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Li J, Cao J, Chen Q, Liu D, Li R. Investigating the therapeutic potential of sinomenine in rheumatoid arthritis: anti-inflammatory, antioxidant, and immunomodulatory mechanisms. NAUNYN-SCHMIEDEBERG'S ARCHIVES OF PHARMACOLOGY 2024; 397:3945-3958. [PMID: 37991542 DOI: 10.1007/s00210-023-02810-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Accepted: 10/20/2023] [Indexed: 11/23/2023]
Abstract
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.
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Affiliation(s)
- Juan Li
- The First Ward of Rheumatology and Immunology, Xi'an No. 5 Hospital, Xi'an, 710000, China
| | - Junjie Cao
- Laboratory medicine department, Xi'an No. 5 Hospital, Xi'an, 710000, China
| | - Qingping Chen
- The First Ward of Rheumatology and Immunology, Xi'an No. 5 Hospital, Xi'an, 710000, China
| | - Dan Liu
- Rheumatology and Immunology Department, The First Affiliated Hospital of Xi'an Medical University, Xi'an, 710000, China
| | - Rui Li
- The First Ward of Rheumatology and Immunology, Xi'an No. 5 Hospital, Xi'an, 710000, China.
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Warjukar PR, Mohabey AV, Jain PB, Bandre GR. Decoding the Correlation Between Inflammatory Response Marker Interleukin-6 (IL-6) and C-reactive Protein (CRP) With Disease Activity in Rheumatoid Arthritis. Cureus 2024; 16:e62954. [PMID: 39050325 PMCID: PMC11265957 DOI: 10.7759/cureus.62954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Accepted: 06/23/2024] [Indexed: 07/27/2024] Open
Abstract
BACKGROUND Excessive interleukin-6 (IL-6) production in rheumatoid arthritis (RA) leads to joint destruction, inflammation, and systemic symptoms. IL-6 inhibitors alleviate symptoms. C-reactive protein (CRP), an inflammation biomarker, correlates with RA activity. In this study, we assess IL-6 and CRP levels in RA patients to understand their association with disease activity. MATERIALS AND METHODS This cross-sectional study was conducted at a tertiary care hospital in central India for 15 months, from July 2022 to September 2023. The study involved 75 participants diagnosed with RA and receiving outpatient treatment. Exclusion criteria included anti-IL-6 drug treatment, bedridden individuals, proxy patients, and those without consent. Disease activity was assessed using the 28-joint disease activity score (DAS28), while IL-6 and CRP levels were measured following the standard procedures. RESULTS The average CRP levels were found to be 51.67 ± 47.49 mg/L, while IL-6 levels averaged 65.16 ± 43.67 pg/ml. The results revealed a substantial positive correlation between IL-6 levels and DAS28 (r = 0.603, p value < 0.001), indicating a significant association. Additionally, a moderate correlation between CRP levels and DAS28 (r = 0.493, p value < 0.001) highlighted a significant relationship between these variables. CONCLUSIONS The analysis showed that higher IL-6 levels were associated with increased disease activity and suggested IL-6 as a valuable indicator for assessing RA severity. Also, CRP levels had a moderate correlation with disease activity. Overall, IL-6 is a better marker for disease activity when compared to CRP levels in patients with RA.
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Affiliation(s)
- Prajakta R Warjukar
- Biochemistry, Datta Meghe Medical College, Datta Meghe Institute of Higher Education and Research, Nagpur, IND
| | - Ankush V Mohabey
- Orthopedics, All India Institute of Medical Sciences, Nagpur, Nagpur, IND
| | - Pradeep B Jain
- Biochemistry, Datta Meghe Medical College, Datta Meghe Institute of Higher Education and Research, Nagpur, IND
| | - Gulshan R Bandre
- Microbiology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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3
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Rosik J, Kulpa J, Szczepanik M, Pawlik A. The Role of Semaphorins in the Pathogenesis of Rheumatoid Arthritis. Cells 2024; 13:618. [PMID: 38607057 PMCID: PMC11011349 DOI: 10.3390/cells13070618] [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] [Received: 02/06/2024] [Revised: 03/28/2024] [Accepted: 04/01/2024] [Indexed: 04/13/2024] Open
Abstract
Rheumatoid arthritis (RA) is one of the most common autoimmune diseases. Inflammation of the synovial fluid propagates the pathological process of angiogenesis. Semaphorins play a crucial role in the context of endothelial cell function, and their pleiotropic nature has various effects on the further development of RA. This narrative review summarises the various roles of semaphorins in the pathology of RA and whether they could play a role in developing novel RA treatment options.
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Affiliation(s)
- Jakub Rosik
- Department of Physiology, Pomeranian Medical University, 70-111 Szczecin, Poland; (J.R.); (J.K.); (M.S.)
| | | | | | - Andrzej Pawlik
- Department of Physiology, Pomeranian Medical University, 70-111 Szczecin, Poland; (J.R.); (J.K.); (M.S.)
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Xv Z, Xv X, Chen N, Yuan J, Li J, Wang L, Yu S, Li G, Ding M, Zong M, Fan L. Soluble signal inhibitory receptor on leukocytes-1 reflects disease activity and assists diagnosis of patients with rheumatoid arthritis. Clin Chim Acta 2024; 556:117808. [PMID: 38309555 DOI: 10.1016/j.cca.2024.117808] [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] [Received: 10/04/2023] [Revised: 01/26/2024] [Accepted: 01/28/2024] [Indexed: 02/05/2024]
Abstract
BACKGROUND SIRL-1, an immunosuppressive receptor encoded by the VSTM1 gene, has recently been linked to rheumatoid arthritis (RA) due to its association with activated polymorphonuclear neutrophils (PMNs). Considering that the activated PMNs play a crucial role in the pathogenesis of rheumatoid arthritis (RA), we aimed to measure the levels of soluble SIRL-1, investigating whether they add value to RA in the clinical diagnosis. METHODS Utilizing an enzyme-linked immunosorbent assay, the concentration of sSIRL-1 was measured in serum samples from cohort 1 diagnosed with RA (n = 96), gout (n = 54), osteoarthritis (n = 47), healthy controls (n = 86) and synovial fluid samples from OA (n = 8) and RA (n = 8) patients, respectively. Additionally, an external validation in cohort 2 (n = 156) comprising various inflammatory diseases was employed. RESULTS The study revealed a distinctive upregulation of sSIRL-1 in the serum of RA compared to HC and other arthralgia diseases (p < 0.0001), which also displayed a significant elevation in synovial fluid from RA compared to OA (p < 0.05). Notably, sSIRL-1 levels exhibited a significant decrease in patients who achieved disease remission (p < 0.05). Furthermore, the diagnostic accuracy of RA was enhanced when sSIRL-1 was combined with anti-CCP and RF, yielding an impressive AUC value of 0.950. CONCLUSION The expression pattern of sSIRL-1 in RA, coupled with its correlation with disease activity, underscores its potential clinical utility for both diagnosis and disease monitoring in RA patients. This study offers valuable insights into the evolving diagnostic landscape of RA.
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Affiliation(s)
- Zhen Xv
- Department of Clinical Laboratory, The Affiliated East Hospital of Tongji University, Shanghai East Hospital, Tongji University School of Medicine, Shanghai 200092, People's Republic of China
| | - Xuejing Xv
- Department of Clinical Laboratory, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University, Nanjing, People's Republic of China
| | - Nianzhen Chen
- Department of Clinical Laboratory, The Affiliated East Hospital of Tongji University, Shanghai East Hospital, Tongji University School of Medicine, Shanghai 200092, People's Republic of China
| | - Jiayi Yuan
- Department of Clinical Laboratory, The Affiliated East Hospital of Tongji University, Shanghai East Hospital, Tongji University School of Medicine, Shanghai 200092, People's Republic of China
| | - Jing Li
- Department of Clinical Laboratory, The Affiliated East Hospital of Tongji University, Shanghai East Hospital, Tongji University School of Medicine, Shanghai 200092, People's Republic of China
| | - Lan Wang
- Department of Clinical Laboratory, The Affiliated East Hospital of Tongji University, Shanghai East Hospital, Tongji University School of Medicine, Shanghai 200092, People's Republic of China
| | - Shanshan Yu
- Department of Clinical Laboratory, The Affiliated East Hospital of Tongji University, Shanghai East Hospital, Tongji University School of Medicine, Shanghai 200092, People's Republic of China
| | - Gen Li
- Department of Clinical Laboratory, The Affiliated East Hospital of Tongji University, Shanghai East Hospital, Tongji University School of Medicine, Shanghai 200092, People's Republic of China
| | - Menglei Ding
- Department of Clinical Laboratory, The Affiliated East Hospital of Tongji University, Shanghai East Hospital, Tongji University School of Medicine, Shanghai 200092, People's Republic of China
| | - Ming Zong
- Department of Clinical Laboratory, The Affiliated East Hospital of Tongji University, Shanghai East Hospital, Tongji University School of Medicine, Shanghai 200092, People's Republic of China.
| | - Lieying Fan
- Department of Clinical Laboratory, The Affiliated East Hospital of Tongji University, Shanghai East Hospital, Tongji University School of Medicine, Shanghai 200092, People's Republic of China.
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Zhu Z, Wan L. Exploration of the molecular mechanism guiding Xinfeng capsule regulatory mechanism for rheumatoid arthritis inflammation. Am J Transl Res 2024; 16:973-987. [PMID: 38586085 PMCID: PMC10994809 DOI: 10.62347/tpoq4910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 03/13/2024] [Indexed: 04/09/2024]
Abstract
OBJECTIVES Rheumatoid arthritis (RA) is an autoimmune disease characterized by chronic inflammation of the joint synovium. The traditional Chinese medicine Xinfeng capsule (XFC) has a remarkable alleviating effect on inflammatory symptoms, such as joint pain and swelling, in patients with RA. However, the underlying mechanism of action remains to be elucidated. This study intended to conduct network pharmacology, animal experiments, data mining, and molecular docking to explore the molecular mechanism through which XFC can improve the inflammatory symptoms of RA. METHODS The Apriori association rules and a random walk model were employed to evaluate the effect of XFC on the clinical inflammatory indexes of RA. The active ingredients and the potential target genes of XFC were obtained from public databases. Based on the search tool for recurring instances of neighboring genes (STRING) database, the Database for Annotation, Visualization and Integrated Discovery (DAVID) database, Cytoscape software, and molecular docking method, the molecular mechanism by which XFC acts on RA was also analyzed. Finally, an adjuvant arthritis rat model was established to verify the effects of XFC on inflammation-related signaling pathways and inflammatory factors. RESULTS XFC significantly reduced the level of C-reactive protein (CRP), vascular endothelial growth factor (VEGF), and the erythrocyte sedimentation rate (ESR). The docking space structures of the active ingredients in XFC, namely triptolide and quercetin, and the key targets were stable. Inflammation-related biological processes were identified as the key factors involved in the development of RA, and the regulation of the toll-like receptor (TLR) signaling pathway may be the key link for XFC toward improving the inflammatory state of RA. The expression levels of toll-like receptor 4 (TLR4), myeloid differentiation primary response protein MyD88 (MyD88), interleukin-1 receptor-associated kinase 1 (IRAK1), TNF receptor-associated factor 6 (TRAF6), TGF-beta-activated kinase 1 (TAK1), phospho-Inhibitor of NF-κB kinaseβ (p-IKKβ), phospho-Nuclear factor-k-gene binding (p-NF-κB), and interleukin-1β (IL-1β) can all be decreased by XFC. XFC improves joint inflammation symptoms by lowering pro-inflammatory factors tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), and interferon-γ (INF-γ) levels. CONCLUSIONS XFC could effectively improve the clinical inflammatory indexes of RA. The active ingredients of XFC improved the inflammatory state of RA by regulating the TLR-signaling pathway.
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Affiliation(s)
- Ziheng Zhu
- The First Affiliated Hospital of Anhui University of Chinese MedicineHefei 230038, Anhui, China
| | - Lei Wan
- The First Affiliated Hospital of Anhui University of Chinese MedicineHefei 230038, Anhui, China
- Key Laboratory of Xin’an Medical Education MinistryHefei 230038, Anhui, China
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Pascual-García S, Martínez-Peinado P, Pujalte-Satorre C, Navarro-Sempere A, Esteve-Girbés J, López-Jaén AB, Javaloyes-Antón J, Cobo-Velacoracho R, Navarro-Blasco FJ, Sempere-Ortells JM. Exosomal Osteoclast-Derived miRNA in Rheumatoid Arthritis: From Their Pathogenesis in Bone Erosion to New Therapeutic Approaches. Int J Mol Sci 2024; 25:1506. [PMID: 38338785 PMCID: PMC10855630 DOI: 10.3390/ijms25031506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 01/19/2024] [Accepted: 01/23/2024] [Indexed: 02/12/2024] Open
Abstract
Rheumatoid arthritis (RA) is an autoimmune disease that causes inflammation, pain, and ultimately, bone erosion of the joints. The causes of this disease are multifactorial, including genetic factors, such as the presence of the human leukocyte antigen (HLA)-DRB1*04 variant, alterations in the microbiota, or immune factors including increased cytotoxic T lymphocytes (CTLs), neutrophils, or elevated M1 macrophages which, taken together, produce high levels of pro-inflammatory cytokines. In this review, we focused on the function exerted by osteoclasts on osteoblasts and other osteoclasts by means of the release of exosomal microRNAs (miRNAs). Based on a thorough revision, we classified these molecules into three categories according to their function: osteoclast inhibitors (miR-23a, miR-29b, and miR-214), osteoblast inhibitors (miR-22-3p, miR-26a, miR-27a, miR-29a, miR-125b, and miR-146a), and osteoblast enhancers (miR-20a, miR-34a, miR-96, miR-106a, miR-142, miR-199a, miR-324, and miR-486b). Finally, we analyzed potential therapeutic targets of these exosomal miRNAs, such as the use of antagomiRs, blockmiRs, agomiRs and competitive endogenous RNAs (ceRNAs), which are already being tested in murine and ex vivo models of RA. These strategies might have an important role in reestablishing the regulation of osteoclast and osteoblast differentiation making progress in the development of personalized medicine.
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Affiliation(s)
- Sandra Pascual-García
- Department of Biotechnology, University of Alicante, 03690 San Vicente del Raspeig, Spain
| | | | | | - Alicia Navarro-Sempere
- Department of Biotechnology, University of Alicante, 03690 San Vicente del Raspeig, Spain
| | - Jorge Esteve-Girbés
- Department of Legal Studies of the State, University of Alicante, 03690 San Vicente del Raspeig, Spain
| | - Ana B. López-Jaén
- Department of Biotechnology, University of Alicante, 03690 San Vicente del Raspeig, Spain
| | - Juan Javaloyes-Antón
- Department of Physics, Systems Engineering and Signal Theory, University of Alicante, 03690 San Vicente del Raspeig, Spain
| | - Raúl Cobo-Velacoracho
- Department of Biotechnology, University of Alicante, 03690 San Vicente del Raspeig, Spain
| | - Francisco J. Navarro-Blasco
- Department of Biotechnology, University of Alicante, 03690 San Vicente del Raspeig, Spain
- Rheumatology Unit, University General Hospital of Elche, 03203 Elche, Spain
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7
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Barrera-Vázquez OS, Hernández-González O. Structural and Pharmacological Network Focused on MiRNAs Involved in Rheumatoid Arthritis: A Systematic Review. Curr Mol Med 2024; 24:599-609. [PMID: 37185324 DOI: 10.2174/1566524023666230423144114] [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] [Received: 09/28/2022] [Revised: 02/14/2023] [Accepted: 02/17/2023] [Indexed: 05/17/2023]
Abstract
BACKGROUND Rheumatoid Arthritis (RA) is a chronic autoimmune disease that has a prevalence of over one percent of the world population, causing substantial pain, joint deformity, and functional disability in patients. The identification and measurement of miRNAs are relatively easy to perform. Future studies will corroborate if miRNAs can fulfill their roles as biomarkers with either predictive or diagnostic evaluation of treatment potential and provide actual clinical utility. METHODS In the last decade, various advances have been made regarding the identification of the origin and exact functions of miRNAs, allowing us to have a potential use both in the research and clinical fields. OBJECTIVE This systematic review aimed to collect, analyze, and improve the current understanding of RA-related miRNAs and their applicability in therapeutics. A bibliographic search of the miRNAs involved in RA was carried out, and through the use of databases, their target genes and small molecules that had some relationship with their expression were searched. The analysis of these data was done through structural network analysis. RESULTS During the network analysis, miR-30a, miR-30c, let-7a, miR-144, miR-17-5p, miR-124, miR -23b, miR-23, miR-15a, miR-16 were the most connected, which could be used as possible biomarkers or be candidates for further analysis due to their interaction with other miRNAs and genes. CONCLUSION Additionally, this is the first systematic review, in which we proposed that small compounds like toxicants and drugs could have a potential role within RA because they regulate the expression of miRNAs involved in this pathology. Some of these compounds are commonly found as environmental contaminants, and others as drugs. These ideas open a new panorama of understanding RA, proposing possible causes or treatments against this pathology. Therefore, these small molecules would give us some indication of a relationship with RA, thereby helping in seeking causes, treatment, or prevention of this disease. CONCLUSION This is the first time it is intended to use structural network analysis to determine possible biomarkers of AR for diagnosis and prognosis through the expression of these miRNAs and their relationship with compounds of daily life.
