Woodruff Trent M, Strachan Anna J, Dryburgh Nathan, Shiels Ian A, Reid Robert C, Fairlie David P, Taylor Stephen M
University of Queensland, St. Lucia, Australia.
Arthritis Rheum. 2002 Sep;46(9):2476-85. doi: 10.1002/art.10449.
To determine if the new, orally active C5a receptor antagonist, the cyclic peptide AcF-[OPdChaWR], reduces the severity of pathology in a rat model of immune-mediated monarticular arthritis.
Arthritis was induced in the right knee of previously sensitized rats by the intraarticular injection of methylated bovine serum albumin. Rats were examined for either 14 days or 28 days, or for 49 days following a second antigen challenge at 28 days. The C5a antagonist (1 or 3 mg/kg/day) and/or ibuprofen (30 mg/kg/day) were administered orally on a daily basis either before or after arthritis induction.
Rats receiving AcF-[OPdChaWR] had significant reductions in right knee swelling, gait disturbance, lavaged joint cell numbers, and right knee histopathology, as well as in serum levels of tumor necrosis factor alpha (TNFalpha) and intraarticular levels of interleukin-6 and TNFalpha on day 14. In the 14- and 28-day studies, ibuprofen resulted in a similar reduction in gait abnormalities and intraarticular inflammatory cells compared with the C5a antagonist, but was less effective in reducing knee swelling over the course of the study and had no effect on knee histopathology. Combination therapy with AcF-[OPdChaWR] and ibuprofen resulted in no greater efficacy than with the C5a antagonist alone. Rats injected twice with the antigen in the 49-day study displayed the most severe histopathology and this, as well as knee swelling and gait abnormalities, was significantly reduced by repeated treatment with the C5a antagonist.
An agent that inhibits the action of C5a in this model significantly reduced joint pathology, while ibuprofen was not effective. C5a antagonists could therefore have broader therapeutic benefits than nonsteroidal antiinflammatory drugs as antiarthritic agents for rheumatoid arthritis.
确定新型口服活性C5a受体拮抗剂环肽AcF-[OPdChaWR]是否能减轻免疫介导的单关节关节炎大鼠模型的病理严重程度。
通过关节内注射甲基化牛血清白蛋白,在先前致敏的大鼠右膝诱发关节炎。对大鼠进行14天或28天的检查,或在第28天再次进行抗原攻击后检查49天。在关节炎诱导前或诱导后,每天口服给予C5a拮抗剂(1或3mg/kg/天)和/或布洛芬(30mg/kg/天)。
接受AcF-[OPdChaWR]的大鼠在第14天时,右膝肿胀、步态障碍、灌洗关节细胞数量、右膝组织病理学以及血清肿瘤坏死因子α(TNFα)水平和关节内白细胞介素-6及TNFα水平均显著降低。在14天和28天的研究中,与C5a拮抗剂相比,布洛芬在减轻步态异常和关节内炎性细胞方面效果相似,但在研究过程中减轻膝关节肿胀的效果较差,且对膝关节组织病理学无影响。AcF-[OPdChaWR]与布洛芬联合治疗的疗效并不比单独使用C5a拮抗剂更好。在49天的研究中,两次注射抗原的大鼠表现出最严重的组织病理学,而通过C5a拮抗剂重复治疗,这种情况以及膝关节肿胀和步态异常均显著减轻。
在该模型中,一种抑制C5a作用的药物可显著减轻关节病理,而布洛芬无效。因此,作为类风湿关节炎的抗关节炎药物,C5a拮抗剂可能比非甾体抗炎药具有更广泛的治疗益处。