A novel drug combination of Tofacitinib and Iguratimod alleviates rheumatoid arthritis and secondary osteoporosis

被引：8
作者：
Chen, Jie [1 ,2 ]
Che, Qincheng [1 ,2 ]
Kou, Yuying [3 ,4 ,5 ]
Rong, Xing [3 ,4 ,5 ]
Zhang, Xiaojie [1 ,2 ]
Li, Minqi [3 ,4 ,5 ]
Shu, Qiang [1 ,2 ]
机构：
[1] Shandong Univ, Qilu Hosp, Cheeloo Coll Med, Dept Rheumatol, Jinan, Peoples R China
[2] Qilu Hosp, Shandong Prov Clin Res Ctr Immune Dis & Gout, Dept Rheumatol, Jinan, Peoples R China
[3] Shandong Univ, Dept Bone Metab, Cheeloo Coll Med, Sch & Hosp Stomatol, Jinan, Peoples R China
[4] Shandong Prov Clin Res Ctr Oral Dis, Shandong Engn Lab Dent Mat & Oral Tissue Regenerat, Jinan, Peoples R China
[5] Shandong Univ, Ctr Osteoporosis & Bone Mineral Res, Jinan, Peoples R China
来源：
INTERNATIONAL IMMUNOPHARMACOLOGY | 2023年 / 124卷
关键词：
Rheumatoid arthritis; Tofacitinib; Iguratimod; Osteoporosis; Pyroptosis; TUMOR-NECROSIS-FACTOR; NF-KAPPA-B; DOUBLE-BLIND; TNF-ALPHA; ACTIVATION; NLRP3-INFLAMMASOME; SUSCEPTIBILITY; METHOTREXATE; CELLS;
D O I：
10.1016/j.intimp.2023.110913
中图分类号：
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号：
100102 ;
摘要：
Background: The inadequate response of some patients with rheumatoid arthritis (RA) to current therapies is an issue that needs to be addressed. Patients with refractory RA (RRA) are often accompanied by high Tumor necrosis factor (TNF) expression. We evaluated the synergistic therapeutic effects of the combination of Iguratimod (IGU) and Tofacitinib (TOF) on RRA and secondary osteoporosis. Methods: Pathological changes in the ankle joints of collagen-induced arthritis (CIA) + TNF model rats were assessed using hematoxylin and eosin (HE) staining. Immunohistochemistry (IHC) and immunofluorescence (IF) were used to evaluate pyroptosis-related protein levels in the synovial tissues. Moreover, the knee joint was investigated by performing HE staining, IHC, and micro-computed tomography. Furthermore, in vitro, western blotting and enzyme-linked immunosorbent assay (ELISA) were performed to detect the effects of TOF and IGU on TNF-alpha-induced pyroptosis in fibroblast-like synoviocytes of RA. Results: After treatment with TOF and/or IGU, the arthritis scores, inflammatory cell infiltration in synovial tissues, and levels of interleukin (IL)-18, IL-18, and IL-6 in the plasma were remarkably increased in the CIA + TNF model and dramatically decreased in the combination group. The expression of pyroptosis-related proteins was significantly lower in the combination group than in the CIA + TNF group, and a consistent trend was observed in vitro. Bone destruction was significantly alleviated, and the bone turnover rate was remarkably increased in the combination group compared to that in the CIA + TNF model. Conclusion: TOF + IGU alleviated the severity of RRA in the CIA + TNF rat model, relieving joint inflammation, reducing bone erosion, and suppressing pyroptosis. The combined application of TOF and IGU may have a superimposed therapeutic effect on RRA and secondary osteoporotic bone remodeling.
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页数：9
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