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Affiliation(s)
| | - Olivia Hernández-González
- Laboratorio de Microscopia Electrónica, Instituto Nacional de Rehabilitación, Mexico City, 14389, Mexico
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8
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Ryu JJ, Jang CH. A liquid crystal-based biosensor for sensitive detection of tumor necrosis factor-alpha. Mikrochim Acta 2023; 191:55. [PMID: 38153588 DOI: 10.1007/s00604-023-06125-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 11/26/2023] [Indexed: 12/29/2023]
Abstract
Tumor necrosis factor-alpha (TNF-α) is a cytokine secreted by the macrophages and Th1 cells of the immune system in response to inflammation. Given its significance as a biomarker with elevated levels in physiological fluids in various conditions, there is an increasing demand for a simple and accurate TNF-α detection strategy. In this article, we present a liquid crystal (LC)-based biosensor developed for sensitive TNF-α detection. The biosensor operates as follows: TNF-α and detection antibodies (DAbs) form complexes during preincubation. These complexes then bind with the surface-immobilized capture antibodies (CAbs), facilitating the antigen-antibody reaction between the CAbs and the TNF-α/DAb complexes. This target recognition interaction alters the surface topography, disrupting the vertical orientation of LCs produced by dimethyloctadecyl[3-(trimethoxysilyl)-propyl]ammonium chloride. The orientational change in the LCs can be easily visualized with a polarized optical microscope, resulting in brighter images as TNF-α levels rise. Our results demonstrated a linear range of 5.00-500 pg/mL, with a limit of detection and limit of quantification being 1.08 and 3.56 pg/mL, respectively. Recovery experiments on diluted saliva samples produced reasonable results, with TNF-α recoveries ranging from 97.1% ± 2.58% to 107% ± 5.95%.
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Affiliation(s)
- Je-Jin Ryu
- Department of Chemistry, Gachon University, Seongnam-daero 1342, Sujeong-Gu, Seongnam-Si, Gyeonggi-Do, 13120, Republic of Korea
| | - Chang-Hyun Jang
- Department of Chemistry, Gachon University, Seongnam-daero 1342, Sujeong-Gu, Seongnam-Si, Gyeonggi-Do, 13120, Republic of Korea.
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9
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Xiao D, Fang L, Liu Z, He Y, Ying J, Qin H, Lu A, Shi M, Li T, Zhang B, Guan J, Wang C, Abu-Amer Y, Shen J. DNA methylation-mediated Rbpjk suppression protects against fracture nonunion caused by systemic inflammation. J Clin Invest 2023; 134:e168558. [PMID: 38051594 PMCID: PMC10849763 DOI: 10.1172/jci168558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 11/30/2023] [Indexed: 12/07/2023] Open
Abstract
Challenging skeletal repairs are frequently seen in patients experiencing systemic inflammation. To tackle the complexity and heterogeneity of the skeletal repair process, we performed single-cell RNA sequencing and revealed that progenitor cells were one of the major lineages responsive to elevated inflammation and this response adversely affected progenitor differentiation by upregulation of Rbpjk in fracture nonunion. We then validated the interplay between inflammation (via constitutive activation of Ikk2, Ikk2ca) and Rbpjk specifically in progenitors by using genetic animal models. Focusing on epigenetic regulation, we identified Rbpjk as a direct target of Dnmt3b. Mechanistically, inflammation decreased Dnmt3b expression in progenitor cells, consequently leading to Rbpjk upregulation via hypomethylation within its promoter region. We also showed that Dnmt3b loss-of-function mice phenotypically recapitulated the fracture repair defects observed in Ikk2ca-transgenic mice, whereas Dnmt3b-transgenic mice alleviated fracture repair defects induced by Ikk2ca. Moreover, Rbpjk ablation restored fracture repair in both Ikk2ca mice and Dnmt3b loss-of-function mice. Altogether, this work elucidates a common mechanism involving a NF-κB/Dnmt3b/Rbpjk axis within the context of inflamed bone regeneration. Building on this mechanistic insight, we applied local treatment with epigenetically modified progenitor cells in a previously established mouse model of inflammation-mediated fracture nonunion and showed a functional restoration of bone regeneration under inflammatory conditions through an increase in progenitor differentiation potential.
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Affiliation(s)
- Ding Xiao
- Department of Orthopaedic Surgery, School of Medicine, Washington University, St. Louis, Missouri, USA
- The Second Xiangya Hospital, Central South University, Changsha, China
| | - Liang Fang
- Department of Orthopaedic Surgery, School of Medicine, Washington University, St. Louis, Missouri, USA
| | - Zhongting Liu
- Department of Mechanical Engineering & Materials Sciences, School of Engineering and
| | - Yonghua He
- Department of Orthopaedic Surgery, School of Medicine, Washington University, St. Louis, Missouri, USA
| | - Jun Ying
- Department of Orthopaedic Surgery, School of Medicine, Washington University, St. Louis, Missouri, USA
| | - Haocheng Qin
- Department of Orthopaedic Surgery, School of Medicine, Washington University, St. Louis, Missouri, USA
- The Second Xiangya Hospital, Central South University, Changsha, China
| | - Aiwu Lu
- Department of Orthopaedic Surgery, School of Medicine, Washington University, St. Louis, Missouri, USA
| | - Meng Shi
- Department of Orthopaedic Surgery, School of Medicine, Washington University, St. Louis, Missouri, USA
| | - Tiandao Li
- Department of Developmental Biology, Center of Regenerative Medicine, Washington University, St. Louis, Missouri, USA
| | - Bo Zhang
- Department of Developmental Biology, Center of Regenerative Medicine, Washington University, St. Louis, Missouri, USA
| | - Jianjun Guan
- Department of Mechanical Engineering & Materials Sciences, School of Engineering and
| | - Cuicui Wang
- Department of Orthopaedic Surgery, School of Medicine, Washington University, St. Louis, Missouri, USA
- Department of Developmental Biology, Center of Regenerative Medicine, Washington University, St. Louis, Missouri, USA
| | - Yousef Abu-Amer
- Department of Orthopaedic Surgery, School of Medicine, Washington University, St. Louis, Missouri, USA
- Shriners Hospital for Children, St. Louis, Missouri, USA
| | - Jie Shen
- Department of Orthopaedic Surgery, School of Medicine, Washington University, St. Louis, Missouri, USA
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10
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Wang Q, Liu Y, Wu J, Chen S, Hu T, Liu Y, Li X, Li X, Wu Y, Yu J, Zeng T, Luo Y, Hu X, Tan LM. Potential significance of changes in serum levels of IL-17, TNF-α and DKK-1 in the progression of the rheumatoid arthritis. Autoimmunity 2023; 56:2276068. [PMID: 37909152 DOI: 10.1080/08916934.2023.2276068] [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] [Received: 03/26/2023] [Accepted: 10/21/2023] [Indexed: 11/02/2023]
Abstract
To detect the value of serum interleukin-17 (IL-17), tumour necrosis factor-α (TNF-α), and Dickkopf-1 (DKK-1) in rheumatoid arthritis (RA) at different disease stages. 141 RA patients were randomly obtained and diagnosed in a large tertiary first-class hospital in Jiangxi Province from November 2021 to January 2022. RA was divided into 38 low activity and remission phase (low remission patients), 72 moderate activity patients, 41 high activity patients, according to the disease activity score 28 (DAS28) of RA and 70 healthy controls. IL-17 and TNF-α in serum detected by flow cytometry; DKK-1by ELISA; rheumatoid factor (RF) and C-reactive protein (CRP) by rate scattering turbidimetry; erythrocyte sedimentation rate (ESR) by Widmanstat method; anti-cyclic citrullinated polypeptide antibody (Anti-CCP) by chemiluminescence. The changes among the groups were statistically analysed and evaluated their diagnostic value. ①Anti-CCP, CRP, and ESR levels in the moderate-to-high activity group were higher than controls, while IL-17, TNF-α, and DKK-1levels higher than low remission group, moderate activity group and controls (p < 0.05). ②IL-17, TNF-α and DKK-1 were positively correlated with RA disease activity, with the correlations of IL-17, TNF-α and DKK-1 all over 0.5 (p < 0.05). ③The ROC curve showed that among all indices the AUC of DKK-1 was the largest, 0. 922, and has the highest sensitivity and negative predictive value for RA, 0.965 and 0.953, respectively. The specificity and positive predictive value of TNF-α is highest, 0.918 and 0.921, respectively, combined them had the highest predictive value in moderate-to-high activity RA, with AUC of 0.968, and had the highest sensitivity of 0.965. The IL-17, TNF-α and DKK-1 levels were elevated in RA and positively correlated with disease activity, involved in the Wnt signalling pathway of inflammatory and joint destructive effects, combining them to monitor the RA disease process and biologically treat the cytokines in the pathogenesis of RA were valuable.
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Affiliation(s)
- Qunxia Wang
- Department of Clinical Laboratory, The Second Affiliated Hospital of Nanchang University, Jiangxi Province's Key Laboratory of Laboratory Medicine, Nanchang, Jiangxi, People's Republic of China
| | - Yanzhao Liu
- Department of Clinical Laboratory, The Second Affiliated Hospital of Nanchang University, Jiangxi Province's Key Laboratory of Laboratory Medicine, Nanchang, Jiangxi, People's Republic of China
| | - Jiazhen Wu
- Department of Clinical Laboratory, The Second Affiliated Hospital of Nanchang University, Jiangxi Province's Key Laboratory of Laboratory Medicine, Nanchang, Jiangxi, People's Republic of China
| | - Simei Chen
- Department of Clinical Laboratory, The Second Affiliated Hospital of Nanchang University, Jiangxi Province's Key Laboratory of Laboratory Medicine, Nanchang, Jiangxi, People's Republic of China
| | - Tingting Hu
- Department of Clinical Laboratory, The Second Affiliated Hospital of Nanchang University, Jiangxi Province's Key Laboratory of Laboratory Medicine, Nanchang, Jiangxi, People's Republic of China
| | - Yuhan Liu
- Department of Clinical Laboratory, The Second Affiliated Hospital of Nanchang University, Jiangxi Province's Key Laboratory of Laboratory Medicine, Nanchang, Jiangxi, People's Republic of China
| | - Xu Li
- Department of Clinical Laboratory, The Second Affiliated Hospital of Nanchang University, Jiangxi Province's Key Laboratory of Laboratory Medicine, Nanchang, Jiangxi, People's Republic of China
| | - Xiaohang Li
- Department of Clinical Laboratory, The Second Affiliated Hospital of Nanchang University, Jiangxi Province's Key Laboratory of Laboratory Medicine, Nanchang, Jiangxi, People's Republic of China
| | - Yang Wu
- Department of Clinical Laboratory, The Second Affiliated Hospital of Nanchang University, Jiangxi Province's Key Laboratory of Laboratory Medicine, Nanchang, Jiangxi, People's Republic of China
| | - Jianlin Yu
- Department of Clinical Laboratory, The Second Affiliated Hospital of Nanchang University, Jiangxi Province's Key Laboratory of Laboratory Medicine, Nanchang, Jiangxi, People's Republic of China
| | - Tingting Zeng
- Department of Clinical Laboratory, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, People's Republic of China
| | - Yi Luo
- The Second Affiliated Hospital of Jiangxi, University of Chinese Medicine, Nanchang, Jiangxi, People's Republic of China
| | - Xiaoyan Hu
- Department of Clinical Laboratory, The Second Affiliated Hospital of Nanchang University, Jiangxi Province's Key Laboratory of Laboratory Medicine, Nanchang, Jiangxi, People's Republic of China
| | - Li-Ming Tan
- Department of Clinical Laboratory, The Second Affiliated Hospital of Nanchang University, Jiangxi Province's Key Laboratory of Laboratory Medicine, Nanchang, Jiangxi, People's Republic of China
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11
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Senturk A, Alver A, Karkucak M, Küçük M, Ahmadi Rendi T. Oxidative modification of carbonic anhydrase by peroxynitrite trigger immune response in mice and rheumatic disease patients. Am J Med Sci 2023; 366:438-448. [PMID: 37678670 DOI: 10.1016/j.amjms.2023.09.002] [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] [Received: 02/01/2023] [Revised: 08/11/2023] [Accepted: 09/04/2023] [Indexed: 09/09/2023]
Abstract
BACKGROUND Carbonic anhydrases (CA) are metalloenzymes with wide tissue distribution, involved in many important physiological processes, and in some rheumatic diseases, autoantibodies are formed against these enzymes. Recent studies have suggested that oxidative stress triggers anti-CA antibody formation. In this study, we aimed to investigate the effects of modification with oxidative/nitrosative stress end products on CA antigenicity in mice and the relationship between the modified CA autoantibodies and oxidant-antioxidant status in patients with rheumatoid arthritis (RA) and Sjögren's syndrome (SjS). METHODS CA I and CA II isoenzymes were isolated from human erythrocytes and modified with 4-hydroxynonenal (4-HNE), malondialdehyde (MDA), and peroxynitrite (PN). Balb-c mice were immunized with these agents to determine the effects of modification on CA antigenicity. The autoantibody titers of modified CA isoenzymes were detected in patients. In addition MDA, 4-HNE, 3-nitrotyrosine (3-NT), superoxide dismutase (SOD), and glutathione peroxidase (GSH-Px) activities were measured to assess the oxidant-antioxidant status in patients. RESULTS Modifications of carbonic anhydrase with oxidative stress end products, HNE, MDA and PN, lead to alterations in the immune response to these enzymes in mice. It was found that HNE and MDA decreased the antigenicity while PN increased. In addition, PN-modified CA autoantibody levels were found to be significantly different in both RA and SjS patients compared to their controls (p<0.05). CONCLUSIONS PN modifications can also trigger an immune response against CA isoenzymes in mice, and PN-modified CA I and CA II autoantibody titers were found at a significantly high level in both RA and SjS patients.
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Affiliation(s)
- Ayse Senturk
- Macka Vocational School, Karadeniz Technical University, Trabzon 61750, Türkiye.
| | - Ahmet Alver
- Faculty of Medicine, Department of Medical Biochemistry, Karadeniz Technical University, Trabzon, Türkiye
| | - Murat Karkucak
- Faculty of Medicine, Department of Physical Medicine and Rehabilitation, Karadeniz Technical University, Trabzon, Türkiye
| | - Murat Küçük
- Faculty of Science, Department of Chemistry, Karadeniz Technical University, Trabzon, Türkiye
| | - Taghi Ahmadi Rendi
- Graduate School of Medical Science, Department of Medical Biochemistry, Karadeniz Technical University, Trabzon, Türkiye; Faculty of Medicine, Department of Medical Biochemistry, Istanbul University, Istanbul, Turkey
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12
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Bai X, Li Y, Li Y, Li M, Luo M, Tian K, Jiang M, Xiong Y, Lu Y, Li Y, Yu H, Huang X. Antinociceptive activity of doliroside B. PHARMACEUTICAL BIOLOGY 2023; 61:201-212. [PMID: 36628487 PMCID: PMC9848282 DOI: 10.1080/13880209.2022.2163407] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 11/16/2022] [Accepted: 12/22/2022] [Indexed: 06/17/2023]
Abstract
CONTEXT Dolichos trilobus Linn (Leguminosae) is often used in Yi ethnic medicine to treat pain, fracture, and rheumatism. OBJECTIVE To explore the therapeutic potential of doliroside B (DB) from D. trilobus and its disodium salt (DBDS) and the underlying mechanism in pain. MATERIALS AND METHODS In the writhing test, Kunming mice were orally treated with DB and DBDS at doses of 0.31, 0.62, 1.25, 2.5, and 5 mg/kg. Vehicle, morphine, indomethacin, and acetylsalicylic acid were used as negative and positive control on the nociception-induced models, respectively. In the hot plate test, mice were orally treated with DB and DBDS at doses of 2.5, 5, 10, and 20 mg/kg. In the formalin test, mice were orally treated with DB and DBDS at doses of 2.5, 5, 10, and 20 mg/kg. In the meanwhile, lipopolysaccharide-induced inflammatory model in RAW264.7 macrophages was adopted to study the mechanism of pain alleviation for DBDS. RESULTS DBDS (5 mg/kg) inhibited the writhing number by 80.2%, which exhibited the highest antinociceptive activity in pain models. DBDS could selectively inhibite the activity of COX-1. Meanwhile, it also reduced the production of NO, iNOS, and IL-6 by 55.8%, 69.0%, and 49.9% inhibition, respectively. It was found that DBDS also positively modulated the function of GABAA1 receptor. DISCUSSION AND CONCLUSIONS DBDS displayed antinociceptive activity by acting on both the peripheral and central nervous systems, which may act on multitargets. Further work is warranted for developing DBDS into a potential drug for the treatment of pain.
