The Efficacy of Antioxidative Stress Therapy on Oxidative Stress Levels in Rheumatoid Arthritis: A Systematic Review and Meta-analysis of Randomized Controlled Trials

Protective Effect of Ergothioneine against Oxidative Stress-Induced Chondrocyte Death

Reactive oxygen species (ROS) induce oxidative stress in cells and are associated with various diseases, including autoimmune diseases. Ergothioneine (EGT) is a natural amino acid derivative derived from the ergot fungus and has been reported to exhibit an effective antioxidant function in many models of oxidative stress-related diseases. Recently, mutations in OCTN1, a membrane transporter of EGT, have been reported to be associated with rheumatoid arthritis. Therefore, we investigated the chondrocyte-protective function of EGT using a model of oxidative stress-induced injury of chondrocytes by hydrogen peroxide (H2O2). Human chondrocytes were subjected to oxidative stress induced by H2O2 treatment, and cell viability, the activity of lactate dehydrogenase (LDH) released into the medium, dead cell ratio, intracellular ROS production, and mitochondrial morphology were assessed. EGT improved chondrocyte viability and LDH activity in the medium and strongly suppressed the dead cell ratio. EGT also exerted protective effects on intracellular ROS production and mitochondrial morphology. These results provide evidence to support the protective effects of EGT on chondrocytes induced by oxidative stress.

Investigating the therapeutic potential of sinomenine in rheumatoid arthritis: anti-inflammatory, antioxidant, and immunomodulatory mechanisms

An autoimmune disease, rheumatoid arthritis (RA) is characterized by the onset of inflammation and subsequent damage to the joints. Although several therapies are available for RA, none are effective, and many have undesirable side effects. The roots of Sinomenium acutum produce an alkaloid called Sinomenine (SIN), which has been used for centuries in Chinese medicine to treat arthritis due to its anti-inflammatory properties. This study aimed to explore the potential therapeutic benefits of SIN through oral administration following RA induction using Freund's complete adjuvant (FCA) injections. The study monitored changes in the arthritic index, hind paw volume, inflammation and oxidative stress markers. Results demonstrated that SIN effectively inhibited the activity of NF-κB and IKKβ in knee joint tissues, which led to a decrease in tissue levels of TNF-α, IL-6, IL-1β, and iNOS in RA-induced rats. The production of anti-inflammatory cytokines such as IL-10, Arg-1, and Fizz1 also increased. In rat knee joints, SIN elevated the expression of TIMP-1 and TIMP-3 and decreased the expression of MMP-2 and MMP-9. Additionally, SIN modulated the RANK/RANKL/OPG pathway in RA-induced rat knee joint tissues, reducing RANKL expression and increasing OPG. SIN also effectively decreased MDA, NO, and elevated antioxidant enzymes (SOD, CAT, GPx, and GSH) in RA-induced rats via Nrf2/Keap 1 signaling pathway activation. In conclusion, this study suggests that SIN possesses potential therapeutic benefits for treating RA by modulating the RANK/RANKL/OPG pathway, which may impact osteoclast activity, oxidative stress, and inflammation in knee joint tissues.

Malondialdehyde Serum Levels in a Full Characterized Series of 430 Rheumatoid Arthritis Patients

Background. Oxidative stress has been involved in the pathogenesis of rheumatoid arthritis (RA). The serum malondialdehyde (MDA) level is a reliable biomarker of oxidative stress status. In the present work, we aimed to analyze how a comprehensive characterization of the disease characteristics in RA, including a lipid profile, insulin resistance, and subclinical atherosclerosis, relates to serum MDA levels. Methods. In a cross-sectional study that included 430 RA patients, serum MDA levels were evaluated. Multivariable analysis was performed to examine the relationship of MDA with disease activity scores and disease characteristics, including subclinical carotid atherosclerosis, a comprehensive lipid molecule profile, and indices of insulin resistance and beta cell function indices. Results. The erythrocyte sedimentation rate (ESR) showed a significant and positive relationship with MDA. However, this did not occur for other acute phase reactants such as C-reactive protein or interleukin-6. Although the DAS28-ESR score (Disease Activity Score in 28 joints) had a positive and significant association with MDA serum levels, other disease activity scores that do not use the erythrocyte sedimentation rate in their formula did not show a significant relationship with MDA. Other disease characteristics, such as disease duration and the existence of rheumatoid factor and antibodies against citrullinated protein, were not related to serum MDA levels. This also occurred for lipid profiles, insulin resistance indices, and subclinical carotid atherosclerosis, for which no associations with circulating MDA were found. Conclusions. The disease characteristics are not related to circulating MDA levels in patients with RA.

