Schett G, Hayer S, Tohidast-Akrad M, Schmid B J, Lang S, Türk B, Kainberger F, Haralambous S, Kollias G, Newby A C, Xu Q, Steiner G, Smolen J
Department of Internal Medicine III, University of Vienna, Austria.
Arthritis Rheum. 2001 Dec;44(12):2888-98. doi: 10.1002/1529-0131(200112)44:12<2888::aid-art477>3.0.co;2-3.
Rheumatoid arthritis is a prototype of a destructive inflammatory disease. Inflammation triggered by the overexpression of tumor necrosis factor alpha (TNFalpha) is a driving force of this disorder and mediates tissue destruction. Since matrix metalloproteinases (MMPs) are among the molecules activated by TNFalpha, we hypothesized that overexpression of their natural inhibitor, tissue inhibitor of metalloproteinases 1 (TIMP-1), in TNFalpha transgenic mice could inhibit the development of destructive arthritis.
Systemic treatment was carried out by replication-defective adenoviral vectors for TIMP-1, beta-galactosidase, or phosphate buffered saline (PBS), which were applied once at the onset of arthritis. Clinical, serologic, radiologic, and histologic outcomes were assessed 18 days after the treatment.
The AdTIMP-1 group showed significantly reduced paw swelling and increased grip strength compared with the 2 control groups, whereas total body weight, TNFalpha, and interleukin-6 levels were similar in all 3 groups. Radiographic assessment revealed a significant reduction of joint destruction in the AdTIMP-1 group; this was confirmed by histologic analyses showing reduced formation of pannus and erosions in the AdTIMP-1 group compared with the AdLacZ and PBS control groups. The formation of arthritis-specific autoantibodies to heterogeneous nuclear RNP A2 was not observed in the AdTIMP-1 group but was present in the 2 control groups.
These results indicate a central role of MMPs in TNFalpha-mediated tissue damage in vivo and a promising therapeutic role for TIMP-1.
类风湿性关节炎是一种破坏性炎症性疾病的典型代表。由肿瘤坏死因子α(TNFα)过度表达引发的炎症是这种疾病的驱动力,并介导组织破坏。由于基质金属蛋白酶(MMPs)是被TNFα激活的分子之一,我们推测在TNFα转基因小鼠中其天然抑制剂金属蛋白酶组织抑制剂1(TIMP-1)的过度表达可抑制破坏性关节炎的发展。
通过复制缺陷型腺病毒载体对TIMP-1、β-半乳糖苷酶或磷酸盐缓冲盐水(PBS)进行全身治疗,在关节炎发作时给药一次。治疗18天后评估临床、血清学、放射学和组织学结果。
与两个对照组相比,AdTIMP-1组的爪肿胀明显减轻,握力增加,而三组的总体重、TNFα和白细胞介素-6水平相似。放射学评估显示AdTIMP-1组的关节破坏明显减少;组织学分析证实,与AdLacZ和PBS对照组相比,AdTIMP-1组的血管翳形成和侵蚀减少。AdTIMP-1组未观察到针对异质性核RNP A2的关节炎特异性自身抗体的形成,但在两个对照组中存在。
这些结果表明MMPs在TNFα介导的体内组织损伤中起核心作用,TIMP-1具有良好的治疗作用。