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Affiliation(s)
- Xishan Bai
- Key Laboratory of Chemistry in Ethnic Medicinal Resources, State Ethnic Affairs Commission & Ministry of Education, School of Ethnic Medicine, Yunnan Minzu University, Kunming, China
| | - Yanhong Li
- Key Laboratory of Chemistry in Ethnic Medicinal Resources, State Ethnic Affairs Commission & Ministry of Education, School of Ethnic Medicine, Yunnan Minzu University, Kunming, China
| | - Yuxiao Li
- Key Laboratory of Chemistry in Ethnic Medicinal Resources, State Ethnic Affairs Commission & Ministry of Education, School of Ethnic Medicine, Yunnan Minzu University, Kunming, China
| | - Min Li
- State Key Laboratory of Bioactive Substance and Function of Natural Medicines, Institute of Materia Medica, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Ming Luo
- Key Laboratory of Chemistry in Ethnic Medicinal Resources, State Ethnic Affairs Commission & Ministry of Education, School of Ethnic Medicine, Yunnan Minzu University, Kunming, China
| | - Kai Tian
- Key Laboratory of Chemistry in Ethnic Medicinal Resources, State Ethnic Affairs Commission & Ministry of Education, School of Ethnic Medicine, Yunnan Minzu University, Kunming, China
| | - Mengyuan Jiang
- Key Laboratory of Chemistry in Ethnic Medicinal Resources, State Ethnic Affairs Commission & Ministry of Education, School of Ethnic Medicine, Yunnan Minzu University, Kunming, China
| | - Yong Xiong
- Key Laboratory of Chemistry in Ethnic Medicinal Resources, State Ethnic Affairs Commission & Ministry of Education, School of Ethnic Medicine, Yunnan Minzu University, Kunming, China
| | - Ya Lu
- Key Laboratory of Chemistry in Ethnic Medicinal Resources, State Ethnic Affairs Commission & Ministry of Education, School of Ethnic Medicine, Yunnan Minzu University, Kunming, China
| | - Yukui Li
- Key Laboratory of Chemistry in Ethnic Medicinal Resources, State Ethnic Affairs Commission & Ministry of Education, School of Ethnic Medicine, Yunnan Minzu University, Kunming, China
| | - Haibo Yu
- State Key Laboratory of Bioactive Substance and Function of Natural Medicines, Institute of Materia Medica, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xiangzhong Huang
- Key Laboratory of Chemistry in Ethnic Medicinal Resources, State Ethnic Affairs Commission & Ministry of Education, School of Ethnic Medicine, Yunnan Minzu University, Kunming, China
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13
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Issara-Amphorn J, Sjoelund VH, Smelkinson M, Montalvo S, Yoon SH, Manes NP, Nita-Lazar A. Myristoylated, alanine-rich C-kinase substrate (MARCKS) regulates toll-like receptor 4 signaling in macrophages. Sci Rep 2023; 13:19562. [PMID: 37949888 PMCID: PMC10638260 DOI: 10.1038/s41598-023-46266-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 10/30/2023] [Indexed: 11/12/2023] Open
Abstract
MARCKS (myristoylated alanine-rich C-kinase substrate) is a membrane-associated protein expressed in many cell types, including macrophages. MARCKS is functionally implicated in cell adhesion, phagocytosis, and inflammation. LPS (lipopolysaccharide) triggers inflammation via TLR4 (toll-like receptor 4).The presence of MARCKS and the formation of phospho-MARCKS in various cell types have been described, but the role(s) of MARCKS in regulating macrophage functions remain unclear. We investigated the role of MARCKS in inflammation. Confocal microscopy revealed that MARCKS and phospho-MARCKS increased localization to endosomes and the Golgi apparatus upon LPS stimulation.CRISPR-CAS9 mediated knockout of MARCKS in macrophages downregulated the production of TNF and IL6, suggesting a role for MARCKS in inflammatory responses. Our comprehensive proteomics analysis together with real-time metabolic assays comparing LPS-stimulation of WT and MARCKS knock-out macrophages provided insights into the involvement of MARCKS in specific biological processes including innate immune response, inflammatory response, cytokine production, and molecular functions such as extracellularly ATP-gated cation channel activity, electron transfer activity and oxidoreductase activity, uncovering specific proteins involved in regulating MARCKS activity upon LPS stimulation. MARCKS appears to be a key regulator of inflammation whose inhibition might be beneficial for therapeutic intervention in inflammatory diseases.
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Affiliation(s)
- Jiraphorn Issara-Amphorn
- Functional Cellular Networks Section, Laboratory of Immune System Biology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, 20892-1892, USA
| | - Virginie H Sjoelund
- Functional Cellular Networks Section, Laboratory of Immune System Biology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, 20892-1892, USA
- Barnett Institute, Northeastern University, Boston, MA, 02115, USA
| | - Margery Smelkinson
- Research Technology Branch, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, 20892, USA
| | - Sebastian Montalvo
- Functional Cellular Networks Section, Laboratory of Immune System Biology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, 20892-1892, USA
| | - Sung Hwan Yoon
- Functional Cellular Networks Section, Laboratory of Immune System Biology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, 20892-1892, USA
| | - Nathan P Manes
- Functional Cellular Networks Section, Laboratory of Immune System Biology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, 20892-1892, USA
| | - Aleksandra Nita-Lazar
- Functional Cellular Networks Section, Laboratory of Immune System Biology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, 20892-1892, USA.
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14
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Pascual-García S, Martínez-Peinado P, López-Jaén AB, Navarro-Blasco FJ, Montoyo-Pujol YG, Roche E, Peiró G, Sempere-Ortells JM. Analysis of Novel Immunological Biomarkers Related to Rheumatoid Arthritis Disease Severity. Int J Mol Sci 2023; 24:12351. [PMID: 37569732 PMCID: PMC10418816 DOI: 10.3390/ijms241512351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 07/21/2023] [Accepted: 07/31/2023] [Indexed: 08/13/2023] Open
Abstract
Rheumatoid factor (RF) and anti-citrullinated protein antibodies (ACPAs) are the most frequently used rheumatoid arthritis (RA) diagnostic markers, but they are unable to anticipate the patient's evolution or response to treatment. The aim of this study was to identify possible severity biomarkers to predict an upcoming flare-up or remission period. To address this objective, sera and anticoagulated blood samples were collected from healthy controls (HCs; n = 39) and from early RA (n = 10), flare-up (n = 5), and remission (n = 16) patients. We analyzed leukocyte phenotype markers, regulatory T cells, cell proliferation, and cytokine profiles. Flare-up patients showed increased percentages of cluster of differentiation (CD)3+CD4- lymphocytes (p < 0.01) and granulocytes (p < 0.05) but a decreased natural killer (NK)/T lymphocyte ratio (p < 0.05). Analysis of leukocyte markers by principal component analysis (PCA) and receiver operating characteristic (ROC) curves showed that CD45RO+ (p < 0.0001) and CD45RA+ (p < 0.0001) B lymphocyte expression can discriminate between HCs and early RA patients, while CD3+CD4- lymphocyte percentage (p < 0.0424) and CD45RA+ (p < 0.0424), CD62L+ (p < 0.0284), and CD11a+ (p < 0.0185) B lymphocyte expression can differentiate between flare-up and RA remission subjects. Thus, the combined study of these leukocyte surface markers could have potential as disease severity biomarkers for RA, whose fluctuations could be related to the development of the characteristic pro-inflammatory environment.
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Affiliation(s)
- Sandra Pascual-García
- Department of Biotechnology, University of Alicante, 03690 San Vicente del Raspeig, Spain
| | | | - Ana B. López-Jaén
- Department of Biotechnology, University of Alicante, 03690 San Vicente del Raspeig, Spain
| | - Francisco J. Navarro-Blasco
- Department of Biotechnology, University of Alicante, 03690 San Vicente del Raspeig, Spain
- Rheumatology Unit, University General Hospital of Elche, 03203 Elche, Spain
| | - Yoel G. Montoyo-Pujol
- Medical Oncology Department, Dr. Balmis University General Hospital, Pintor Baeza 12, 03010 Alicante, Spain
- Alicante Institute for Health and Biomedical Research (ISABIAL), Pintor Baeza 12, 03010 Alicante, Spain
| | - Enrique Roche
- Biochemistry and Cell Therapy Unit, Institute of Bioengineering, Miguel Hernandez University of Elche, 03202 Elche, Spain
| | - Gloria Peiró
- Department of Biotechnology, University of Alicante, 03690 San Vicente del Raspeig, Spain
- Alicante Institute for Health and Biomedical Research (ISABIAL), Pintor Baeza 12, 03010 Alicante, Spain
- Pathology Department, Dr. Balmis University General Hospital, Pintor Baeza 12, 03010 Alicante, Spain
| | - José M. Sempere-Ortells
- Department of Biotechnology, University of Alicante, 03690 San Vicente del Raspeig, Spain
- Alicante Institute for Health and Biomedical Research (ISABIAL), Pintor Baeza 12, 03010 Alicante, Spain
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15
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Issara-Amphorn J, Sjoelund V, Smelkinson M, Yoon SH, Manes NP, Nita-Lazar A. Myristoylated, Alanine-rich C-kinase Substrate (MARCKS) regulates Toll-like receptor 4 signaling in macrophages. RESEARCH SQUARE 2023:rs.3.rs-3094036. [PMID: 37790394 PMCID: PMC10543024 DOI: 10.21203/rs.3.rs-3094036/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/05/2023]
Abstract
MARCKS (Myristoylated Alanine-rich C-kinase Substrate) is a membrane protein expressed in many cell types, including macrophages. MARCKS is functionally implicated in cell adhesion, phagocytosis, and inflammation. LPS (lipopolysaccharide) triggers inflammation via TLR4 (Toll-like receptor 4). The presence of MARCKS and the formation of phospho-MARCKS in macrophages have been described, but the role(s) of MARCKS in regulating macrophage functions remain unclear. To investigate the role of MARCKS during inflammation, we activated macrophages using LPS with or without the addition of a PKC inhibitor. We found that PKC inhibition substantially decreased macrophage IL6 and TNF cytokine production. In addition, confocal microscopy revealed that MARCKS and phospho-MARCKS increased localization to endosomes and the Golgi apparatus upon LPS stimulation. CRISPR-CAS9 mediated knockout of MARCKS in macrophages downregulated TNF and IL6 production, suggesting a role for MARCKS in inflammatory responses. Our comprehensive proteomics analysis together with real-time metabolic assays comparing LPS-stimulation of WT and MARCKS knock-out macrophages provided insights into the involvement of MARCKS in specific biological processes and signaling pathways, uncovering specific proteins involved in regulating MARCKS activity upon LPS stimulation. MARCKS appears to be a key regulator of inflammation whose inhibition might be beneficial for therapeutic intervention in inflammatory related diseases.
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16
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Khan YH, Qasim S, Uttra AM, Alotaibi NH, Alanzi AS, Alzarea AI, Alatawi AD, Hussain T. Enalapril attenuated CFA provoked arthritic manifestation by modulating proinflammatory and anti-inflammatory cytokine network. Life Sci 2023; 324:121742. [PMID: 37146938 DOI: 10.1016/j.lfs.2023.121742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 04/10/2023] [Accepted: 04/24/2023] [Indexed: 05/07/2023]
Abstract
Enalapril with documented anti-inflammatory potential was evaluated in current investigation to explore its anti-arthritic efficacy. For anti-arthritic evaluation of enalapril, CFA-instigated arthritic model was employed after which various parameters comprising paw volume, body weight, arthritic index, hematological and biochemical parameters, radiographic analysis and level of various cytokines were estimated. Enalapril demonstrated significant (p˂0.001) anti-arthritic activity by suppressing paw volume, arthritic index while preserved CFA instigated weight loss. Likewise, enalapril also normalized the hematological and biochemical alterations, suppressed the level of proinflammatory cytokines with elevation of anti-inflammatory cytokines. Radiographic and histopathological analysis also further validates the anti-arthritic attribute of enalapril where enalapril preserved the normal architecture of arthritis induced joints. Outcomes of the study pointed out a notable anti-arthritic activity of enalapril. However detailed mechanistic studies are still required to point out the exact mechanism of action.
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Affiliation(s)
- Yusra Habib Khan
- Department of Clinical Pharmacy, College of Pharmacy, Jouf University, Saudi Arabia.
| | - Sumera Qasim
- Department of Pharmacology, College of Pharmacy, Jouf University, Saudi Arabia.
| | - Ambreen Malik Uttra
- Department of Pharmacology, College of Pharmacy, University of Sargodha, Pakistan
| | - Nasser H Alotaibi
- Department of Clinical Pharmacy, College of Pharmacy, Jouf University, Saudi Arabia
| | | | - Abdulaziz I Alzarea
- Department of Clinical Pharmacy, College of Pharmacy, Jouf University, Saudi Arabia
| | - Ahmad D Alatawi
- Department of Clinical Pharmacy, College of Pharmacy, Jouf University, Saudi Arabia
| | - Tauqeer Hussain
- Department of Clinical Pharmacy, College of Pharmacy, Jouf University, Saudi Arabia
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17
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Sebba A, Bingham CO, Bykerk VP, Fiore S, Ford K, Janak JC, Pappas DA, Blachley T, Dave SS, Kremer JM, Yu M, Choy E. Comparative effectiveness of TNF inhibitor vs IL-6 receptor inhibitor as monotherapy or combination therapy with methotrexate in biologic-experienced patients with rheumatoid arthritis: An analysis from the CorEvitas RA Registry. Clin Rheumatol 2023:10.1007/s10067-023-06588-7. [PMID: 37060528 DOI: 10.1007/s10067-023-06588-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 02/22/2023] [Accepted: 03/24/2023] [Indexed: 04/16/2023]
Abstract
OBJECTIVE Randomized controlled trials (RCTs) in biologic-naïve rheumatoid arthritis (RA) patients with high disease activity and inadequate response/intolerance to methotrexate have shown interleukin-6 (IL-6) receptor inhibitors (IL-6Ri) to be superior to tumor necrosis factor inhibitors (TNFi) as monotherapy. This observational study aimed to compare the effectiveness of TNFi vs IL-6Ri as mono- or combination therapy in biologic/targeted synthetic (b/ts) -experienced RA patients with moderate/high disease activity. METHODS Eligible b/ts-experienced patients from the CorEvitas RA registry were categorized as TNFi and IL-6Ri initiators, with subgroups initiating as mono- or combination therapy. Mixed-effects regression models evaluated the impact of treatment on Clinical Disease Activity Index (CDAI), patient-reported outcomes, and disproportionate pain (DP). Unadjusted and covariate-adjusted effects were reported. RESULTS Patients initiating IL-6Ri (n = 286) vs TNFi monotherapy (n = 737) were older, had a longer RA history and higher baseline CDAI, and were more likely to initiate as third-line therapy; IL-6Ri (n = 401) vs TNFi (n = 1315) combination therapy initiators had higher baseline CDAI and were more likely to initiate as third-line therapy. No significant differences were noted in the outcomes between TNFi and IL-6Ri initiators (as mono- or combination therapy). CONCLUSION This observational study showed no significant differences in outcomes among b/ts-experienced TNFi vs IL-6Ri initiators, as either mono- or combination therapy. These findings were in contrast with the previous RCTs in biologic-naïve patients and could be explained by the differences in the patient characteristics included in this study. Further studies are needed to help understand the reasons for this discrepancy in the real-world b/ts-experienced population.