Exploring the effect of LncRNA DANCR to regulate the Keap1-Nrf2/ARE pathway on oxidative stress in rheumatoid arthritis

INTRODUCTION

Aberrant expression of long noncoding RNAs (LncRNAs) can regulate oxidative stress in rheumatoid arthritis (RA). This study focused on investigating the effects of LncRNA differentiation antagonizing nonprotein coding RNA (DANCR) regulation of Keap1-Nrf2/ARE pathway on inflammation and oxidative stress in RA.

METHODS

The levels of LncRNA DANCR/miR-486-3p/Keap1 in peripheral blood of 30 RA groups and 30 normal subjects were examined, and the association of LncRNA DANCR with inflammatory indicators of RA was investigated. We stimulated fibroblast-like synoviocytes (FLS) from RA patients with tumor necrosis factor α and subsequently performed in vitro cellular assays to construct overexpression plasmids and small interfering RNAs of LncRNA DANCR to investigate the relationship between LncRNA DANCR and FLSs viability and migration in RA, as well as the effects on cellular oxidative stress factors and Keap1-Nrf2/ARE pathway; molecular biology analysis was used to predict microRNAs that can bind LncRNA DANCR, and luciferase verified the binding sites of LncRNA DANCR with Keap1 and miR-486-3p; to further refine the gene and protein expression results, we used reverse transcription-quantitative polymerase chain reaction and immunoblotting assays.

RESULTS

In both groups of peripheral blood mononuclear cells, the expression levels of LncRNA DANCR and Keap1 messenger RNA were higher in the RA group than in the normal control group, and the opposite was true for miR-486-3p; LncRNA DANCR was positively correlated with total antioxidant capacity (TAOC), IL6, IL17, malondialdehyde (MDA), but not with IL11, rheumatoid factor, cyclic citrullinated peptide, superoxide dismutase (SOD), with 28-joint disease activity score, reactive oxygen species, C-reactive protein, and erythrocyte sedimentation rate were negatively correlated; overexpression of LncRNA DANCR stimulated the Keap1-Nrf2/ARE pathway, decreased the expression of IL10, SOD, TAOC, and increased the expression levels of MDA, IL11, IL-17, PD-L1, and silencing of LncRNA DANCR was the opposite, but knockdown of miR-486-3p or overexpression of keap1 reversed the expression of the above-mentioned inflammatory and oxidative factors. In addition, pcDNA-DANCR clearly showed stronger cell invasion and migration ability and exacerbated its inflammatory response, which may be related to the regulatory role of miR-486-3p and Keap1-Nrf2/ARE signaling pathway, and we verified their targeting relationship using dual luciferase, showing that DANCR could regulate Keap1-Nrf2/ARE through miR-486-3p modulates the Keap1-Nrf2/ARE pathway and affects inflammatory and oxidative responses in RA patients.

CONCLUSION

The low-expressed LncRNA DANCR may regulate the Keap1-Nrf2/ARE pathway and suppress the inflammatory and oxidative responses in RA patients.

Does Dietary Polyunsaturated Fatty Acid Intake Associate With Bone Mineral Density and Limb Structural Changes in Early Rheumatoid Arthritis?

Background

Rheumatoid arthritis (RA) is an inflammatory disease that can result in bone erosion, lean mass lowering, and increase of fat mass without changes in body weight. The dietary consumption of polyunsaturated fatty acids (PUFAs) has been assessed in many studies due to their potential anti-inflammatory effect.

Aim

The aim of this research was to identify if dietary intake of PUFAs associates with bone mineral density (BMD) and limb structural changes in early rheumatoid arthritis (ERA) compared to a population-based control group. The study was conducted because previous results have been insufficient.

