medicine, University of Nevada School of Medicine, Las Vegas, USA
| | - Tracy Frech
- Department of Internal Medicine, University of Utah, Internal Medicine, Salt Lake City, USA
| | - Jane Box
- Box Arthritis & Rheumatology of the Carolinas, Charlotte, USA
| | - Richard Keating
- Division of Rheumatology, Scripps Green Hospital, La Jolla, USA
| | - Mary Chester Wasko
- Division of Rheumatology, Western Pennsylvania Hospital, Pittsburgh, USA
| | - William St Clair
- Division of Rheumatology and Immunology, Duke University School of Medicine, Durham, USA
| | - Alan Kivitz
- Altoona Center for Clinical Research, Duncansville, USA
| | - Weiquang Huang
- The Feinstein Institute for Medical Research, Manhasset, USA
| | | | - Beverly Welch
- National Institute of Allergy and Infectious Diseases, NIH, Bethesda, USA
| | - Sherrie Callahan
- National Institute of Allergy and Infectious Diseases, NIH, Bethesda, USA
| | | | - Karen Boyle
- Rho Federal Systems Division, Chapel Hill, USA
| | - Kate York
- Rho Federal Systems Division, Chapel Hill, USA
| | | | - Ellen Goldmuntz
- National Institute of Allergy and Infectious Diseases, NIH, Bethesda, USA
| | - Betty Diamond
- The Feinstein Institute for Medical Research, Manhasset, USA
| | - Anne Davidson
- The Feinstein Institute for Medical Research, Manhasset, USA
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Popkova TV, Novikova DS. ACCORDING TO THE MATERIALS OF THE 2015/2016 NEW EUROPEAN LEAGUE AGAINST RHEUMATISM (EULAR) GUIDELINES FOR REDUCING CARDIOVASCULAR RISK IN PATIENTS WITH INFLAMMATORY ARTHRITIS: GENERAL CHARACTERIZATION AND DISCUSSION PROBLEMS. RHEUMATOLOGY SCIENCE AND PRACTICE 2018. [DOI: 10.14412/1995-4484-2018-272-279] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
According to the materials of the 2015/2016 new European League Against Rheumatism (EULAR) guidelines for reducing cardiovascular risk in patients with inflammatory arthritis. The authors identify three main principles of prevention of cardiovascular diseases in rheumatoid arthritis and other chronic inflammatory arthritis and provide a general characterization of the guidelines, by reviewing the discussion problems.
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Soulaidopoulos S, Nikiphorou E, Dimitroulas T, Kitas GD. The Role of Statins in Disease Modification and Cardiovascular Risk in Rheumatoid Arthritis. Front Med (Lausanne) 2018; 5:24. [PMID: 29473041 PMCID: PMC5809441 DOI: 10.3389/fmed.2018.00024] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2017] [Accepted: 01/24/2018] [Indexed: 01/22/2023] Open
Abstract
Rheumatoid arthritis (RA) is an autoimmune, inflammatory disorder associated with excess cardiovascular morbidity and mortality. A complex interplay between traditional risk factors (dyslipidemia, insulin resistance, arterial hypertension, obesity, smoking) and chronic inflammation is implicated in the development of premature atherosclerosis and consequently in the higher incidence of cardiovascular events observed in RA patients. Despite the acknowledgment of elevated cardiovascular risk among RA individuals, its management remains suboptimal. While statin administration has a crucial role in primary and secondary cardiovascular disease prevention strategies as lipid modulating factors, there are limited data concerning the precise benefit of such therapy in patients with RA. Systemic inflammation and anti-inflammatory treatments influence lipid metabolism, leading to variable states of dyslipidemia in RA. Hence, the indications for statin therapy for cardiovascular prevention may differ between RA patients and the general population and the precise role of lipid lowering treatment in RA is yet to be established. Furthermore, some evidence supports a potential beneficial impact of statins on RA disease activity, attributable to their anti-inflammatory and immunomodulatory properties. This review discusses existing data on the efficacy of statins in reducing RA-related cardiovascular risk as well as their potential beneficial effects on disease activity.