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Affiliation(s)
- Anthony Sebba
- Rheumatology, Arthritis Associates, Palm Harbor, FL, USA.
| | - Clifton O Bingham
- Division of Rheumatology, Johns Hopkins University, Baltimore, MD, USA
| | - Vivian P Bykerk
- Inflammatory Arthritis Center, Hospital for Special Surgery, New York, NY, USA
| | | | - Kerri Ford
- Medical Affairs, Sanofi, Cambridge, MA, USA
| | | | - Dimitrios A Pappas
- CorEvitas, LLC, Waltham, MA, USA
- Division of Rheumatology, Columbia University, New York, NY, USA
| | | | | | - Joel M Kremer
- CorEvitas, LLC, Waltham, MA, USA
- Department of Medicine, Center for Rheumatology, Albany Medical College, Albany, NY, USA
| | - Miao Yu
- CorEvitas, LLC, Waltham, MA, USA
| | - Ernest Choy
- CREATE Centre, Division of Infection and Immunity, Cardiff University, Wales, UK
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18
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Almusalami EM, Lockett A, Ferro A, Posner J. Serum amyloid A—A potential therapeutic target for hyper-inflammatory syndrome associated with COVID-19. Front Med (Lausanne) 2023; 10:1135695. [PMID: 37007776 PMCID: PMC10060655 DOI: 10.3389/fmed.2023.1135695] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2023] [Accepted: 02/24/2023] [Indexed: 03/18/2023] Open
Abstract
Serum amyloid-A (SAA) is associated with inflammatory disorders such as rheumatoid arthritis, Familial Mediterranean Fever, sarcoidosis, and vasculitis. There is accumulating evidence that SAA is a reliable biomarker for these autoinflammatory and rheumatic diseases and may contribute to their pathophysiology. Hyperinflammatory syndrome associated with COVID-19 is a complex interaction between infection and autoimmunity and elevation of SAA is strongly correlated with severity of the inflammation. In this review we highlight the involvement of SAA in these different inflammatory conditions, consider its potential role and discuss whether it could be a potential target for treatment of the hyperinflammatory state of COVID-19 with many potential advantages and fewer adverse effects. Additional studies linking SAA to the pathophysiology of COVID-19 hyper-inflammation and autoimmunity are needed to establish the causal relationship and the therapeutic potential of inhibitors of SAA activity.
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Affiliation(s)
- Eman M. Almusalami
- Centre for Pharmaceutical Medicine Research, King’s College London, London, United Kingdom
- *Correspondence: Eman M. Almusalami,
| | - Anthony Lockett
- Centre for Pharmaceutical Medicine Research, King’s College London, London, United Kingdom
| | - Albert Ferro
- Centre for Pharmaceutical Medicine Research, King’s College London, London, United Kingdom
- School of Cardiovascular and Metabolic Medicine and Sciences, British Heart Foundation Centre for Research Excellence, King’s College London, London, United Kingdom
| | - John Posner
- Centre for Pharmaceutical Medicine Research, King’s College London, London, United Kingdom
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19
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Gandhi SR, Gandhi GR, Antony PJ, Hillary VE, Ceasar SA, Hariharan G, Liu Y, Gurgel RQ, Quintans JDSS, Quintans-Júnior LJ. Health functions and related molecular mechanisms of Miconia genus: A systematic review. Heliyon 2023; 9:e14609. [PMID: 36967930 PMCID: PMC10036935 DOI: 10.1016/j.heliyon.2023.e14609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Revised: 03/02/2023] [Accepted: 03/13/2023] [Indexed: 03/17/2023] Open
Abstract
The Miconia genus is traditionally used in folk medicine in Brazil and other tropical American countries and is represented by 282 species in this region. It is a multifaceted genus of medicinal plants widely used to treat rheumatoid arthritis (RA), pain, inflammatory diseases, and many more therapeutic applications. In the present study, we systematically identify and discuss the literature on in vivo and in vitro studies focusing on the therapeutic potentials and related molecular mechanisms of the Miconia genus. The review also assessed phytochemicals and their pharmacological properties and considered safety concerns related to the genus. Literature searches to identify studies on the Miconia genus were carried out through four main electronic databases, namely PubMed, Embase, Scopus, and Web of Science limited to Medical Subjects Headings (MeSH) and Descriptores en Ciencias de la Salud (DCS) (Health Sciences Descriptors) to identify studies published up to December 2022. The relevant information about the genus was gathered using the keywords 'Miconia', 'biological activities', 'therapeutic mechanisms', 'animal model, 'cell-line model', 'antinociceptive', 'hyperalgesia', 'anti-inflammatory', and 'inflammation'. The therapeutic potentials and mechanisms of action of 14 species from genus Miconia were examined in 18 in vitro studies and included their anti-inflammatory, anticancer, analgesic, antibacterial, cytotoxic, mutagenic, antioxidant, anti-leishmanial, antinociceptive, schistosomicidal, and anti-osteoarthritis potentials, and in eight in vivo studies, assessing their analgesic, antioxidant, antinociceptive, and anti-osteoarthritis activities. Some of the main related molecular mechanisms identified are the modulation of cytokines such as IL-1β, IL-6, and TNF-α, as well as the inhibition of inflammatory mediators and prostaglandin synthesis. The limited number of studies showed that commonly available species from the genus Miconia are safe for consumption. Miconia albicans Sw.Triana and Miconia rubiginosa (Bonpl.) DC was the most frequently used species and showed significant efficacy and potential for developing safe drugs to treat pain and inflammation.
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20
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Fonseca Peixoto R, Ewerton Maia Rodrigues C, Henrique de Sousa Palmeira P, Cézar Comberlang Queiroz Davis Dos Santos F, Keesen de Souza Lima T, de Sousa Braz A. Immune hallmarks of rheumatoid arthritis management: A brief review. Cytokine 2022; 158:156007. [PMID: 35985174 DOI: 10.1016/j.cyto.2022.156007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Revised: 07/31/2022] [Accepted: 08/08/2022] [Indexed: 11/17/2022]
Abstract
The purpose of this review was to examine current evidence on immunomodulation mediated by conventional drugs and the use of novel biological agents for the treatment of rheumatoid arthritis (RA). Currently, treatment is focused on maximizing quality of life through sustained clinical remission and/or attenuating disease activity. To do so, disease-modifying antirheumatic drugs, especially methotrexate, are used alone or in combination with other drugs, including leflunomide, biological disease-modifying antirheumatic drugs (bDMARDs) and targeted synthetic disease-modifying antirheumatic drugs (tsDMARDs). The most recent strategies modulate the immune response of the individual RA patient using tsDMARDs such as JAK inhibitors and bDMARDs such as ig-CTLA-4, anti- IL6R, anti-TNF-α and anti-CD20. To better understand current immunopharmacological interventions, we also looked at documented mechanisms of RA-mediated immunomodulation, highlighting perspectives potentially boosting RA treatment.
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Affiliation(s)
- Rephany Fonseca Peixoto
- Laboratory of Immunology of Infectious Diseases, Department of Cellular and Molecular Biology, Federal University of Paraiba, João Pessoa, Paraíba 58051-900, Brazil
| | - Carlos Ewerton Maia Rodrigues
- Post‑Graduate Program in Medical Sciences, Medical School, University of Fortaleza (Unifor), Fortaleza, Brazil; Department of Internal Medicine, Federal University of Ceará, Brazil.
| | - Pedro Henrique de Sousa Palmeira
- Laboratory of Immunology of Infectious Diseases, Department of Cellular and Molecular Biology, Federal University of Paraiba, João Pessoa, Paraíba 58051-900, Brazil
| | | | - Tatjana Keesen de Souza Lima
- Laboratory of Immunology of Infectious Diseases, Department of Cellular and Molecular Biology, Federal University of Paraiba, João Pessoa, Paraíba 58051-900, Brazil
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Paradoxical Duel Role of Collagen in Rheumatoid Arthritis: Cause of Inflammation and Treatment. Bioengineering (Basel) 2022; 9:bioengineering9070321. [PMID: 35877372 PMCID: PMC9311863 DOI: 10.3390/bioengineering9070321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 07/06/2022] [Accepted: 07/11/2022] [Indexed: 11/17/2022] Open
Abstract
In biology, collagen-biomaterial regulates several signaling mechanisms of bone and immune cells involved in tissue repair and any imbalance in collagen turnover may affect the homeostasis of cells, becoming a major cause of several complications. In this case, the administration of oral collagen may play a potential role in returning cells to their normal function. For several decades, the beneficial effects of collagen have been explored widely, and thus many commercial products are available in cosmetics, food, and biomedical fields. For instance, collagen-based-products have been widely used to treat the complications of cartilage-related-disorders. Many researchers are reporting the anti-arthritogenic properties of collagen-based materials. In contrast, collagen, especially type-II collagen (CII), has been widely used to induce arthritis by immunization in an animal-model with or without adjuvants, and the potentially immunogenic-properties of collagen have been continuously reported for a long time. Additionally, the immune tolerance of collagen is mainly regulated by the T-lymphocytes and B-cells. This controversial hypothesis is getting more and more evidence nowadays from both sides to support its mechanism. Therefore, this review links the gap between the arthritogenic and anti-arthritogenic effects of collagen and explored the actual mechanism to understand the fundamental concept of collagen in arthritis. Accordingly, this review opens-up several unrevealed scientific knots of collagen and arthritis and helps the researchers understand the potential use of collagen in therapeutic applications.
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Fattah SA, Abdel Fattah MA, Mesbah NM, Saleh SM, Abo-Elmatty DM, Mehanna ET. The expression of zinc finger 804a (ZNF804a) and cyclin-dependent kinase 1 (CDK1) genes is related to the pathogenesis of rheumatoid arthritis. Arch Physiol Biochem 2022; 128:688-693. [PMID: 31994908 DOI: 10.1080/13813455.2020.1716810] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
CONTEXT ZNF804a and CDK1 genes code for proteins involved in inflammatory pathways. OBJECTIVE This study aimed to investigate the correlation of ZNF804a and CDK1 expression profiles in RA with the activity and the severity of the disease and to assess their association with inflammatory reactions in the Egyptian RA patients. METHODS ZNF804a and CDK1 expression profiles were assessed using quantitative PCR (qRT-PCR). Clinical and laboratory parameters were evaluated. RESULTS ZNF804a expression was down-regulated by 0.177-fold while CDK1 expression was up-regulated to 3.29-fold in RA patients compared with healthy controls (p < .001). ZNF804a down-regulation was negatively correlated with CRP, RF, disease activity score of 28 joints (DAS) using CRP (DAS-CRP) and TNF-α. CDK1 overexpression was correlated with IFN-1 and ACPA in RA patients. CONCLUSION ZNF804a and CDK1 genes are implicated in RA pathogenesis due to their influences on TNF-α and IFN-1 which contribute to inflammation in RA patients.
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Affiliation(s)
- Shaimaa A Fattah
- Department of Biochemistry, Faculty of Pharmacy, Suez Canal University, Ismailia, Egypt
| | - Maha A Abdel Fattah
- Department of Physical Medicine, Rheumatology and Rehabilitation, Faculty of Medicine, Suez Canal University, Ismailia, Egypt
| | - Noha M Mesbah
- Department of Biochemistry, Faculty of Pharmacy, Suez Canal University, Ismailia, Egypt
| | - Samy M Saleh
- Department of Biochemistry, Faculty of Pharmacy, Suez Canal University, Ismailia, Egypt
| | - Dina M Abo-Elmatty
- Department of Biochemistry, Faculty of Pharmacy, Suez Canal University, Ismailia, Egypt
| | - Eman T Mehanna
- Department of Biochemistry, Faculty of Pharmacy, Suez Canal University, Ismailia, Egypt
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Srivastava S, Rasool M. Underpinning IL-6 biology and emphasizing selective JAK blockade as the potential alternate therapeutic intervention for rheumatoid arthritis. Life Sci 2022; 298:120516. [DOI: 10.1016/j.lfs.2022.120516] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 03/08/2022] [Accepted: 03/25/2022] [Indexed: 02/07/2023]
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MicroRNAs (miRNAs) in Cardiovascular Complications of Rheumatoid Arthritis (RA): What Is New? Int J Mol Sci 2022; 23:ijms23095254. [PMID: 35563643 PMCID: PMC9101033 DOI: 10.3390/ijms23095254] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 05/04/2022] [Accepted: 05/06/2022] [Indexed: 02/08/2023] Open
Abstract
Rheumatoid Arthritis (RA) is among the most prevalent and impactful rheumatologic chronic autoimmune diseases (AIDs) worldwide. Within a framework that recognizes both immunological activation and inflammatory pathways, the exact cause of RA remains unclear. It seems however, that RA is initiated by a combination between genetic susceptibility, and environmental triggers, which result in an auto-perpetuating process. The subsequently, systemic inflammation associated with RA is linked with a variety of extra-articular comorbidities, including cardiovascular disease (CVD), resulting in increased mortality and morbidity. Hitherto, vast evidence demonstrated the key role of non-coding RNAs such as microRNAs (miRNAs) in RA, and in RA-CVD related complications. In this descriptive review, we aim to highlight the specific role of miRNAs in autoimmune processes, explicitly on their regulatory roles in the pathogenesis of RA, and its CV consequences, their main role as novel biomarkers, and their possible role as therapeutic targets.
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Mohamed HI, El-Kamel AH, Hammad GO, Heikal LA. Design of Targeted Flurbiprofen Biomimetic Nanoparticles for Management of Arthritis: In Vitro and In Vivo Appraisal. Pharmaceutics 2022; 14:140. [PMID: 35057036 PMCID: PMC8778214 DOI: 10.3390/pharmaceutics14010140] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 12/30/2021] [Accepted: 01/04/2022] [Indexed: 12/04/2022] Open
Abstract
Flurbiprofen (FLUR) is a potent non-steroidal anti-inflammatory drug used for the management of arthritis. Unfortunately, its therapeutic effect is limited by its rapid clearance from the joints following intra-articular injection. To improve its therapeutic efficacy, hyaluronic acid-coated bovine serum albumin nanoparticles (HA-BSA NPs) were formulated and loaded with FLUR to achieve active drug targeting. NPs were prepared by a modified nano-emulsification technique and their HA coating was proven via turbidimetric assay. Physicochemical characterization of the selected HA-BSA NPs revealed entrapment efficiency of 90.12 ± 1.06%, particle size of 257.12 ± 2.54 nm, PDI of 0.25 ± 0.01, and zeta potential of -48 ± 3 mv. The selected formulation showed in-vitro extended-release profile up to 6 days. In-vivo studies on adjuvant-induced arthritis rat model exhibited a significant reduction in joint swelling after intra-articular administration of FLUR-loaded HA-BSA NPs. Additionally, there was a significant reduction in CRP level in blood as well as TNF-α, and IL-6 levels in serum and joint tissues. Immunohistochemical study indicated a significant decrease in iNOS level in joint tissues. Histopathological analysis confirmed the safety of FLUR-loaded HA-BSA NPs. Thus, our results reveal that FLUR loaded HA-BSA NPs have a promising therapeutic effect in the management of arthritis.
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Affiliation(s)
- Hagar I. Mohamed
- Department of Pharmaceutics, Faculty of Pharmacy, Alexandria University, Alexandria 21521, Egypt; (H.I.M.); (L.A.H.)
| | - Amal H. El-Kamel
- Department of Pharmaceutics, Faculty of Pharmacy, Alexandria University, Alexandria 21521, Egypt; (H.I.M.); (L.A.H.)
| | - Ghada O. Hammad
- Department of Pharmacology & Therapeutics, Faculty of Pharmacy, Pharos University in Alexandria, Alexandria 21526, Egypt;
| | - Lamia A. Heikal
- Department of Pharmaceutics, Faculty of Pharmacy, Alexandria University, Alexandria 21521, Egypt; (H.I.M.); (L.A.H.)
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Medhat E, Ayeldeen G, Hosni Ahmed H, Shaker O, Gheita T, Salama Ashour S. HOTAIR and THRIL Long Non Coding RNAs and Their Target Genes in Rheumatoid Arthritis patients. Rep Biochem Mol Biol 2022; 10:614-621. [PMID: 35291607 PMCID: PMC8903355 DOI: 10.52547/rbmb.10.4.697] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Accepted: 10/24/2021] [Indexed: 05/20/2023]
Abstract
BACKGROUND Rheumatoid arthtritis (RA) is a chronic systemic inflammatory autoimmune disease characterized by irreversible joint damage and deformity. The aim of this study is to investigate THRIL and HOTAIR serum expression and their target genes in Egyptian RA patients and to evaluate their relationship to the clinico-pathological data. METHODS The present study included fifty-two RA patients and fifty-six healthy controls. RA patients were classified according to DAS28 score. All subjects were subjected to full history taking and clinical examination. Quantitative real time PCR was done to estimate the expression levels of serum THRIL and HOTAIR as well as their target genes tumor necrosis factor alpha (TNF-α) and metalloproteinase 2 (MMP-2) were estimated by ELISA techniques. RESULTS Results revealed that both THRIL and HOTAIR were statistically over expressed in RA patients compared to healthy group with p-value< 0.05. Results showed as well that the target genes for those long-non coding RNAs, TNF-α and MMP-2, were also significantly higher in RA patients compared to healthy controls. CONCLUSION Both THRIL and HOTAIR associated with their target genes, can be considered as diagnostic markers for RA.