Methods

The study group consisted of 83 ERA patients and 321 control subjects. A dual-energy X-Ray absorptiometry (DXA) machine was used to measure hip, lumbar spine, and radius BMD, as well as arm and leg fat, lean, and bone mass. Dietary habits and inflammatory markers were assessed to evaluate the effects to BMD and limb structural changes.

Results

In ERA subjects, higher dietary consumption of PUFAs was associated with a decrease in arm fat mass (b -28.17, P = .02) and possibly with higher lumbar BMD (b 0.008, P = .058). Limb bone and lean mass changes were not associated with dietary intake of PUFAs.

Conclusion

Balanced nutrition is essential. Consuming PUFAs could be beneficial in ERA preventing structural changes to hands, but additional research is needed.

Effects of Melatonin on Sleep Quality and Disease Activity in Patients With Rheumatoid Arthritis

Background and Objective In rheumatoid arthritis (RA) patients sleep disturbance is one of serious and prevalent problems. Considering the known effects of melatonin on sleep quality and inflammation, this study aimed to investigate melatonin supplementation effect on quality of sleep and disease activity in patients with RA.Methods In this randomized, placebo-controlled trial (double-blind), 64 RA patients were selected and divided into experimental and placebo groups randomly; experimental group received 3 mg/d of melatonin and another group consumed placebo for 60 days. Before and after the investigation, assessment of the quality of sleep determined using the Pittsburgh Sleep Quality Index (PSQI). Disease Activity Score-28 (DAS28) and the Visual Analogue Scale (VAS) questionnaires were used for evaluation of disease activity and pain intensity, respectively.Results Melatonin significantly reduced PSQI, DAS28 and VAS scores, when values compared with baseline. In contrast to placebo group, good sleep quality within the melatonin group increased significantly compared to baseline and this improvement in sleep quality was significant when compared between groups. The scores of DAS28 and pain VAS at the end of trial were significantly reduced compared to the baseline in both groups. However, reduction in the DAS28 and VAS scores of the melatonin group were stronger than reductions in the placebo receiving group.Conclusions This study results revealed that melatonin was safe and effective in improving sleep quality and reducing DAS28 and pain VAS scores in RA patients.

Endoplasmic Reticulum Stress, Oxidative Stress, and Rheumatic Diseases

Background: The endoplasmic reticulum (ER) is a multi-functional organelle responsible for cellular homeostasis, protein synthesis, folding and secretion. It has been increasingly recognized that the loss of ER homeostasis plays a central role in the development of autoimmune inflammatory disorders, such as rheumatic diseases. Purpose/Main contents: Here, we review current knowledge of the contribution of ER stress to the pathogenesis of rheumatic diseases, with a focus on rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE). We also review the interplay between protein folding and formation of reactive oxygen species (ROS), where ER stress induces oxidative stress (OS), which further aggravates the accumulation of misfolded proteins and oxidation, in a vicious cycle. Intervention studies targeting ER stress and oxidative stress in the context of rheumatic diseases are also reviewed. Conclusions: Loss of ER homeostasis is a significant factor in the pathogeneses of RA and SLE. Targeting ER stress, unfolded protein response (UPR) pathways and oxidative stress in these diseases both in vitro and in animal models have shown promising results and deserve further investigation.

Organokines in Rheumatoid Arthritis: A Critical Review

Rheumatoid arthritis (RA) is a systemic autoimmune disease that primarily affects the joints. Organokines can produce beneficial or harmful effects in this condition. Among RA patients, organokines have been associated with increased inflammation and cartilage degradation due to augmented cytokines and metalloproteinases production, respectively. This study aimed to perform a review to investigate the role of adipokines, osteokines, myokines, and hepatokines on RA progression. PubMed, Embase, Google Scholar, and Cochrane were searched, and 18 studies were selected, comprising more than 17,000 RA patients. Changes in the pattern of organokines secretion were identified, and these could directly or indirectly contribute to aggravating RA, promoting articular alterations, and predicting the disease activity. In addition, organokines have been implicated in higher radiographic damage, immune dysregulation, and angiogenesis. These can also act as RA potent regulators of cells proliferation, differentiation, and apoptosis, controlling osteoclasts, chondrocytes, and fibroblasts as well as immune cells chemotaxis to RA sites. Although much is already known, much more is still unknown, principally about the roles of organokines in the occurrence of RA extra-articular manifestations.