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Affiliation(s)
- Stergios Soulaidopoulos
- 4th Department of Internal Medicine, Hippokration University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Elena Nikiphorou
- Department of Academic Rheumatology, King’s College London, London, United Kingdom
- Department of Rheumatology, Whittington NHS Health, London, United Kingdom
| | - Theodoros Dimitroulas
- 4th Department of Internal Medicine, Hippokration University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - George D. Kitas
- Arthritis Research UK Centre for Epidemiology, University of Manchester, Manchester, United Kingdom
- Department of Rheumatology, Dudley Group NHS Fountation Trust, Dudley, United Kingdom
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Walker ME, Souza PR, Colas RA, Dalli J. 13-Series resolvins mediate the leukocyte-platelet actions of atorvastatin and pravastatin in inflammatory arthritis. FASEB J 2017; 31:3636-3648. [PMID: 28465323 PMCID: PMC5503705 DOI: 10.1096/fj.201700268] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Accepted: 04/13/2017] [Indexed: 02/06/2023]
Abstract
Rheumatoid arthritis is an inflammatory condition characterized by overzealous inflammation that leads to joint damage and is associated with an increased incidence of cardiovascular disease. Statins are frontline therapeutics for patients with cardiovascular disease and exert beneficial actions in rheumatoid arthritis. The mechanism that mediates the beneficial actions of statins in rheumatoid arthritis remains of interest. In the present study, we found that the administration of 2 clinically relevant statins—atorvastatin (0.2 mg/kg) or pravastatin (0.2 mg/kg)—to mice during inflammatory arthritis up-regulated systemic and tissue amounts of a novel family of proresolving mediators, termed 13-series resolvins (RvTs), and significantly reduced joint disease. Of note, administration of simvastatin (0.2 mg/kg) did not significantly up-regulate RvTs or reduce joint inflammation. We also found that atorvastatin and pravastatin each reduced systemic leukocyte activation, including platelet-monocyte aggregates (∼25–60%). These statins decreased neutrophil trafficking to the joint as well as joint monocyte and macrophage numbers. Atorvastatin and pravastatin produced significant reductions (∼30–50%) in expression of CD11b and major histocompatibility complex class II on both monocytes and monocyte-derived macrophages in joints. Administration of an inhibitor to cyclooxygenase-2, the initiating enzyme in the RvT pathway, reversed the protective actions of these statins on both joint and systemic inflammation. Together, these findings provide evidence for the role of RvTs in mediating the protective actions of atorvastatin and pravastatin in reducing local and vascular inflammation, and suggest that RvTs may be useful in measuring the anti-inflammatory actions of statins.—Walker, M. E., Souza, P. R., Colas, R. A., Dalli, J. 13-Series resolvins mediate the leukocyte-platelet actions of atorvastatin and pravastatin in inflammatory arthritis.
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Affiliation(s)
- Mary E Walker
- Lipid Mediator Unit, Centre for Biochemical Pharmacology, William Harvey Research Institute, Barts and the London School of Medicine, Queen Mary University of London, London, United Kingdom
| | - Patricia R Souza
- Lipid Mediator Unit, Centre for Biochemical Pharmacology, William Harvey Research Institute, Barts and the London School of Medicine, Queen Mary University of London, London, United Kingdom
| | - Romain A Colas
- Lipid Mediator Unit, Centre for Biochemical Pharmacology, William Harvey Research Institute, Barts and the London School of Medicine, Queen Mary University of London, London, United Kingdom
| | - Jesmond Dalli
- Lipid Mediator Unit, Centre for Biochemical Pharmacology, William Harvey Research Institute, Barts and the London School of Medicine, Queen Mary University of London, London, United Kingdom
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Peripheral tolerance can be modified by altering KLF2-regulated Treg migration. Proc Natl Acad Sci U S A 2016; 113:E4662-70. [PMID: 27462110 DOI: 10.1073/pnas.1605849113] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
Tregs are essential for maintaining peripheral tolerance, and thus targeting these cells may aid in the treatment of autoimmunity and cancer by enhancing or reducing suppressive functions, respectively. Before these cells can be harnessed for therapeutic purposes, it is necessary to understand how they maintain tolerance under physiologically relevant conditions. We now report that transcription factor Kruppel-like factor 2 (KLF2) controls naive Treg migration patterns via regulation of homeostatic and inflammatory homing receptors, and that in its absence KLF2-deficient Tregs are unable to migrate efficiently to secondary lymphoid organs (SLOs). Diminished Treg trafficking to SLOs is sufficient to initiate autoimmunity, indicating that SLOs are a primary site for maintaining peripheral tolerance under homeostatic conditions. Disease severity correlates with impaired Treg recruitment to SLOs and, conversely, promotion of Tregs into these tissues can ameliorate autoimmunity. Moreover, stabilizing KLF2 expression within the Treg compartment enhances peripheral tolerance by diverting these suppressive cells from tertiary tissues into SLOs. Taken together, these results demonstrate that peripheral tolerance is enhanced or diminished through modulation of Treg trafficking to SLOs, a process that can be controlled by adjusting KLF2 protein levels.