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Affiliation(s)
- Engy Medhat
- Medical Biochemistry and Molecular Biology Department, Faculty of Medicine, Cairo University.
- Corresponding author: Engy Medhat; Tel: 002 01002975847; E-mail:
| | - Ghada Ayeldeen
- Medical Biochemistry and Molecular Biology Department, Faculty of Medicine, Cairo University.
| | - Hanan Hosni Ahmed
- Medical Biochemistry and Molecular Biology Department, Faculty of Medicine, Cairo University.
| | - Olfat Shaker
- Medical Biochemistry and Molecular Biology Department, Faculty of Medicine, Cairo University.
| | - Tamer Gheita
- Rheumatology Department, Faculty of Medicine, Cairo University.
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Ahmed S, Jacob B, Carsons SE, De Leon J, Reiss AB. Treatment of Cardiovascular Disease in Rheumatoid Arthritis: A Complex Challenge with Increased Atherosclerotic Risk. Pharmaceuticals (Basel) 2021; 15:ph15010011. [PMID: 35056068 PMCID: PMC8778152 DOI: 10.3390/ph15010011] [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: 10/12/2021] [Revised: 12/13/2021] [Accepted: 12/17/2021] [Indexed: 12/24/2022] Open
Abstract
Rheumatoid arthritis (RA) carries significant risk for atherosclerotic cardiovascular disease (ASCVD). Traditional ASCVD risk factors fail to account for this accelerated atherosclerosis. Shared inflammatory pathways are fundamental in the pathogenesis of both diseases. Considering the impact of RA in increasing cardiovascular morbidity and mortality, the characterization of therapies encompassing both RA and ASCVD management merit high priority. Despite little progress, several drugs discussed here promote remission and or lower rheumatoid disease activity while simultaneously conferring some level of atheroprotection. Methotrexate, a widely used disease-modifying drug used in RA, is associated with significant reduction in cardiovascular adverse events. MTX promotes cholesterol efflux from macrophages, upregulates free radical scavenging and improves endothelial function. Likewise, the sulfonamide drug sulfasalazine positively impacts the lipid profile by increasing HDL-C, and its use in RA has been correlated with reduced risk of myocardial infraction. In the biologic class, inhibitors of TNF-α and IL-6 contribute to improvements in endothelial function and promote anti-atherogenic properties of HDL-C, respectively. The immunosuppressant hydroxychloroquine positively affects insulin sensitization and the lipid profile. While no individual therapy has elicited optimal atheroprotection, further investigation of combination therapies are ongoing.
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Nada D, Gaber R, Mahmoud AS, Elkhouly R, Alashkar D. Hyperuricemia Among Egyptian Rheumatoid Arthritis Patients. Is It an Association or an Inflammatory Marker? A Cross-Sectional Observational Study. Open Access Rheumatol 2021; 13:305-314. [PMID: 34675698 PMCID: PMC8502065 DOI: 10.2147/oarrr.s331488] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Accepted: 09/21/2021] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVE To detect the prevalence of hyperuricemia in Egyptian rheumatoid arthritis (RA) patients as well as to assess its association with the severity of joint inflammation and disease-modifying antirheumatic drugs (DMARDs) in those patients. METHODS A total of 150 RA patients were recruited; all patients were subjected to (1) clinical and functional assessment by disease activity score in 28 joints (DAS28) and modified health assessment questionnaire (MHAQ). (2) Laboratory investigations: serum uric acid (SUA) level, complete blood count (CBC), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), rheumatoid factor (RF), anti-cyclic citrullinated peptide (anti-CCP), tumor necrosis factor α (TNF-α), interleukin 1 (IL1), and interleukin 6 (IL6) levels. (3) Radiological evaluation: (A) plain X-ray of both hands and feet; (B) musculoskeletal ultrasound (MSUS) of both wrists, hands, shoulder, ankle, and knee joints. RESULTS SUA was significantly correlated with disease activity by DAS28. Acute-phase reactants and inflammatory markers (IL1β, IL6, and TNF-α) were also significantly elevated in RA patients with low and high hyperuricemia compared to those with normal SUA. A total of 90% of RA patients with low hyperuricemia had synovial proliferation with power Doppler (1+ and 2+), and 30 patients had mild effusion (1+), while nearly all patients with high hyperuricemia had hypoechoic synovial proliferation (2+ and 3+), and 20 patients had moderate effusion. However, 70% RA patients with normal serum uric acid showed mild synovitis and effusion (1+). No significant association was found between the administered DMARDs and levels of SUA as well as inflammatory markers; however, high-dose steroid treatment was associated with high SUA level. CONCLUSION Elevation of serum uric acid levels in Egyptian RA patients was prevalent and might be an inflammatory marker for severity of joint inflammation. Moreover, higher doses of steroids could be considered a cause of hyperuricemia.
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Affiliation(s)
- Doaa Nada
- Rheumatology and Rehabilitation Department, Faculty of Medicine, Tanta University, Tanta, Al Gharbeia Governorate, Egypt
| | - Rasha Gaber
- Medical Biochemistry Department, Faculty of Medicine, Tanta University, Tanta, Al Gharbeia Governorate, Egypt
| | - Al Shymaa Mahmoud
- Radiology Departments, Faculty of Medicine, Tanta University, Tanta, Al Gharbeia Governorate, Egypt
| | - Radwa Elkhouly
- Rheumatology and Rehabilitation Department, Faculty of Medicine, Tanta University, Tanta, Al Gharbeia Governorate, Egypt
| | - Doaa Alashkar
- Rheumatology and Rehabilitation Department, Faculty of Medicine, Tanta University, Tanta, Al Gharbeia Governorate, Egypt
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Bone-sparing effects of rituximab and body composition analysis in a cohort of postmenopausal women affected by rheumatoid arthritis - retrospective study. Reumatologia 2021; 59:206-210. [PMID: 34538950 PMCID: PMC8436793 DOI: 10.5114/reum.2021.108430] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Accepted: 08/06/2021] [Indexed: 12/04/2022] Open
Abstract
Objective Osteoporosis is the most common bone tissue disease and it is characterized by a reduced bone mineral density (BMD). The main physiopathological mechanisms converge on the uncoupling between bone formation and resorption, thus leading to an enhanced risk of fractures. Several papers have documented the inverse relationships linking high inflammatory cytokines, anti-citrullinated protein antibodies, rheumatoid factor, and BMD in rheumatoid arthritis (RA). Rituximab (RTX) is a chimeric monoclonal antibody directed against the CD20 receptor of B cells. Since the Food and Drug Administration approved it for RA in 2006, there have been many clinical experiences regarding its use. Nevertheless, few studies evaluate the effect of rituximab on BMD. RA is a disease characterized by immune dysfunction with high levels of inflammatory cytokines, autoantibodies, and it is reasonable that a B cell depleting therapy could restore a physiological cytokine balance, thus exerting an osteoprotective effect on the bone tissue. The purpose of this paper is to highlight any difference in BMD and to assess differences in body composition over a retrospective 18-month follow-up period after RTX treatment with a B cell depleting therapy. Material and methods We analyzed by dual energy X-ray absorptiometry BMD expressed as g/cm2 and body composition modifications over 18 months with RTX treatment of 20 postmenopausal RA patients. Results After eighteen months of therapy with RTX, a statistically significant increase in vertebral (L1–L4) BMD and the stability of femoral BMD were documented. Conclusions Rituximab is associated with an improvement of vertebral and preservation of femoral BMD, suggesting a bone-sparing effect due to B cell depletion. Furthermore, patients displayed a redistribution of fat masses toward the hip region.
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Liu Y, Fu H, Zuo L. Anti-inflammatory activities of a new VEGF blocker, Conbercept. Immunopharmacol Immunotoxicol 2021; 43:594-598. [PMID: 34402367 DOI: 10.1080/08923973.2021.1959608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Angiogenesis and inflammation exhibit a mutually reinforcing relationship in many human diseases. Vascular endothelial growth factor (VEGF) is one of the most important proangiogenic mediators. Conbercept is a novel VEGF inhibitor. METHOD Type II collagen-induced rat rheumatoid arthritis (CIA) model was established to evaluate the anti-chronic inflammation activities of Conbercept. ELISA was used to measure the concentrations of immune factors in the blood of arthritis rats. The xylene-induced ear edema was conducted to evaluate the effect of Conbercept on acute inflammation. RESULT AND DISCUSSION Our results showed that Conbercept significantly reduced the paw edema volume and the arthritis index in CIA rats. Furthermore, we found that Conbercept decreased the serum levels of vascular endothelial growth factor (VEGF), tumor necrosis factor-α (TNF-α), and interleukin-6 (IL-6) in CIA rats. Xylene-induced ear edema is a widely used method to study acute inflammation. Conbercept significantly inhibited xylene-induced ear edema. CONCLUSION All results indicate that Conbercept exhibits significant inhibition of acute and chronic inflammation.
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Affiliation(s)
- Yang Liu
- Department of Immunology, Guizhou Medical University, Guiyang, China.,Department of Anesthesiology, The Affiliated Hospital of Guizhou Medical University, Guiyang, China
| | - Hua Fu
- Department of Gastroenterology, The Affiliated Hospital of Guizhou Medical University, Guiyang, China
| | - Li Zuo
- Department of Immunology, Guizhou Medical University, Guiyang, China
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Nichols BE, Hook JS, Weng K, Ahn C, Moreland JG. Novel neutrophil phenotypic signature in pediatric patients with type 1 diabetes and diabetic ketoacidosis. J Leukoc Biol 2021; 111:849-856. [PMID: 34342036 DOI: 10.1002/jlb.3a1220-826r] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Type 1 diabetes (T1D) is a chronic inflammatory condition sometimes complicated by acute diabetic ketoacidosis (DKA). A subset of patients with T1D develop DKA independent of known risk factors. This study tested the hypothesis that circulating polymorphonuclear leukocytes (PMN) from children with T1D and DKA would exhibit a primed phenotype and that the signature would be unique in patients predisposed to have DKA. Using a prospective cohort study design, neutrophil phenotype was assessed in 30 patients with T1D seen in endocrinology clinic for routine care, 30 patients with acute DKA, and 36 healthy donors. Circulating PMN from patients with DKA display a primed phenotype with increased basal cell-surface CD11b, L-selectin shedding, and enhanced fMLF-elicited reactive oxygen species (ROS) production. Moreover, PMN from T1D patients both with and without DKA lack the capacity to be further primed by incubation with TNF-α, a classic priming stimulus. Primed PMN phenotypic signatures demonstrated are independent of hemoglobin A1c, the premier biological marker for DKA risk, and are consistent with a hyperinflammatory state. A single nucleotide polymorphism in TLR-1 (1805G>T), known to be associated with a hyperinflammatory PMN phenotype, correlated with DKA. This study elucidated a novel phenotypic signature in circulating PMN from children with T1D with and without DKA, and suggests the possibility of a previously unrecognized PMN phenotype with potential clinical implications. Immunophenotype and genotype may be applicable as biomarkers for DKA risk stratification in patients with T1D.
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Affiliation(s)
- Blake E Nichols
- Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Jessica S Hook
- Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Kayson Weng
- Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Chul Ahn
- Department of Population and Data Sciences, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Jessica G Moreland
- Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, Texas, USA.,Department of Microbiology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
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Sun S, Du Y, Li S, Gao B, Xia R, Cao W, Zhang C, Zhu E. Anti-inflammatory activity of different isolated sites of Chloranthus serratus in complete Freund's adjuvant-induced arthritic rats. Exp Ther Med 2021; 22:848. [PMID: 34149894 PMCID: PMC8210295 DOI: 10.3892/etm.2021.10280] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Accepted: 05/05/2021] [Indexed: 12/15/2022] Open
Abstract
Chloranthus serratus is a traditional Chinese medicine for treating arthritis and bruises. The aim of the present study was to investigate the anti-arthritic activities and possible associated mechanisms of different isolated sites of Chloranthus serratus (DISC) in adjuvant-induced arthritis (AA) rats. The therapeutic effects of the extracts were assessed through changes in body weights, swelling rates, arthritis indexes (AI) and organ indexes. The levels of nitric oxide (NO), malondialdehyde and superoxide dismutase were determined using one-step method, TBA method and hydroxylamine method, respectively; the levels of TNF-α, IL-1β, IL-6, prostaglandin E2, macrophage inhibitor factor-1, VEGF, immunoglobulin (Ig) G, IgM and IFN-γ in serum were determined using ELISA. Pathological changes and positive expression of VEGF in the ankle joints were investigated using hematoxylin-eosin staining and immunohistochemical staining, respectively. DISC treatment increased the weight gains and thymus indexes, and decreased the swelling rates, spleen indexes and AI in AA rats. The water isolated site (WA) and ethyl acetate isolated site (EA) significantly reversed complete Freund's adjuvant (CFA)-induced changes in the levels of NO, IL-6, TNF-α, IgG and IFN-γ, while the n-butanol isolated site (NB) only reversed the changes in IL-6 and IgG contents. Some changes in the chloroform isolated site group showed the same trend as those in the model group. The extracts relieved synovial hyperplasia, inflammatory cell infiltration and articular surface defects, and reduced the positive expression rate of VEGF in the synovial tissues of the AA rats to varying degrees. The WA exhibited the most marked effects, followed by the EA and NB, indicating that WA had optimal therapeutic effects on CFA-induced arthritic rats, which may be mediated by the oxidative stress and inhibition of inflammatory factors. C. serratus may serve as a potential candidate for the treatment of rheumatoid arthritis.
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Affiliation(s)
- Shuping Sun
- Pharmacy Teaching and Research Department, College of Pharmacy, Wannan Medical College, Wuhu, Anhui 241002, P.R. China
- Institute of Natural Daily Chemistry, Wannan Medical College, Wuhu, Anhui 241002, P.R. China
| | - Yunyan Du
- Pharmacy Teaching and Research Department, College of Pharmacy, Wannan Medical College, Wuhu, Anhui 241002, P.R. China
| | - Shengli Li
- The Third Orthopedics Department, The Fifth People's Hospital of Wuhu, Wuhu, Anhui 241000, P.R. China
| | - Bianbian Gao
- Pharmacy Teaching and Research Department, College of Pharmacy, Wannan Medical College, Wuhu, Anhui 241002, P.R. China
| | - Rongping Xia
- Pharmacy Teaching and Research Department, College of Pharmacy, Wannan Medical College, Wuhu, Anhui 241002, P.R. China
| | - Wenjing Cao
- Pharmacy Teaching and Research Department, College of Pharmacy, Wannan Medical College, Wuhu, Anhui 241002, P.R. China
| | - Chao Zhang
- Pharmacy Teaching and Research Department, College of Pharmacy, Wannan Medical College, Wuhu, Anhui 241002, P.R. China
| | - Enze Zhu
- Pharmacy Teaching and Research Department, College of Pharmacy, Wannan Medical College, Wuhu, Anhui 241002, P.R. China
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Bhagavatham SKS, Khanchandani P, Kannan V, Potikuri D, Sridharan D, Pulukool SK, Naik AA, Dandamudi RB, Divi SM, Pargaonkar A, Ray R, Santha SSR, Seshagiri PB, Narasimhan K, Gumdal N, Sivaramakrishnan V. Adenosine deaminase modulates metabolic remodeling and orchestrates joint destruction in rheumatoid arthritis. Sci Rep 2021; 11:15129. [PMID: 34301999 PMCID: PMC8302689 DOI: 10.1038/s41598-021-94607-5] [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: 02/14/2021] [Accepted: 07/14/2021] [Indexed: 02/07/2023] Open
Abstract
Rheumatoid Arthritis (RA) is a chronic autoimmune disease associated with inflammation and joint remodeling. Adenosine deaminase (ADA), a risk factor in RA, degrades adenosine, an anti-inflammatory molecule, resulting in an inflammatory bias. We present an integrative analysis of clinical data, cytokines, serum metabolomics in RA patients and mechanistic studies on ADA-mediated effects on in vitro cell culture models. ADA activity differentiated patients into low and high ADA sets. The levels of the cytokines TNFα, IFNγ, IL-10, TGFβ and sRANKL were elevated in RA and more pronounced in high ADA sets. Serum metabolomic analysis shows altered metabolic pathways in RA which were distinct between low and high ADA sets. Comparative analysis with previous studies shows similar pathways are modulated by DMARDs and biologics. Random forest analysis distinguished RA from control by methyl-histidine and hydroxyisocaproic acid, while hexose-phosphate and fructose-6-phosphate distinguished high ADA from low ADA. The deregulated metabolic pathways of High ADA datasets significantly overlapped with high ADA expressing PBMCs GEO transcriptomics dataset. ADA induced the death of chondrocytes, synoviocyte proliferation, both inflammation in macrophages and their differentiation into osteoclasts and impaired differentiation of mesenchymal stem cells to osteoblasts and mineralization. PBMCs expressing elevated ADA had increased expression of cytokines and P2 receptors compared to synovial macrophages which has low expression of ADA. Our data demonstrates increased cytokine levels and distinct metabolic signatures of RA based on the ADA activity, suggests an important role for ADA in the pathophysiology of RA joints and as a potential marker and therapeutic target in RA patients.
