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Fenton CG, Crastin A, Martin CS, Suresh S, Montagna I, Hussain B, Naylor AJ, Jones SW, Hansen MS, Gorvin CM, Price M, Filer A, Cooper MS, Lavery GG, Raza K, Hardy RS. 11β-Hydroxysteroid Dehydrogenase Type 1 within Osteoclasts Mediates the Bone Protective Properties of Therapeutic Corticosteroids in Chronic Inflammation. Int J Mol Sci 2022; 23:7334. [PMID: 35806338 PMCID: PMC9266304 DOI: 10.3390/ijms23137334] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 06/23/2022] [Accepted: 06/29/2022] [Indexed: 02/02/2023] Open
Abstract
Therapeutic glucocorticoids (GCs) are powerful anti-inflammatory tools in the management of chronic inflammatory diseases such as rheumatoid arthritis (RA). However, their actions on bone in this context are complex. The enzyme 11β-hydroxysteroid dehydrogenase type 1 (11β-HSD1) is a mediator of the anti-inflammatory actions of therapeutic glucocorticoids (GCs) in vivo. In this study we delineate the role of 11β-HSD1 in the effects of GC on bone during inflammatory polyarthritis. Its function was assessed in bone biopsies from patients with RA and osteoarthritis, and in primary osteoblasts and osteoclasts. Bone metabolism was assessed in the TNF-tg model of polyarthritis treated with oral GC (corticosterone), in animals with global (TNF-tg11βKO), mesenchymal (including osteoblast) (TNF-tg11βflx/tw2cre) and myeloid (including osteoclast) (TNF-tg11βflx/LysMcre) deletion. Bone parameters were assessed by micro-CT, static histomorphometry and serum metabolism markers. We observed a marked increase in 11β-HSD1 activity in bone in RA relative to osteoarthritis bone, whilst the pro-inflammatory cytokine TNFα upregulated 11β-HSD1 within osteoblasts and osteoclasts. In osteoclasts, 11β-HSD1 mediated the suppression of bone resorption by GCs. Whilst corticosterone prevented the inflammatory loss of trabecular bone in TNF-tg animals, counterparts with global deletion of 11β-HSD1 were resistant to these protective actions, characterised by increased osteoclastic bone resorption. Targeted deletion of 11β-HSD1 within osteoclasts and myeloid derived cells partially reproduced the GC resistant phenotype. These data reveal the critical role of 11β-HSD1 within bone and osteoclasts in mediating the suppression of inflammatory bone loss in response to therapeutic GCs in chronic inflammatory disease.
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Affiliation(s)
- Chloe G Fenton
- Institute for Metabolism and Systems Research, University of Birmingham, Birmingham B15 2TT, UK; (C.G.F.); (C.S.M.); (I.M.); (C.M.G.); (M.P.); (G.G.L.)
- Research into Inflammatory Arthritis Centre Versus Arthritis, Institute of Inflammation and Ageing, University of Birmingham, Birmingham B15 2TT, UK; (A.J.N.); (A.F.); (K.R.)
| | - Ana Crastin
- Institute of Clinical Science, University of Birmingham, Birmingham B15 2TT, UK; (A.C.); (S.S.); (B.H.)
| | - Claire S Martin
- Institute for Metabolism and Systems Research, University of Birmingham, Birmingham B15 2TT, UK; (C.G.F.); (C.S.M.); (I.M.); (C.M.G.); (M.P.); (G.G.L.)
| | - Saicharan Suresh
- Institute of Clinical Science, University of Birmingham, Birmingham B15 2TT, UK; (A.C.); (S.S.); (B.H.)
| | - Isabella Montagna
- Institute for Metabolism and Systems Research, University of Birmingham, Birmingham B15 2TT, UK; (C.G.F.); (C.S.M.); (I.M.); (C.M.G.); (M.P.); (G.G.L.)
| | - Bismah Hussain
- Institute of Clinical Science, University of Birmingham, Birmingham B15 2TT, UK; (A.C.); (S.S.); (B.H.)
| | - Amy J Naylor
- Research into Inflammatory Arthritis Centre Versus Arthritis, Institute of Inflammation and Ageing, University of Birmingham, Birmingham B15 2TT, UK; (A.J.N.); (A.F.); (K.R.)
| | - Simon W Jones
- MRC Arthritis Research UK Centre for Musculoskeletal Ageing Research, University of Birmingham, Edgbaston Campus, Birmingham B15 2TT, UK;
| | - Morten S Hansen
- Molecular Endocrinology Laboratory (KMEB), Department of Endocrinology, Odense University Hospital, DK-5000 Odense, Denmark;
| | - Caroline M Gorvin
- Institute for Metabolism and Systems Research, University of Birmingham, Birmingham B15 2TT, UK; (C.G.F.); (C.S.M.); (I.M.); (C.M.G.); (M.P.); (G.G.L.)