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Xing B, Yin YF, Zhao LD, Wang L, Zheng WJ, Chen H, Wu QJ, Tang FL, Zhang FC, Shan G, Zhang X. Effect of 3-hydroxy-3-methylglutaryl-coenzyme a reductase inhibitor on disease activity in patients with rheumatoid arthritis: a meta-analysis. Medicine (Baltimore) 2015; 94:e572. [PMID: 25715256 PMCID: PMC4554148 DOI: 10.1097/md.0000000000000572] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
HMG-CoA reductase inhibitors (also known as statins) are widely used as lipid-lowering agents in patients with rheumatoid arthritis (RA) to reduce their cardiovascular risk. However, whether they have an effect on RA disease activity is controversial. This study aimed to investigate the effect of statins on disease activity in RA patients. A systematic literature review was performed using the MEDLINE, EMBASE, Cochrane Library, ISI WEB of Knowledge, Scopus, and Clinical Trials Register databases. Only prospective randomized controlled trials or controlled clinical trials comparing the efficacy of statins with placebo on adult RA patients were included. The efficacy was measured according to the ACR criteria, EULAR criteria, DAS28, HAQ score, ESR, or CRP. The Jadad score was used for quality assessment. The inverse variance method was used to analyze continuous outcomes. A fixed-effects model was used when there was no significant heterogeneity; otherwise, a random-effects model was used. For stability of results, we performed leave-one-study-out sensitivity analysis by omitting individual studies one at a time from the meta-analysis. Publication bias was assessed using Egger test. A total 13 studies involving 737 patients were included in the meta-analysis; 11 studies were included in the meta-analysis based on DAS28, while the other 2 studies were only included in the meta-analysis based on ESR or CRP. The standardized mean difference (SMD) in DAS28 between the statin group and the placebo group was -0.55 (95% CI [-0.83, -0.26], P = 0.0002), with an I2 value of 68%. Subgroup analysis showed that patients with more active disease tended to benefit more from statin therapy (SMD -0.73, P = 0.01) than patients with moderate or low disease activity (SMD -0.38, P = 0.03). Statin therapy also significantly reduced tender joint counts, swollen joint counts, ESR, and CRP compared with placebo, but the reduction in HAQ score and VAS was not significant (P > 0.05). This meta-analysis suggested that statin therapy might be effective in the reduction of RA disease activity measured by DAS28, TJC, SJC, as well as ESR and CRP.
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Affiliation(s)
- Bin Xing
- From the Department of Rheumatology and Clinical Immunology (BX, YFY, LDZ, LW, WJZ, HC, QJW, FLT, FCZ, XZ), Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Key Laboratory of Rheumatology and Clinical Immunology, Ministry of Education; and Department of Epidemiology (GS), Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Dancevic CM, McCulloch DR. Current and emerging therapeutic strategies for preventing inflammation and aggrecanase-mediated cartilage destruction in arthritis. Arthritis Res Ther 2014; 16:429. [PMID: 25606593 PMCID: PMC4289229 DOI: 10.1186/s13075-014-0429-9] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Arthritis is a multifactorial disease for which current therapeutic intervention with high efficacy remains challenging. Arthritis predominately affects articular joints, and cartilage deterioration and inflammation are key characteristics. Current therapeutics targeting inflammatory responses often cause severe side effects in patients because of the systemic inhibition of cytokines or other global immunosuppressive activities. Furthermore, a lack of primary response or failure to sustain a response to treatment through acquired drug resistance is an ongoing concern. Nevertheless, treatments such as disease-modifying anti-rheumatic drugs, biological agents, and corticosteroids have revealed promising outcomes by decreasing pain and inflammation in patients and in some cases reducing radiographic progression of the disease. Emerging and anecdotal therapeutics with anti-inflammatory activity, alongside specific inhibitors of the A Disintegrin-like And Metalloproteinase domain with Thrombospondin-1 repeats (ADAMTS) cartilage-degrading aggrecanases, provide promising additions to current arthritis treatment strategies. Thus, it is paramount that treatment strategies be optimized to increase efficacy, reduce debilitating side effects, and improve the quality of life of patients with arthritis. Here, we review the current strategies that attempt to slow or halt the progression of osteoarthritis and rheumatoid arthritis, providing an up-to-date summary of pharmaceutical treatment strategies and side effects. Importantly, we highlight their potential to indirectly regulate ADAMTS aggrecanase activity through their targeting of inflammatory mediators, thus providing insight into a mechanism by which they might inhibit cartilage destruction to slow or halt radiographic progression of the disease. We also contrast these with anecdotal or experimental administration of statins that could equally regulate ADAMTS aggrecanase activity and are available to arthritis sufferers worldwide. Finally, we review the current literature regarding the development of synthetic inhibitors directed toward the aggrecanases ADAMTS4 and ADAMTS5, a strategy that might directly inhibit cartilage destruction and restore joint function in both rheumatoid arthritis and osteoarthritis.
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Affiliation(s)
- Carolyn M Dancevic
- School of Medicine and Molecular and Medical Research SRC, Faculty of Health, Deakin University, 75 Pigdons Road, Waurn Ponds, VIC 3216 Australia
| | - Daniel R McCulloch
- School of Medicine and Molecular and Medical Research SRC, Faculty of Health, Deakin University, 75 Pigdons Road, Waurn Ponds, VIC 3216 Australia
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