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Affiliation(s)
- Sai Krishna Srimadh Bhagavatham
- grid.444651.60000 0004 0496 6988Disease Biology Lab, Department of Biosciences, Sri Sathya Sai Institute of Higher Learning, Puttaparthi, 515134 India
| | - Prakash Khanchandani
- grid.496668.30000 0004 1767 3076Department of Orthopedics, Sri Sathya Sai Institute of Higher Medical Sciences, PG, Puttaparthi, 515134 India
| | - Vishnu Kannan
- grid.444651.60000 0004 0496 6988Disease Biology Lab, Department of Biosciences, Sri Sathya Sai Institute of Higher Learning, Puttaparthi, 515134 India ,grid.411552.60000 0004 1766 4022Present Address: Department of Botany/Biotechnology, CMS College, Kottayam, 686001 India
| | | | - Divya Sridharan
- grid.34980.360000 0001 0482 5067Molecular Reproduction and Developmental Genetics, Indian Institute of Science, Bengaluru, 560012 India
| | - Sujith Kumar Pulukool
- grid.444651.60000 0004 0496 6988Disease Biology Lab, Department of Biosciences, Sri Sathya Sai Institute of Higher Learning, Puttaparthi, 515134 India
| | - Ashwin Ashok Naik
- grid.444651.60000 0004 0496 6988Disease Biology Lab, Department of Biosciences, Sri Sathya Sai Institute of Higher Learning, Puttaparthi, 515134 India
| | - Rajesh Babu Dandamudi
- grid.444651.60000 0004 0496 6988Department of Chemistry, Sri Sathya Sai Institute of Higher Learning, Prasanthi Nilayam, India ,Present Address: Phenomenex India, Hyderabad, Telangana 500084 India
| | - Sai Mangala Divi
- grid.496668.30000 0004 1767 3076Department of Biochemistry, Sri Sathya Sai Institute of Higher Medical Sciences, PG, Puttaparthi, 515134 India
| | - Ashish Pargaonkar
- grid.464737.50000 0004 1775 153XAgilent Technologies India Pvt Ltd, Bengaluru, 560048 India
| | - Rahul Ray
- grid.496668.30000 0004 1767 3076Department of Orthopedics, Sri Sathya Sai Institute of Higher Medical Sciences, PG, Puttaparthi, 515134 India
| | - Saibharath Simha Reddy Santha
- grid.444651.60000 0004 0496 6988Disease Biology Lab, Department of Biosciences, Sri Sathya Sai Institute of Higher Learning, Puttaparthi, 515134 India
| | - Polani B. Seshagiri
- grid.34980.360000 0001 0482 5067Molecular Reproduction and Developmental Genetics, Indian Institute of Science, Bengaluru, 560012 India
| | - K. Narasimhan
- Sri Sathya Sai General Hospital, Puttaparthi, 515134 India
| | | | - Venketesh Sivaramakrishnan
- grid.444651.60000 0004 0496 6988Disease Biology Lab, Department of Biosciences, Sri Sathya Sai Institute of Higher Learning, Puttaparthi, 515134 India
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Klyne DM, Barbe MF, James G, Hodges PW. Does the Interaction between Local and Systemic Inflammation Provide a Link from Psychology and Lifestyle to Tissue Health in Musculoskeletal Conditions? Int J Mol Sci 2021; 22:ijms22147299. [PMID: 34298917 PMCID: PMC8304860 DOI: 10.3390/ijms22147299] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 07/02/2021] [Accepted: 07/04/2021] [Indexed: 01/02/2023] Open
Abstract
Musculoskeletal conditions are known to involve biological, psychological, social and, often, lifestyle elements. However, these domains are generally considered in isolation from each other. This siloed approach is unlikely to be adequate to understand the complexity of these conditions and likely explains a major component of the disappointing effects of treatment. This paper presents a hypothesis that aims to provide a foundation to understand the interaction and integration between these domains. We propose a hypothesis that provides a plausible link between psychology and lifestyle factors with tissue level effects (such as connective tissue dysregulation/accumulation) in musculoskeletal conditions that is founded on understanding the molecular basis for interaction between systemic and local inflammation. The hypothesis provides plausible and testable links between mind and body, for which empirical evidence can be found for many aspects. We present this hypothesis from the perspective of connective tissue biology and pathology (fibrosis), the role of inflammation locally (tissue level), and how this inflammation is shaped by systemic inflammation through bidirectional pathways, and various psychological and lifestyle factors via their influence on systemic inflammation. This hypothesis provides a foundation for new consideration of the development and refinement of personalized multidimensional treatments for individuals with musculoskeletal conditions.
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Affiliation(s)
- David M. Klyne
- NHMRC Centre of Clinical Research Excellence in Spinal Pain, Injury and Health, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane 4072, Australia; (G.J.); (P.W.H.)
- Correspondence: ; Tel.: +61-7-3365-4569
| | - Mary F. Barbe
- Department of Anatomy and Cell Biology, Lewis Katz School of Medicine, Temple University, Philadelphia, PA 19140, USA;
| | - Greg James
- NHMRC Centre of Clinical Research Excellence in Spinal Pain, Injury and Health, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane 4072, Australia; (G.J.); (P.W.H.)
| | - Paul W. Hodges
- NHMRC Centre of Clinical Research Excellence in Spinal Pain, Injury and Health, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane 4072, Australia; (G.J.); (P.W.H.)
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Bao X, Ma L, He C. MicroRNA-23a-5p regulates cell proliferation, migration and inflammation of TNF-α-stimulated human fibroblast-like MH7A synoviocytes by targeting TLR4 in rheumatoid arthritis. Exp Ther Med 2021; 21:479. [PMID: 33767774 PMCID: PMC7976437 DOI: 10.3892/etm.2021.9910] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 12/22/2020] [Indexed: 12/23/2022] Open
Abstract
Rheumatoid arthritis (RA) is a chronic inflammatory disease characterized by synovial joint inflammation. RA synovial fibroblasts (RASFs) constitute a major cell subset of the RA synovia. MicroRNAs (miRNAs/miRs) have been reported to serve a role in the activation and proliferation of RASFs. The present study aimed to investigate the effects and underlying mechanisms of miR-23a-5p on RA progression. Peripheral blood was collected from patients with RA (n=20) to analyze the expression levels of miR-23a-5p. The effects of miR-23a-5p on cell apoptosis, proliferation and migration in MH7A cells were determined in TNF-α-treated human fibroblast-like synoviocytes (MH7A cells) by flow cytometry, colony formation assay and Transwell assay, respectively. The cell cycle distribution was evaluated using flow cytometry. The binding relationship between miR-23a-5p and toll-like receptor (TLR) 4 was analyzed using a dual luciferase reporter gene assay. ELISA and reverse transcription-quantitative PCR assays were used to detect the levels of the inflammatory factors IL-6, IL-1β and IL-10. The expression levels of apoptosis- and migration-related proteins were analyzed using western blotting. The results of the present study revealed that the expression levels of miR-23a-5p were significantly downregulated in the plasma of patients with RA and in MH7A cells. In addition, the TNF-α-induced increase in the cell proliferative and migratory rates and the production of IL-6 and IL-1β were markedly inhibited following miR-23a-5p overexpression. The TNF-α-induced decreases in MH7A cell apoptosis were also reversed following miR-23a-5p overexpression. Additionally, transfection with miR-23a-5p mimics significantly inhibited the activation of the TLR4/NF-κB signaling pathway in TNF-α-treated MH7A cells by targeting TLR4. Notably, TLR4 overexpression weakened the effects of miR-23a-5p mimic on cell proliferation, apoptosis, migration, inflammation and the TLR4/NF-κB signaling pathway in TNF-α-induced MH7A cells. In conclusion, the findings of the present study indicated that the miR-23a-5p/TLR4/NF-κB axis may serve as a promising target for RA diagnosis and treatment.
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Affiliation(s)
- Xiao Bao
- Department of Rheumatology and Immunology, The People's Hospital of De Yang City, Deyang, Sichuan 618000, P.R. China
| | - Ling Ma
- Department of Rheumatology and Immunology, The People's Hospital of De Yang City, Deyang, Sichuan 618000, P.R. China
| | - Chengsong He
- Department of Rheumatology and Immunology, Southwest Medical University Affiliated Hospital, Luzhou, Sichuan 646000, P.R. China
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Tripathy A, Padhan P, Swain N, Raghav SK, Gupta B. Increased Extracellular ATP in Plasma of Rheumatoid Arthritis Patients Activates CD8 +T Cells. Arch Med Res 2021; 52:423-433. [PMID: 33541740 DOI: 10.1016/j.arcmed.2020.12.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 11/11/2020] [Accepted: 12/28/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND Rheumatoid arthritis (RA) is an autoimmune disorder with genetic and environmental causes often linked with the disease etiology. A disrupted metabolism has often been a characteristic of RA and an altered metabolic state of immune cells has been associated with their phenotypic and functional changes. The energy in the form of ATP produced by the metabolically active cells may thus initiate a cascade of immune responses there by influencing the disease pathogenesis or progression. AIM OF THE STUDY Through this study we have focused on determining the role of ATP in etiology of RA and aberrant cellular functions. METHODS Blood samples of 80 healthy controls (HC) and 95 RA patients were screened for extracellular ATP concentration, transcriptome analyses, an inflammatory mediator and the results were statistically analysed. RESULTS In this study, ATP is shown to be excessive in the plasma of RA patients (453.5 ± 16.09% in RA vs. 233.9 ± 10.07% in HC, p <0.0001) and significantly increases with the disease severity. The abundant extracellular ATP could activate circulating cytotoxic CD8+T cells in RA patients to produce Granzyme B. CONCLUSION Plasma ATP is thus identified to have a significant potential in progression and prognosis of RA and may thus be studied further to design better therapeutic approaches for the disease.
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Affiliation(s)
- Archana Tripathy
- Disease Biology Laboratory, School of Biotechnology, Kalinga Institute of Industrial Technology, Deemed to be University, Bhubaneswar, Odisha, India
| | - Prasanta Padhan
- Department of Rheumatology, Kalinga Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Nitish Swain
- Disease Biology Laboratory, School of Biotechnology, Kalinga Institute of Industrial Technology, Deemed to be University, Bhubaneswar, Odisha, India
| | - Sunil K Raghav
- Laboratory of Immuno-Genomics and Systems Biology, Institute of Life Sciences, Bhubaneswar, Odisha, India
| | - Bhawna Gupta
- Disease Biology Laboratory, School of Biotechnology, Kalinga Institute of Industrial Technology, Deemed to be University, Bhubaneswar, Odisha, India.
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Wang W, Chen Q, Wang J, Li T, Song G, Tao K, Liu J, Wu Z. The level of thymic stromal lymphopoietin and its gene polymorphism are associated with rheumatoid arthritis. Immunobiology 2021; 226:152055. [PMID: 33535091 DOI: 10.1016/j.imbio.2021.152055] [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: 09/20/2020] [Revised: 12/17/2020] [Accepted: 01/11/2021] [Indexed: 01/12/2023]
Abstract
OBJECTIVE To study the correlation between TSLP gene SNPs and RA in a Han Chinese population. METHODS The genotypes of TSLP genes rs11466749, rs11466750 and rs10073816 among 197 RA patients and 197 controls were analysed by direct sequencing. ELISA was used to detect the plasma TSLP level. Logistic regression analysis was also conducted to identify risk factors for RA. RESULTS The rs11466749 locus GG genotype (OR = 5.30, 95% CI: 1.76-15.95, P < 0.01), dominant model (OR = 1.68, 95% CI: 1.03-2.73, P = 0.04), recessive model (OR = 5.15, 95% CI: 1.72-15.43, P < 0.01), and G allele (OR = 2.02, 95% CI: 1.33-3.09, P < 0.01) were associated with an increased risk of RA. The rs1073816 locus AA genotype (OR = 4.58, 95% CI: 1.49-14.01, P < 0.01), dominant model (OR = 1.75, 95% CI: 1.09-2.79, P = 0.03), recessive model (OR = 4.27, 95% CI: 1.40-13.00, P = 0.03) and A allele (OR = 1.94, 95% CI: 1.29-2.91, P < 0.01) were associated with an increased risk of RA. The rs1073816 locus GA genotype (OR = 0.29, 95% CI: 0.18-0.45, P < 0.01), dominant model (OR = 0.32, 95% CI: 0.21-0.49, P < 0.01) and A allele (OR = 0.45, 95% CI: 0.32-0.63, P < 0.01) were related to a decreased risk of RA susceptibility. The rs1466749 locus GG genotype, rs11466750 AA genotype, and rs10073816 GG genotype were independent risk factors for RA (P < 0.05). The AUC of plasma TSLP level in the diagnosis of RA was 0.8661 (95% CI: 0.8301-0.9002, P < 0.001). There were statistically significant differences in plasma TSLP levels among subjects with different genotypes at rs11466749, rs11466750, and rs10073816 in the TSLP gene (P < 0.05). CONCLUSION Plasma TSLP levels are a potential molecular marker of RA. SNPs at rs11466749, rs11466750 and rs10073816 of the TSLP gene are related to the susceptibility of the Han Chinese population to RA.
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Affiliation(s)
- Weifeng Wang
- Department of Central Laboratory, Clinical Medicine Scientific and Technical Innovation Park, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200435, China
| | - Qiudan Chen
- Department of Central Laboratory, Clinical Laboratory, Jing'an District Center Hospital of Shanghai, Fudan University, Shanghai 200040, China
| | - Jianguang Wang
- Department of Orthopedics, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, China
| | - Tianming Li
- School of Life Sciences and Technology, Tongji University, Shanghai 200092, China
| | - Guanglei Song
- Department of Central Laboratory, Center of Naval Spectial Medicine, Naval Medical University, Shanghai 200052, China
| | - Kun Tao
- Department of Orthopedics, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, China.
| | - Junjian Liu
- Department of Orthopedics, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, China.
| | - Zhong Wu
- Department of Orthopedics, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, China.
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Ansari MM, Ahmad A, Kumar A, Alam P, Khan TH, Jayamurugan G, Raza SS, Khan R. Aminocellulose-grafted-polycaprolactone coated gelatin nanoparticles alleviate inflammation in rheumatoid arthritis: A combinational therapeutic approach. Carbohydr Polym 2021; 258:117600. [PMID: 33593531 DOI: 10.1016/j.carbpol.2020.117600] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 12/25/2020] [Accepted: 12/29/2020] [Indexed: 12/20/2022]
Abstract
Rheumatoid arthritis (RA) is a chronic autoimmune disorder and serious cause of disability. Despite considerable advances in RA management, challenges like extensive drug metabolism and rapid clearance causes poor bioavailability. Core-shell nanocarriers for co-delivery of glycyrrhizic acid (GA) and budesonide against RA were developed. GA-loaded gelatin nanoparticles (NPs) were synthesized and coated with budesonide encapsulated aminocellulose-grafted polycaprolactone (PCL-AC). GA- and budesonide-loaded PCL-AC-gel NPs had diameter of 200-225 nm. Dual drug-loaded (DDL) NPs reduced joint swelling and erythema in rats while markedly ameliorating bone erosion evidenced by radiological analysis, suppressed collagen destruction, restored synovial tissue, bone and cartilage histoarchitecture with reduced inflammatory cells infiltration. NPs also reduced various inflammatory biomarkers such as TNF-α, IL-1β, COX-2, iNOS. Results of this study suggest that dual NPs exerted superior therapeutic effects in RA compared to free drugs which may be attributed to slow and sustained drug release and NPs' ability to inhibit inflammatory mediators.