- Centre for Membrane Proteins and Receptors (COMPARE), Universities of Birmingham and Nottingham, Birmingham B15 2TT, UK
| | - Maria Price
- Institute for Metabolism and Systems Research, University of Birmingham, Birmingham B15 2TT, UK; (C.G.F.); (C.S.M.); (I.M.); (C.M.G.); (M.P.); (G.G.L.)
| | - Andrew Filer
- Research into Inflammatory Arthritis Centre Versus Arthritis, Institute of Inflammation and Ageing, University of Birmingham, Birmingham B15 2TT, UK; (A.J.N.); (A.F.); (K.R.)
- MRC Arthritis Research UK Centre for Musculoskeletal Ageing Research, University of Birmingham, Edgbaston Campus, Birmingham B15 2TT, UK;
| | - Mark S Cooper
- ANZAC Research Institute, The University of Sydney, Sydney, NSW 2006, Australia;
| | - Gareth G Lavery
- Institute for Metabolism and Systems Research, University of Birmingham, Birmingham B15 2TT, UK; (C.G.F.); (C.S.M.); (I.M.); (C.M.G.); (M.P.); (G.G.L.)
- MRC Arthritis Research UK Centre for Musculoskeletal Ageing Research, University of Birmingham, Edgbaston Campus, Birmingham B15 2TT, UK;
| | - Karim Raza
- Research into Inflammatory Arthritis Centre Versus Arthritis, Institute of Inflammation and Ageing, University of Birmingham, Birmingham B15 2TT, UK; (A.J.N.); (A.F.); (K.R.)
- MRC Arthritis Research UK Centre for Musculoskeletal Ageing Research, University of Birmingham, Edgbaston Campus, Birmingham B15 2TT, UK;
- Department of Rheumatology, Sandwell and West Birmingham NHS Trust, Birmingham B15 2TT, UK
| | - Rowan S Hardy
- Institute for Metabolism and Systems Research, University of Birmingham, Birmingham B15 2TT, UK; (C.G.F.); (C.S.M.); (I.M.); (C.M.G.); (M.P.); (G.G.L.)
- Research into Inflammatory Arthritis Centre Versus Arthritis, Institute of Inflammation and Ageing, University of Birmingham, Birmingham B15 2TT, UK; (A.J.N.); (A.F.); (K.R.)
- Institute of Clinical Science, University of Birmingham, Birmingham B15 2TT, UK; (A.C.); (S.S.); (B.H.)
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Global Deletion of 11β-HSD1 Prevents Muscle Wasting Associated with Glucocorticoid Therapy in Polyarthritis. Int J Mol Sci 2021; 22:ijms22157828. [PMID: 34360594 PMCID: PMC8346140 DOI: 10.3390/ijms22157828] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 07/05/2021] [Accepted: 07/16/2021] [Indexed: 02/02/2023] Open
Abstract
Glucocorticoids provide indispensable anti-inflammatory therapies. However, metabolic adverse effects including muscle wasting restrict their use. The enzyme 11beta-hydroxysteroid dehydrogenase type 1 (11β-HSD1) modulates peripheral glucocorticoid responses through pre-receptor metabolism. This study investigates how 11β-HSD1 influences skeletal muscle responses to glucocorticoid therapy for chronic inflammation. We assessed human skeletal muscle biopsies from patients with rheumatoid arthritis and osteoarthritis for 11β-HSD1 activity ex vivo. Using the TNF-α-transgenic mouse model (TNF-tg) of chronic inflammation, we examined the effects of corticosterone treatment and 11β-HSD1 global knock-out (11βKO) on skeletal muscle, measuring anti-inflammatory gene expression, muscle weights, fiber size distribution, and catabolic pathways. Muscle 11β-HSD1 activity was elevated in patients with rheumatoid arthritis and correlated with inflammation markers. In murine skeletal muscle, glucocorticoid administration suppressed IL6 expression in TNF-tg mice but not in TNF-tg11βKO mice. TNF-tg mice exhibited reductions in muscle weight and fiber size with glucocorticoid therapy. In contrast, TNF-tg11βKO mice were protected against glucocorticoid-induced muscle atrophy. Glucocorticoid-mediated activation of catabolic mediators (FoxO1, Trim63) was also diminished in TNF-tg11βKO compared to TNF-tg mice. In summary, 11β-HSD1 knock-out prevents muscle atrophy associated with glucocorticoid therapy in a model of chronic inflammation. Targeting 11β-HSD1 may offer a strategy to refine the safety of glucocorticoids.