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Affiliation(s)
- Md Meraj Ansari
- Institute of Nano Science and Technology, Habitat Centre, Phase 10, Sector 64, Mohali, Punjab, 160062, India
| | - Anas Ahmad
- Institute of Nano Science and Technology, Habitat Centre, Phase 10, Sector 64, Mohali, Punjab, 160062, India
| | - Ajay Kumar
- Institute of Nano Science and Technology, Habitat Centre, Phase 10, Sector 64, Mohali, Punjab, 160062, India
| | - Pravej Alam
- Department of Biology, College of Sciences and Humanities, Prince Sattam bin Abdulaziz University, PO Box - 173, Alkharj, 11942, Saudi Arabia
| | | | - Govindasamy Jayamurugan
- Institute of Nano Science and Technology, Habitat Centre, Phase 10, Sector 64, Mohali, Punjab, 160062, India
| | - Syed Shadab Raza
- Laboratory for Stem Cell & Restorative Neurology, Department of Biotechnology, Era's Lucknow Medical College and Hospital, Sarfarazganj, Lucknow, 226003, Uttar Pradesh, India; Department of Stem Cell Biology and Regenerative Medicine, Era University, Sarfarazganj, Lucknow, 226003, Uttar Pradesh, India
| | - Rehan Khan
- Institute of Nano Science and Technology, Habitat Centre, Phase 10, Sector 64, Mohali, Punjab, 160062, India.
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Dessie G, Ayelign B, Akalu Y, Shibabaw T, Molla MD. Effect of Leptin on Chronic Inflammatory Disorders: Insights to Therapeutic Target to Prevent Further Cardiovascular Complication. Diabetes Metab Syndr Obes 2021; 14:3307-3322. [PMID: 34305402 PMCID: PMC8296717 DOI: 10.2147/dmso.s321311] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Accepted: 06/30/2021] [Indexed: 01/08/2023] Open
Abstract
In response to obesity-associated chronic inflammatory disorders, adipose tissue releases a biologically active peptide known as leptin. Leptin activates the secretion of chemical mediators, which contribute to the pathogenesis of chronic inflammatory disorders, such as rheumatoid arthritis (RA), systemic lupus erythematosus (SLE) and psoriasis. Conversely, adiposity and obesity are the major aggravating risk factors in the pathogenesis of metabolic syndrome (MetS), including type II diabetes mellitus and obesity-associated hypertension. Elevated level of leptin in obesity-associated hypertension causes an increase in the production of aldosterone, which also results in elevation of arterial blood pressure. Hyperleptinemia is associated with the progress of the atherosclerosis through secretion of pro-inflammatory cytokines, like interleukin 6 (IL-6), tumor necrosis factor α (TNF-α), IL-17, and other cytokines to promote inflammation. The release of those cytokines leads to chronic inflammatory disorders and obesity-associated MetS. Thus, the aberrant leptin level in both MetS and chronic inflammatory disorders also leads to the complication of cardiovascular diseases (CVD). Therapeutic target of leptin regarding its pro-inflammatory effect and dysregulated sympathetic nervous system activity may prevent further cardiovascular complication. This review mainly assesses the mechanism of leptin on the pathogenesis and further cardiovascular risk complication of chronic inflammatory disorders.
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Affiliation(s)
- Gashaw Dessie
- Department of Biochemistry, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
- Correspondence: Gashaw Dessie Tel +251 975152796 Email
| | - Birhanu Ayelign
- Department of Immunology and Molecular Biology, School of Biomedical and Laboratory Science, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Yonas Akalu
- Department of Physiology, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Tewodros Shibabaw
- Department of Biochemistry, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Meseret Derbew Molla
- Department of Biochemistry, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Fan C, Cui X, Chen S, Huang S, Jiang H. LncRNA LOC100912373 modulates PDK1 expression by sponging miR-17-5p to promote the proliferation of fibroblast-like synoviocytes in rheumatoid arthritis. Am J Transl Res 2020; 12:7709-7723. [PMID: 33437356 PMCID: PMC7791483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Accepted: 11/03/2020] [Indexed: 06/12/2023]
Abstract
Rheumatoid arthritis (RA) is a common autoimmune disease and characterized by chronic inflammation, abnormal synovial cell proliferation, and joint swelling and tenderness, and it causes patients substantial pain. To date, the pathogenesis of RA remains unclear, and specific treatment is still lacking in the clinic. Evidence from previous research indicated that the long noncoding RNA (lncRNA) LOC100912373 is a key lncRNA and involved in RA. However, our understanding of the specific mechanism of lncRNA LOC100912373 in RA development and progression is still in its infancy. In this study, fibroblast-like synoviocytes (FLSs) were cultured by enzyme-dispersed and substrate-attached explant methods. The MTT method, flow cytometry and transmission electron microscopy were used to determine the effect of lncRNA LOC100912373 on FLSs. The expression of key genes such as lncRNA LOC100912373, miR-17-5p, PDK1 and AKT in FLSs was detected by RT-qPCR, immunofluorescence and Western blot. The localization of lncRNA LOC100912373 was determined by fluorescence in situ hybridization. The specific targeting relationship between lncRNA LOC100912373 and miR-17-5p/PDK1 was verified by RNA immunoprecipitation and luciferase reporter gene analysis. The results showed that lncRNA LOC100912373 localized in the cytoplasm and was highly expressed in the synovial tissues and FLSs of AA rats. LncRNA LOC100912373 overexpression promoted the proliferation of FLSs. In addition, lncRNA LOC100912373 could bind to miR-17-5p, and the expression of lncRNA LOC100912373 was negatively correlated with miR-17-5p and positively correlated with PDK1/AKT. In conclusion, lncRNA LOC100912373 may upregulate the expression of PDK1 by sponging miR-17-5p, accelerating the phosphorylation of AKT and inducing the proliferation of FLSs, thus promoting the occurrence and development of RA.
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Affiliation(s)
- Chang Fan
- Experimental Center of Clinical Research, The First Affiliated Hospital of Anhui University of Chinese MedicineHefei, Anhui, China
- School of Pharmacy, Anhui University of Chinese MedicineHefei, Anhui, China
| | - Xiaoya Cui
- Experimental Center of Clinical Research, The First Affiliated Hospital of Anhui University of Chinese MedicineHefei, Anhui, China
- School of Pharmacy, Anhui University of Chinese MedicineHefei, Anhui, China
| | - Sen Chen
- Experimental Center of Clinical Research, The First Affiliated Hospital of Anhui University of Chinese MedicineHefei, Anhui, China
- School of Pharmacy, Anhui University of Chinese MedicineHefei, Anhui, China
| | - Shaopeng Huang
- Experimental Center of Clinical Research, The First Affiliated Hospital of Anhui University of Chinese MedicineHefei, Anhui, China
- School of Pharmacy, Anhui University of Chinese MedicineHefei, Anhui, China
| | - Hui Jiang
- Experimental Center of Clinical Research, The First Affiliated Hospital of Anhui University of Chinese MedicineHefei, Anhui, China
- School of Pharmacy, Anhui University of Chinese MedicineHefei, Anhui, China
- The Anhui Provincial Laboratory of Applied Basis and Development of Internal Medicine of Modern Traditional Chinese MedicineHefei, Anhui, China
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Wagner L, Haefeli WE, Merle U, Lorenz HM, Hohmann N, Weiss J, Theile D. A nuclear factor kappa B reporter cell line used to evaluate ex vivo the net inflammatory effect of plasma samples from patients with rheumatoid arthritis, psoriasis, or COVID-19. Cytokine 2020; 138:155399. [PMID: 33338916 DOI: 10.1016/j.cyto.2020.155399] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 12/03/2020] [Accepted: 12/04/2020] [Indexed: 12/27/2022]
Abstract
BACKGROUND The overall clinical outcome of inflammatory conditions is the result of the balance between pro-inflammatory and anti-inflammatory mediators. Because nuclear factor kappa B (NF-ĸB) is at the bottom of many inflammatory conditions, methods to evaluate the net effect of inflammation modulators on this master regulator have been conceptualized for years. METHODS Using an ex vivo NF-ĸB reporter cell line-based assay, plasma samples of patients with rheumatoid arthritis (n = 27), psoriasis (n = 15), or severe coronavirus disease-19 (COVID-19) (n = 21) were investigated for NF-ĸB activation compared to plasma samples from 9 healthy volunteers. RESULTS When separated by C-reactive protein (CRP) threshold levels, samples of patients exhibiting increased CRP levels (≥5 mg/l) activated NF-ĸB more efficiently than samples from patients with levels below 5 mg/l (P = 0.0001) or healthy controls (P = 0.04). Overall, there was a moderate association of CRP levels with NF-ĸB activation (Spearman r = 0.66; p < 0.0001). Plasma from COVID-19 patients activated NF-ĸB more efficiently (mean 2.4-fold compared to untreated reporter cells) than samples from any other condition (healthy controls, 1.8-fold, P = 0.0025; rheumatoid arthritis, 1.7-fold, P < 0.0001; psoriasis, 1.7-fold, P < 0.0001). In contrast, effects of rheumatoid arthritis, psoriasis, or healthy volunteer samples did not differ. CONCLUSION This study shows that a NF-ĸB reporter cell line can be used to evaluate the net inflammatory effect of clinical plasma samples. Patients with chronic but stable rheumatoid arthritis or psoriasis do not exhibit increased plasma levels of NF-ĸB-activating compounds as opposed to COVID-19 patients with high inflammatory burden.
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Affiliation(s)
- Lelia Wagner
- Department of Clinical Pharmacology and Pharmacoepidemiology, Heidelberg University Hospital, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany
| | - Walter E Haefeli
- Department of Clinical Pharmacology and Pharmacoepidemiology, Heidelberg University Hospital, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany
| | - Uta Merle
- Department of Gastroenterology and Hepatology, Heidelberg University Hospital, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany
| | - Hanns-Martin Lorenz
- Department of Hematology, Oncology and Rheumatology, Heidelberg University Hospital, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany
| | - Nicolas Hohmann
- Department of Clinical Pharmacology and Pharmacoepidemiology, Heidelberg University Hospital, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany
| | - Johanna Weiss
- Department of Clinical Pharmacology and Pharmacoepidemiology, Heidelberg University Hospital, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany
| | - Dirk Theile
- Department of Clinical Pharmacology and Pharmacoepidemiology, Heidelberg University Hospital, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany.
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Thudium CS, Bay-Jensen AC, Cahya S, Dow ER, Karsdal MA, Koch AE, Zhang W, Benschop RJ. The Janus kinase 1/2 inhibitor baricitinib reduces biomarkers of joint destruction in moderate to severe rheumatoid arthritis. Arthritis Res Ther 2020; 22:235. [PMID: 33046136 PMCID: PMC7552555 DOI: 10.1186/s13075-020-02340-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 10/02/2020] [Indexed: 12/26/2022] Open
Abstract
Background Tissue released blood-based biomarkers can provide insight into drug mode of action and response. To understand the changes in extracellular matrix turnover, we analyzed biomarkers associated with joint tissue turnover from a phase 3, randomized, placebo-controlled study of baricitinib in patients with active rheumatoid arthritis (RA). Methods Serum biomarkers associated with synovial inflammation (C1M, C3M, and C4M), cartilage degradation (C2M), bone resorption (CTX-I), and bone formation (osteocalcin) were analyzed at baseline, and weeks 4 and 12, from a subgroup of patients (n = 240) randomized to placebo or 2-mg or 4-mg baricitinib (RA-BUILD, NCT01721057). Mixed-model repeated measure was used to identify biomarkers altered by baricitinib. The relationship between changes in biomarkers and clinical measures was evaluated using correlation analysis. Results Treatment arms were well balanced for baseline biomarkers, demographics, and disease activity. At week 4, baricitinib 4-mg significantly reduced C1M from baseline by 21% compared to placebo (p < 0.01); suppression was sustained at week 12 (27%, p < 0.001). Baricitinib 4-mg reduced C3M and C4M at week 4 by 14% and 12% compared to placebo, respectively (p < 0.001); they remained reduced by 16% and 11% at week 12 (p < 0.001). In a pooled analysis including all treatment arms, patients with the largest reduction (upper 25% quartile) in C1M, C3M, and C4M by week 12 had significantly greater clinical improvement in the Simplified Disease Activity Index at week 12 compared to patients with the smallest reduction (lowest 25% quartile). Conclusion Baricitinib treatment resulted in reduced circulating biomarkers associated with joint tissue destruction as well as concomitant RA clinical improvement. Trial registration ClinicalTrials.gov NCT01721057; date of registration: November 1, 2012
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Affiliation(s)
- Christian S Thudium
- Nordic Bioscience, Biomarkers and Research, Herlev Hovedgade 205-207, DK-2730, Herlev, Denmark.
| | - Anne C Bay-Jensen
- Nordic Bioscience, Biomarkers and Research, Herlev Hovedgade 205-207, DK-2730, Herlev, Denmark
| | | | - Ernst R Dow
- Eli Lilly and Company, Indianapolis, Indiana, USA
| | - Morten A Karsdal
- Nordic Bioscience, Biomarkers and Research, Herlev Hovedgade 205-207, DK-2730, Herlev, Denmark
| | - Alisa E Koch
- Eli Lilly and Company, Indianapolis, Indiana, USA
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Polyakova YV, Zavodovsky BV, Sivordova LE, Akhverdyan YR, Zborovskaya IA. Visfatin and Rheumatoid Arthritis: Pathogenetic Implications and Clinical Utility. Curr Rheumatol Rev 2020; 16:224-239. [DOI: 10.2174/1573397115666190409112621] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Revised: 03/15/2019] [Accepted: 04/02/2019] [Indexed: 12/12/2022]
Abstract
Objective:
Analysis and generalization of data related to visfatin involvement in the
pathogenesis of inflammation at various stages of rheumatoid arthritis.
Data Synthesis:
Visfatin is an adipocytokine which has also been identified in non-adipose tissues.
It influences directly on the maturation of B cells, which are involved in autoantibody production
and T cell activation. Visfatin can promote inflammation via regulation of pro-inflammatory cytokines
including TNF, IL-1β and IL-6. The concentration of circulating visfatin in rheumatoid arthritis
patients is higher compared to healthy individuals. Several studies suggest that visfatin level is
associated with rheumatoid arthritis activity, and its elevation may precede clinical signs of the relapse.
In murine collagen-induced arthritis, visfatin levels were also found to be elevated both in
inflamed synovial cells and in joint vasculature. Visfatin blockers have been shown to confer fast
and long-term attenuation of pathological processes; however, most of their effects are transient.
Other factors responsible for hyperactivation of the immune system can participate in this process
at a later stage. Treatment of rheumatoid arthritis with a combination of these blockers and inhibitors
of other mediators of inflammation can potentially improve treatment outcomes compared to
current therapeutic strategies. Recent advances in the treatment of experimental arthritis in mice as
well as the application of emerging treatment strategies obtained from oncology for rheumatoid arthritis
management could be a source of novel adipokine-mediated anti-rheumatic drugs.
Conclusion:
The ongoing surge of interest in anticytokine therapy makes further study of visfatin
highly relevant as it may serve as a base for innovational RA treatment.
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Affiliation(s)
- Yulia V. Polyakova
- Research Institute for Clinical and Experimental Rheumatology, Volgograd, Russian Federation
| | - Boris V. Zavodovsky
- Research Institute for Clinical and Experimental Rheumatology, Volgograd, Russian Federation
| | - Larisa E. Sivordova
- Research Institute for Clinical and Experimental Rheumatology, Volgograd, Russian Federation
| | - Yuri R. Akhverdyan
- Research Institute for Clinical and Experimental Rheumatology, Volgograd, Russian Federation
| | - Irina A. Zborovskaya
- Research Institute for Clinical and Experimental Rheumatology, Volgograd, Russian Federation
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Amrhein J, Drynda S, Schlatt L, Karst U, Lohmann CH, Ciarimboli G, Bertrand J. Tofacitinib and Baricitinib Are Taken up by Different Uptake Mechanisms Determining the Efficacy of Both Drugs in RA. Int J Mol Sci 2020; 21:ijms21186632. [PMID: 32927842 PMCID: PMC7556031 DOI: 10.3390/ijms21186632] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 09/03/2020] [Accepted: 09/09/2020] [Indexed: 12/29/2022] Open
Abstract
Background: Rheumatoid arthritis (RA) is a systemic autoimmune disease in which synovial fibroblasts (SF) play a key role. Baricitinib and Tofacitinib both act intracellularly, blocking the ATP-binding side of JAK proteins and thereby the downstream signalling pathway via STAT-3. Therefore, we investigated the role of organic cation transporters (OCTs) in Baricitinib and Tofacitinib cellular transport. Methods: OCT expression was analysed in SF isolated from RA and osteoarthritis (OA) patients, as well as peripheral blood mononuclear cells. The interaction of Baricitinib and Tofacitinib with OCTs was investigated using quenching experiments. The intracellular accumulation of both drugs was quantified using LC/MS. Target inhibition for both drugs was tested using Western blot for phosphorylated JAK1 and STAT3 upon stimulation with IL-6. Results: MATE-1 expression increased in OASF compared to RASF. The other OCTs were not differentially expressed. The transport of Baricitinib was not OCT dependent. Tofacitinib; however, was exported from RASF in a MATE-1 dependent way. Tofacitinib and Baricitinib showed comparable inhibition of downstream signalling pathways. Conclusion: We observed different cellular uptake strategies for Baricitinib and Tofacitinib. Tofacitinib was exported out of healthy cells due to the increased expression of MATE1. This might make Tofacitinib the favourable drug.
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Affiliation(s)
- Jan Amrhein
- Experimental Nephrology, Department of Internal Medicine D, University Hospital Münster, 48149 Münster, Germany; (J.A.); (G.C.)
| | - Susanne Drynda
- Department of Orthopedic Surgery, Otto-von-Guericke University, 39120 Magdeburg, Germany; (S.D.); (C.H.L.)
| | - Lukas Schlatt
- Institute of Inorganic and Analytical Chemistry, University of Münster, 48149 Münster, Germany; (L.S.); (U.K.)
| | - Uwe Karst
- Institute of Inorganic and Analytical Chemistry, University of Münster, 48149 Münster, Germany; (L.S.); (U.K.)
| | - Christoph H. Lohmann
- Department of Orthopedic Surgery, Otto-von-Guericke University, 39120 Magdeburg, Germany; (S.D.); (C.H.L.)
| | - Giuliano Ciarimboli
- Experimental Nephrology, Department of Internal Medicine D, University Hospital Münster, 48149 Münster, Germany; (J.A.); (G.C.)
| | - Jessica Bertrand
- Department of Orthopedic Surgery, Otto-von-Guericke University, 39120 Magdeburg, Germany; (S.D.); (C.H.L.)
- Correspondence: ; Tel.: +49-391-67-15804
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Higher Serum CCN3 Is Associated with Disease Activity and Inflammatory Markers in Rheumatoid Arthritis. J Immunol Res 2020; 2020:3891425. [PMID: 32455138 PMCID: PMC7232667 DOI: 10.1155/2020/3891425] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Accepted: 03/30/2020] [Indexed: 01/18/2023] Open
Abstract
Nephroblastoma overexpressed protein (NOV/CCN3), the early discovered member of the CCN family, has recently been suggested to be involved in a number of inflammatory processes, including wound healing, alveolar epithelial cell inflammation, cancer metastasis, and macrophage foam cell formation. However, the role of CCN3 in rheumatoid arthritis (RA), a classic autoimmune and inflammatory disease, remains elusive. RA is a chronic systemic autoimmune disease that eventually leads to cartilage and bone destruction and joint dysfunction. In this study, we investigated the potential of serum CCN3 as a biomarker for RA. The serum levels of CCN3 were measured by ELISA. The clinical and laboratory parameters were collected from a clinical record system, and disease activity was determined by joint disease activity score 28 (DAS28). Our results showed that the serum levels of CCN3 were significantly increased in RA patients compared to healthy controls. Furthermore, the CCN3 level was positively correlated with DAS28 (CRP), DAS28 (ESR), and the level of anti-CCP Ab, an autoantibody highly specific for RA. Furthermore, CCN3 showed a positive correlation with inflammatory cytokine IL-6, while no significant correlation with TNF-α was observed. These data suggest that CCN3 plays an important role in the development of RA and might be a potential disease activity biomarker for RA.
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Carvalho AMS, Heimfarth L, Pereira EWM, Oliveira FS, Menezes IRA, Coutinho HDM, Picot L, Antoniolli AR, Quintans JSS, Quintans-Júnior LJ. Phytol, a Chlorophyll Component, Produces Antihyperalgesic, Anti-inflammatory, and Antiarthritic Effects: Possible NFκB Pathway Involvement and Reduced Levels of the Proinflammatory Cytokines TNF-α and IL-6. JOURNAL OF NATURAL PRODUCTS 2020; 83:1107-1117. [PMID: 32091204 DOI: 10.1021/acs.jnatprod.9b01116] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Phytol is a diterpene constituent of chlorophyll and has been shown to have several pharmacological properties, particularly in relation to the management of painful inflammatory diseases. Arthritis is one of the most common of these inflammatory diseases, mainly affecting the synovial membrane, cartilage, and bone in joints. Proinflammatory cytokines, such as TNF-α and IL-6, and the NFκB signaling pathway play a pivotal role in arthritis. However, as the mechanisms of action of phytol and its ability to reduce the levels of these cytokines are poorly understood, we decided to investigate its pharmacological effects using a mouse model of complete Freund's adjuvant (CFA)-induced arthritis. Our results showed that phytol was able to inhibit joint swelling and hyperalgesia throughout the whole treatment period. Moreover, phytol reduced myeloperoxidase (MPO) activity and proinflammatory cytokine release in synovial fluid and decreased IL-6 production as well as the COX-2 immunocontent in the spinal cord. It also downregulated the p38MAPK and NFκB signaling pathways. Therefore, our findings demonstrated that phytol can be an innovative antiarthritic agent due to its capacity to attenuate inflammatory reactions in joints and the spinal cord, mainly through the modulation of mediators that are key to the establishment of arthritic pain.
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Affiliation(s)
| | | | | | | | - Irwin R A Menezes
- Department of Biological Chemistry, Regional University of Cariri, Crato, Ceará 63100-000, Brazil
| | - Henrique D M Coutinho
- Department of Biological Chemistry, Regional University of Cariri, Crato, Ceará 63100-000, Brazil
| | - Laurent Picot
- UMRi CNRS 7266 LIENSs, University of La Rochelle, 17042 La Rochelle, France
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Hong R, Wang Y, Dong H, Geng R. DTX3L/ARTD9 contributes to inflammation of fibroblast-like synoviocytes by increasing STAT1 translocation. Tissue Cell 2020; 64:101339. [PMID: 32473705 DOI: 10.1016/j.tice.2020.101339] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Revised: 01/13/2020] [Accepted: 01/14/2020] [Indexed: 11/18/2022]
Abstract
Deltex-3-like (DTX3L), an E3 ligase, which is also known as B-lymphoma and BAL-associated protein (BBAP), is a member of the Deltex (DTX) family and was originally identified as a binding partner of diphtheria-toxin-like ADP-ribosyltransferase-9 (ARTD9). The present study found that DTX3L and ARTD9 were upregulated in synovial tissues obtained from rheumatoid arthritis (RA) patients compared with those from the controls. Healthy synovial tissues were obtained by arthroscopic biopsy from patients with meniscus injury (n = 10 samples) without a history of RA in the Orthopedic Department of the Affiliated Hospital of Nantong University. FLSs were isolated from RA patients who underwent total knee arthroplasty. We performed dual immunofluorescence staining on DTX3L and ARTD9, and these data strongly demonstrated that DTX3L and ARTD9 were colocalized with fibroblast-like synoviocytes (FLSs) in patients with RA. Furthermore, Western blot assays were performed to confirm that the expression levels of DTX3L and ARTD9 in the FLSs increased in a time-dependent manner and peaked at 24 h after TNF-α stimulation. Further, the inhibition of endogenous DTX3L and ARTD9 expression by RNA interference significantly suppressed the TNF-α-induced MMP-9 and IL-6 expression, as shown by Western blots. In contrast, overexpressing DTX3L and ARTD9 increased the MMP-9 and IL-6 mRNA levels in the TNF-α-stimulated FLSs. Moreover, DTX3L and ARTD9 associated with STAT1 under TNF-α-stimulated conditions to modulate STAT1 nuclear localization and transcriptional activity in an immunofluorescence staining assay. Collectively, our findings provide evidence that DTX3L and ARTD9 contribute to the production of inflammatory cytokines in FLSs from RA patients and may play a key role in the inflammatory process of RA via the STAT1 signal transduction pathway.
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Affiliation(s)
- Ruilong Hong
- Department of Orthopaedics, The Third People's Hospital of Yan Cheng, Yan Cheng 224000, China
| | - Yuwu Wang
- Department of Orthopaedics, The Third People's Hospital of Yan Cheng, Yan Cheng 224000, China.
| | - Honghua Dong
- Department of Orthopaedics, The Third People's Hospital of Yan Cheng, Yan Cheng 224000, China
| | - Rui Geng
- School of Medicine, Southeast University, Department of Orthopaedic Surgery, Zhongda Hospital Affiliated to Southeast University, No. 87 Dingjiaqiao Road, 210009, Nanjing, Jiangsu Province, China
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48
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Zhou G, Li Y, Ni J, Jiang P, Bao Z. Role and mechanism of miR-144-5p in LPS-induced macrophages. Exp Ther Med 2019; 19:241-247. [PMID: 31853295 PMCID: PMC6909656 DOI: 10.3892/etm.2019.8218] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Accepted: 10/07/2019] [Indexed: 12/21/2022] Open
Abstract
The aim of the present study was to explore the possible role of microRNA-144-5p (miR-144-5p) in rheumatoid arthritis (RA) and the associated mechanism. Following the induction of THP-1 cell differentiation into macrophages by phorbol ester (100 ng/ml) treatment, an in vitro inflammatory model of RA was established by treating the THP-1 macrophages with 1 µg/ml lipopolysaccharide (LPS). The level of miR-144-5p was subsequently measured using reverse transcription-quantitative PCR, which found that the expression of miR-144-5p was significantly reduced in LPS-treated THP-1 macrophages. Bioinformatics analysis and a dual-luciferase reporter assay were used to predict and confirm TLR2 as a direct target of miR-144-5p, respectively. Toll-like receptor 2 (TLR2) was then validated as a target gene of miR-144-5p. The effects of miR-144-5p upregulation and TLR2 silencing on LPS-treated THP-1 macrophages were then determined by transfection with miR-144-5p mimic and TLR2-siRNA, respectively. Cell viability was subsequently measured using a Cell Counting Kit-8 assay, whilst the expression of tumor necrosis factor-α (TNF-α), interleukin (IL)-6 and IL-8 secreted by THP-1 macrophages was measured using ELISA. Western blotting was performed to measure p65 phosphorylation (p-p65) in the NK-κB signaling pathway. It was found that miR-144-5p overexpression reduced macrophage cell viability, reduced the expression of TNF-α, IL-6 and IL-8, and reduced the expression of TLR2 and p-p65 compared with the control group. Likewise, TLR2 silencing also reduced macrophage cell viability and reduced the expression of TNF-α, IL-6 and IL-8 in THP-1 macrophages. In conclusion, the data from the present study suggested that miR-144-5p overexpression reduced THP-1 macrophage cell viability and inhibited the expression of TNF-α, IL-6 and IL-8 in cells, possibly by inhibiting the expression of TLR2 and suppressing the activation of NK-κB signaling. Therefore, miR-144-5p may serve as a novel therapeutic target for the treatment of RA.
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Affiliation(s)
- Guozhu Zhou
- Third Clinical Medical College, Nanjing University of Chinese Medicine, Nanjing, Jiangsu 210000, P.R. China.,Department of Orthopedics, Jingjiang Chinese Medicine Hospital, Taizhou, Jiangsu 214500, P.R. China
| | - Yuwei Li
- Department of Orthopedics, Suzhou Hospital of Traditional Chinese Medicine, Suzhou, Jiangsu 215000, P.R. China
| | - Jianping Ni
- Department of Orthopedics, Jingjiang Chinese Medicine Hospital, Taizhou, Jiangsu 214500, P.R. China
| | - Ping Jiang
- Department of Orthopedics, Jingjiang Chinese Medicine Hospital, Taizhou, Jiangsu 214500, P.R. China
| | - Zili Bao
- Department of Orthopedics, Jingjiang Chinese Medicine Hospital, Taizhou, Jiangsu 214500, P.R. China
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Investigation of the curative effects of palm vitamin E tocotrienols on autoimmune arthritis disease in vivo. Sci Rep 2019; 9:16793. [PMID: 31727971 PMCID: PMC6856359 DOI: 10.1038/s41598-019-53424-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Accepted: 10/31/2019] [Indexed: 01/08/2023] Open
Abstract
The tocotrienol-rich fraction (TRF) from palm oil contains vitamin E, which possesses potent antioxidant and anti-inflammatory activities. Rheumatoid arthritis (RA) is a chronic joint inflammatory disease characterised by severe joint pain, cartilage destruction, and bone erosion owing to the effects of various pro-inflammatory mediators and cytokines. Here, we investigated the therapeutic effects of TRF in a rat model of collagen-induced arthritis (CIA). Arthritis was induced by a single intradermal injection of collagen type II in Dark Agouti (DA) rats. Rats were then treated with or without TRF by oral gavage from day 28 after the first collagen injection. Arthritic rats supplemented with TRF showed decreased articular index scores, ankle circumferences, paw volumes, and radiographic scores when compared with untreated rats. The untreated arthritic rats showed higher plasma C-reactive protein levels (p < 0.05) and production of pro-inflammatory cytokines than arthritic rats fed TRF. Moreover, there was a marked reduction in the severity of histopathological changes observed in arthritic rats treated with TRF compared with that in untreated arthritic rats. Overall, the results show that TRF had beneficial effects in this rat model of RA.
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50
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He Y, Tang J, Wu B, Yang B, Ou Q, Lin J. Correlation between albumin to fibrinogen ratio, C-reactive protein to albumin ratio and Th17 cells in patients with rheumatoid arthritis. Clin Chim Acta 2019; 500:149-154. [PMID: 31672633 DOI: 10.1016/j.cca.2019.10.009] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Revised: 09/05/2019] [Accepted: 10/10/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND The albumin to fibrinogen ratio (AFR) and the C-reactive protein to albumin ratio (CAR) have been served as inflammatory markers. However, their roles in RA remain unclear. We investigated the association of AFR/CAR with the concentration of autoantibodies and Th17 cells in RA. METHODS A total of 196 RA patients, 200 patients with systemic lupus erythematosus (SLE), and 200 healthy donors (HD) who were admitted to the First Affiliated Hospital of Fujian Medical University were enrolled. The results of FIB, ALB, CRP, anti-cyclic citrullinated peptide antibodies (anti-CCP), rheumatoid factor (RF) and erythrocyte sedimentation rate (ESR) from RA patients and SLE patients were retrospectively analyzed. The percentage of Th17 cells in peripheral blood of RA patients was detected by flow cytometry, and the relative expression of TNF-α, IL-6 and IL-17A was detected by RT-qPCR. Correlation analysis of AFR/CAR and Th17 cells, CRP, ESR, TNF-α, IL-6 and IL-17A in RA was conducted. RESULTS Compared with SLE patients and healthy donors (HD), AFR concentration was significantly lower (P < 0.01) in RA patients, while CAR concentration was significantly increased (P < 0.01) in RA patients. AFR showed negative correlation with CRP (r = -0.7103), ESR (r = -0.6542), RF (-0.2219), Th17 cells (r = -0.5952) and IL-17A (r = -0.4681). CAR was positively correlated with CRP (r = 0.9899), ESR (r = 0.605), RF (0.1867), Th17 cells (r = 0.6818), TNF-α (r = 0.3388), and IL-17A (r = 0.2046). CONCLUSIONS The concentration of AFR in RA patients was reduced, while CAR concentration was increased. AFR and CAR are associated with CRP, ESR, RF, and Th17 cell ratios in RA patients, which can be used as potential indicators for determining RA inflammation.
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Affiliation(s)
- Yujue He
- Department of Laboratory Medicine, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China; First Clinical College, Fujian Medical University, Fuzhou, China; Fujian Key Laboratory of Laboratory Medicine, Fuzhou, China
| | - Jifeng Tang
- Department of Laboratory Medicine, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China; First Clinical College, Fujian Medical University, Fuzhou, China; Fujian Key Laboratory of Laboratory Medicine, Fuzhou, China
| | - Bodeng Wu
- Department of Laboratory Medicine, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Bin Yang
- Department of Laboratory Medicine, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China; First Clinical College, Fujian Medical University, Fuzhou, China; Fujian Key Laboratory of Laboratory Medicine, Fuzhou, China
| | - Qishui Ou
- Department of Laboratory Medicine, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China; First Clinical College, Fujian Medical University, Fuzhou, China; Fujian Key Laboratory of Laboratory Medicine, Fuzhou, China.
| | - Jinpiao Lin
- Department of Laboratory Medicine, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China; First Clinical College, Fujian Medical University, Fuzhou, China; Fujian Key Laboratory of Laboratory Medicine, Fuzhou, China.
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