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Fenton C, Martin C, Jones R, Croft A, Campos J, Naylor AJ, Taylor AE, Chimen M, Cooper M, Lavery GG, Raza K, Hardy RS. Local steroid activation is a critical mediator of the anti-inflammatory actions of therapeutic glucocorticoids. Ann Rheum Dis 2021; 80:250-260. [PMID: 33162397 PMCID: PMC7815637 DOI: 10.1136/annrheumdis-2020-218493] [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: 07/02/2020] [Revised: 10/05/2020] [Accepted: 10/06/2020] [Indexed: 02/02/2023]
Abstract
OBJECTIVES The enzyme 11β-hydroxysteroid dehydrogenase type 1 (11β-HSD1) plays a well-characterised role in the metabolism and activation of endogenous glucocorticoids (GCs). However, despite its potent upregulation at sites of inflammation, its role in peripheral metabolism and action of therapeutic GCs remains poorly understood. We investigated the contribution of 11β-HSD1 to the anti-inflammatory properties of the active GC corticosterone, administered at therapeutic doses in murine models of polyarthritis. METHODS Using the tumour necrosis factor-tg and K/BxN serum-induced models of polyarthritis, we examined the anti-inflammatory properties of oral administration of corticosterone in animals with global, myeloid and mesenchymal targeted transgenic deletion of 11β-HSD1. Disease activity and joint inflammation were scored daily. Joint destruction and measures of local and systemic inflammation were determined by histology, micro-CT, quantitative RT-PCR, fluorescence activated cell sorting and ELISA. RESULTS Global deletion of 11β-HSD1 resulted in a profound GC resistance in animals receiving corticosterone, characterised by persistent synovitis, joint destruction and inflammatory leucocyte infiltration. This was partially reproduced with myeloid, but not mesenchymal 11β-HSD1 deletion, where paracrine GC signalling between cell populations was shown to overcome targeted deletion of 11β-HSD1. CONCLUSIONS We identify an entirely novel component of therapeutic GC action, whereby following their systemic metabolism, they require peripheral reactivation and amplification by 11β-HSD1 at sites of inflammation to deliver their anti-inflammatory therapeutic effects. This study provides a novel mechanistic understanding of the anti-inflammatory properties of therapeutic GCs and their targeting to sites of inflammation in polyarthritis.
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Affiliation(s)
- Chloe Fenton
- Institute for Metabolism and Systems Research, University of Birmingham, Birmingham, UK,Research into Inflammatory Arthritis Centre, Versus Arthritis, Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK
| | - Claire Martin
- Institute for Metabolism and Systems Research, University of Birmingham, Birmingham, UK
| | - Rachel Jones
- Institute for Metabolism and Systems Research, University of Birmingham, Birmingham, UK,MRC Arthritis Research UK Centre for Musculoskeletal Ageing Research, University of Birmingham Edgbaston Campus, Birmingham, UK
| | - Adam Croft
- Research into Inflammatory Arthritis Centre, Versus Arthritis, Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK
| | - Joana Campos
- Research into Inflammatory Arthritis Centre, Versus Arthritis, Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK
| | - Amy J Naylor
- Research into Inflammatory Arthritis Centre, Versus Arthritis, Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK,Centre for Translational Inflammation Research, University of Birmingham, Birmingham, UK
| | - Angela E Taylor
- Institute for Metabolism and Systems Research, University of Birmingham, Birmingham, UK,Centre for Endocrinology, Diabetes and Metabolism, University of Birmingham, Birmingham, UK
| | - Myriam Chimen
- Research into Inflammatory Arthritis Centre, Versus Arthritis, Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK,Institute for Clinical Sciences, University of Birmingham, Birmingham, UK
| | - Mark Cooper
- ANZAC Research Institute, The University of Sydney, Sydney, New South Wales, Australia
| | - Gareth G Lavery
- Institute for Metabolism and Systems Research, University of Birmingham, Birmingham, UK,MRC Arthritis Research UK Centre for Musculoskeletal Ageing Research, University of Birmingham Edgbaston Campus, Birmingham, UK,Centre for Endocrinology, Diabetes and Metabolism, University of Birmingham, Birmingham, UK
| | - Karim Raza
- Research into Inflammatory Arthritis Centre, Versus Arthritis, Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK,Rheumatology, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, UK
| | - Rowan S Hardy
- Research into Inflammatory Arthritis Centre, Versus Arthritis, Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK,MRC Arthritis Research UK Centre for Musculoskeletal Ageing Research, University of Birmingham Edgbaston Campus, Birmingham, UK,Institute for Clinical Sciences, University of Birmingham, Birmingham, UK
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Ciebiera M, Jakiel G, Nowicka G, Laganà AS, Ghezzi F, Łoziński T, Wojtyła C, Włodarczyk M. The effect of ulipristal acetate on tumor necrosis factor α, insulin-like growth factor 1, and plasminogen activator inhibitor-1 serum levels in patients with symptomatic uterine fibroids. Arch Med Sci 2020; 20:751-761. [PMID: 39050181 PMCID: PMC11264157 DOI: 10.5114/aoms.2020.94296] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2019] [Accepted: 01/02/2020] [Indexed: 07/27/2024] Open
Abstract
Introduction Uterine fibroids (UFs) are benign tumors of the female reproductive system originating from the smooth muscle of the uterus. Currently, progesterone is known to play a key role in the differentiation of the myometrial tissue to form UFs and their abnormal growth. The mechanism of action of progesterone in UF tumorigenesis involves its effect on increasing the concentrations and dysregulation of selected growth factors. Material and methods A retrospective cohort study was performed to evaluate and compare tumor necrosis factor α (TNF-α), insulin-like growth factor 1 (IGF-1), plasminogen activator inhibitor-1 (PAI-1) serum concentrations in patients with UFs without prior hormonal treatment, patients with UFs treated with a 3-month standard ulipristal acetate (UPA - a type of selective progesterone receptor modulator) scheme (5 mg/day) and in control patients without UFs. A total of 120 patients were divided into 3 groups (controls, UFs with UPA treatment, UFs without UPA treatment). Results There were no significant differences in TNF-α serum concentrations between patients with UFs who underwent UPA treatment and patients who did not. Serum concentrations of IGF-1 and PAI-1 did not show significant intergroup differences. Conclusions No significant differences were found between TNF-α concentrations in the serum of patients with UFs treated with UPA, and patients without UPA treatment. In addition, our data analysis did not show significant differences in the concentrations of IGF-1 and PAI-1 between patients with UFs and the control group. Further studies on the dependence of specific symptoms on selected growth factors are mandatory.
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Affiliation(s)
- Michał Ciebiera
- II Department of Obstetrics and Gynecology, The Center of Postgraduate Medical Education, Warsaw, Poland
| | - Grzegorz Jakiel
- I Department of Obstetrics and Gynecology, The Center of Postgraduate Medical Education, Warsaw, Poland
| | - Grażyna Nowicka
- Department of Biochemistry and Pharmacogenomics, Faculty of Pharmacy, Medical University of Warsaw, Poland
| | - Antonio Simone Laganà
- Department of Obstetrics and Gynecology, “Filippo Del Ponte” Hospital, University of Insubria, Varese, Italy
| | - Fabio Ghezzi
- Department of Obstetrics and Gynecology, “Filippo Del Ponte” Hospital, University of Insubria, Varese, Italy
| | | | - Cezary Wojtyła
- European Observatory of Health Inequalities, State University of Applied Sciences, Kalisz, Poland
- Department of Gynecologic Oncology and Obstetrics, The Center of Postgraduate Medical Education, Warsaw, Poland
| | - Marta Włodarczyk
- Department of Biochemistry and Pharmacogenomics, Faculty of Pharmacy, Medical University of Warsaw, Poland
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Fenton CG, Webster JM, Martin CS, Fareed S, Wehmeyer C, Mackie H, Jones R, Seabright AP, Lewis JW, Lai YC, Goodyear CS, Jones SW, Cooper MS, Lavery GG, Langen R, Raza K, Hardy RS. Therapeutic glucocorticoids prevent bone loss but drive muscle wasting when administered in chronic polyarthritis. Arthritis Res Ther 2019; 21:182. [PMID: 31370858 PMCID: PMC6676537 DOI: 10.1186/s13075-019-1962-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Accepted: 07/22/2019] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Patients with rheumatoid arthritis (RA) experience extra-articular manifestations including osteoporosis and muscle wasting, which closely associate with severity of disease. Whilst therapeutic glucocorticoids (GCs) reduce inflammation in RA, their actions on muscle and bone metabolism in the context of chronic inflammation remain unclear. We utilised the TNF-tg model of chronic polyarthritis to ascertain the impact of therapeutic GCs on bone and muscle homeostasis in the context of systemic inflammation. METHODS TNF-tg and wild-type (WT) animals received either vehicle or the GC corticosterone (100 μg/ml) in drinking water at onset of arthritis. Arthritis severity and clinical parameters were measured, serum collected for ELISA and muscle and bone biopsies collected for μCT, histology and mRNA analysis. In vivo findings were examined in primary cultures of osteoblasts, osteoclasts and myotubes. RESULTS TNF-tg mice receiving GCs showed protection from inflammatory bone loss, characterised by a reduction in serum markers of bone resorption, osteoclast numbers and osteoclast activity. In contrast, muscle wasting was markedly increased in WT and TNF-tg animals receiving GCs, independently of inflammation. This was characterised by a reduction in muscle weight and fibre size, and an induction in anti-anabolic and catabolic signalling. CONCLUSIONS This study demonstrates that when given in early onset chronic polyarthritis, oral GCs partially protect against inflammatory bone loss, but induce marked muscle wasting. These results suggest that in patients with inflammatory arthritis receiving GCs, the development of interventions to manage deleterious side effects in muscle should be prioritised.
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Affiliation(s)
- C. G. Fenton
- 0000 0004 1936 7486grid.6572.6Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK ,0000 0004 1936 7486grid.6572.6Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK
| | - J. M. Webster
- 0000 0004 1936 7486grid.6572.6Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK ,Centre for Endocrinology, Diabetes and Metabolism, Birmingham Health Partners, Birmingham, UK
| | - C. S. Martin
- 0000 0004 1936 7486grid.6572.6Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK
| | - S. Fareed
- 0000 0004 1936 7486grid.6572.6Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK
| | - C. Wehmeyer
- 0000 0004 1936 7486grid.6572.6Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK
| | - H. Mackie
- 0000 0001 2193 314Xgrid.8756.cCentre of Immunobiology, Institute of Infection, Immunity and Inflammation, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - R. Jones
- 0000 0004 1936 7486grid.6572.6MRC Arthritis Research UK Centre for Musculoskeletal Ageing Research, University of Birmingham, Birmingham, UK
| | - A. P. Seabright
- 0000 0004 1936 7486grid.6572.6School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
| | - J. W. Lewis
- 0000 0004 1936 7486grid.6572.6Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK ,0000 0004 1936 7486grid.6572.6MRC Arthritis Research UK Centre for Musculoskeletal Ageing Research, University of Birmingham, Birmingham, UK
| | - Y. C. Lai
- 0000 0004 1936 7486grid.6572.6Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK ,0000 0004 1936 7486grid.6572.6MRC Arthritis Research UK Centre for Musculoskeletal Ageing Research, University of Birmingham, Birmingham, UK ,0000 0004 1936 7486grid.6572.6School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
| | - C. S. Goodyear
- 0000 0001 2193 314Xgrid.8756.cCentre of Immunobiology, Institute of Infection, Immunity and Inflammation, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - S. W Jones
- 0000 0004 1936 7486grid.6572.6Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK
| | - M. S. Cooper
- 0000 0004 1936 834Xgrid.1013.3ANZAC Research Institute, University of Sydney, Sydney, Australia
| | - G. G. Lavery
- 0000 0004 1936 7486grid.6572.6Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK ,Centre for Endocrinology, Diabetes and Metabolism, Birmingham Health Partners, Birmingham, UK
| | - R. Langen
- 0000 0001 0481 6099grid.5012.6Department of Respiratory Medicine, NUTRIM School of Nutrition and Translational Research in Metabolism, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, Netherlands
| | - K. Raza
- 0000 0004 1936 7486grid.6572.6Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK ,grid.412919.6Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, UK
| | - R. S. Hardy
- 0000 0004 1936 7486grid.6572.6Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK ,0000 0004 1936 7486grid.6572.6Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK ,0000 0004 1936 7486grid.6572.6MRC Arthritis Research UK Centre for Musculoskeletal Ageing Research, University of Birmingham, Birmingham, UK ,0000 0004 1936 7486grid.6572.6Institute of Clinical Sciences, University of Birmingham, Birmingham, UK
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Hardy RS, Fenton C, Croft AP, Naylor AJ, Begum R, Desanti G, Buckley CD, Lavery G, Cooper MS, Raza K. 11 Beta-hydroxysteroid dehydrogenase type 1 regulates synovitis, joint destruction, and systemic bone loss in chronic polyarthritis. J Autoimmun 2018; 92:104-113. [PMID: 29891135 PMCID: PMC6066611 DOI: 10.1016/j.jaut.2018.05.010] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Revised: 05/25/2018] [Accepted: 05/29/2018] [Indexed: 01/15/2023]
Abstract
OBJECTIVE In rheumatoid arthritis, the enzyme 11 beta-hydroxysteroid dehydrogenase type 1 (11β-HSD1) is highly expressed at sites of inflammation, where it converts inactive glucocorticoids (GC) to their active counterparts. In conditions of GC excess it has been shown to be a critical regulator of muscle wasting and bone loss. Here we examine the contribution of 11β-HSD1 to the pathology of persistent chronic inflammatory disease. METHODS To determine the contribution of 11β-HSD1 to joint inflammation, destruction and systemic bone loss associated with persistent inflammatory arthritis, we generated mice with global and mesenchymal specific 11β-HSD1 deletions in the TNF-transgenic (TNF-tg) model of chronic polyarthritis. Disease severity was determined by clinical scoring. Histology was assessed in formalin fixed sections and fluorescence-activated cell sorting (FACS) analysis of synovial tissue was performed. Local and systemic bone loss were measured by micro computed tomography (micro-CT). Measures of inflammation and bone metabolism were assessed in serum and in tibia mRNA. RESULTS Global deletion of 11β-HSD1 drove an enhanced inflammatory phenotype, characterised by florid synovitis, joint destruction and systemic bone loss. This was associated with increased pannus invasion into subchondral bone, a marked polarisation towards pro-inflammatory M1 macrophages at sites of inflammation and increased osteoclast numbers. Targeted mesenchymal deletion of 11β-HSD1 failed to recapitulate this phenotype suggesting that 11β-HSD1 within leukocytes mediate its protective actions in vivo. CONCLUSIONS We demonstrate a fundamental role for 11β-HSD1 in the suppression of synovitis, joint destruction, and systemic bone loss. Whilst a role for 11β-HSD1 inhibitors has been proposed for metabolic complications in inflammatory diseases, our study suggests that this approach would greatly exacerbate disease severity.
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Affiliation(s)
- R S Hardy
- Institute of Inflammation and Ageing, ARUK Rheumatoid Arthritis Centre of Excellence, MRC ARUK Centre for Musculoskeletal Ageing, University of Birmingham, Birmingham, UK; Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK.
| | - C Fenton
- Institute of Inflammation and Ageing, ARUK Rheumatoid Arthritis Centre of Excellence, MRC ARUK Centre for Musculoskeletal Ageing, University of Birmingham, Birmingham, UK; Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK
| | - A P Croft
- Institute of Inflammation and Ageing, ARUK Rheumatoid Arthritis Centre of Excellence, MRC ARUK Centre for Musculoskeletal Ageing, University of Birmingham, Birmingham, UK
| | - A J Naylor
- Institute of Inflammation and Ageing, ARUK Rheumatoid Arthritis Centre of Excellence, MRC ARUK Centre for Musculoskeletal Ageing, University of Birmingham, Birmingham, UK
| | - R Begum
- Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK
| | - G Desanti
- Institute of Inflammation and Ageing, ARUK Rheumatoid Arthritis Centre of Excellence, MRC ARUK Centre for Musculoskeletal Ageing, University of Birmingham, Birmingham, UK
| | - C D Buckley
- Institute of Inflammation and Ageing, ARUK Rheumatoid Arthritis Centre of Excellence, MRC ARUK Centre for Musculoskeletal Ageing, University of Birmingham, Birmingham, UK
| | - G Lavery
- Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK; Centre for Endocrinology, Diabetes and Metabolism, UK
| | - M S Cooper
- ANZAC Research Institute, University of Sydney, Sydney, Australia
| | - K Raza
- Institute of Inflammation and Ageing, ARUK Rheumatoid Arthritis Centre of Excellence, MRC ARUK Centre for Musculoskeletal Ageing, University of Birmingham, Birmingham, UK; Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, UK
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