Stuhlmeier K M, Pollaschek C
Ludwig Boltzmann Institute for Rheumatology and Balneology, Kurbadstrasse 10, 1100 Vienna, Austria.
Rheumatology (Oxford). 2004 Feb;43(2):164-9. doi: 10.1093/rheumatology/keh014. Epub 2003 Sep 16.
Glucocorticoids are still a mainstay in the treatment of rheumatoid arthritis (RA). Unfettered hyaluronan release is a hallmark of RA. The discovery of three genes encoding hyaluronan synthase (HAS) led us to investigate the effect of hydrocortisone and dexamethasone on the activation of these genes at the molecular level and, at least in part, the mode of action of these drugs.
Reverse transcription-polymerase chain reaction (RT-PCR) was used to monitor levels of HAS1, HAS2, and HAS3 mRNAs in cultured fibroblast-like synoviocytes (FS) and in leucocytes isolated from synovial fluid of RA patients. Western blot experiments were used to investigate the effect of hydrocortisone on transforming growth factor beta (TGF-beta)-induced activation of the p38 mitogen-activated protein kinase (MAPK) pathway.
Hydrocortisone and dexamethasone suppressed HAS2 and HAS3 mRNAs accumulation concentration-dependently. Contrary to HAS2 and HAS3, HAS1 in FS was not constitutively activated. When cells were stimulated with TGF-beta, a potent activator of HAS1 mRNA transcription, treating them with hydrocortisone suppressed induced activation of HAS1 in a concentration- and time-dependent manner. Similar suppressive effects of hydrocortisone were observed when leucocytes isolated from synovial fluid of inflamed joints were used instead of cultured FS. Furthermore, western blot experiments confirmed that hydrocortisone blocked TGF-beta-induced phosphorylation of p38 MAPK, a kinase essential for TGF-beta-induced HAS activation.
Our data demonstrate that glucocorticoids suppress all genes encoding hyaluronan. We speculate that inhibition of HAS genes might account for the beneficial effect of glucocorticoid treatment, and also for the detrimental effects of long-term use.
糖皮质激素仍是类风湿关节炎(RA)治疗的主要药物。不受限制的透明质酸释放是RA的一个标志。编码透明质酸合酶(HAS)的三个基因的发现促使我们在分子水平上研究氢化可的松和地塞米松对这些基因激活的影响,以及这些药物至少部分的作用模式。
采用逆转录聚合酶链反应(RT-PCR)监测培养的成纤维细胞样滑膜细胞(FS)和从RA患者滑液中分离的白细胞中HAS1、HAS2和HAS3 mRNA的水平。蛋白质印迹实验用于研究氢化可的松对转化生长因子β(TGF-β)诱导的p38丝裂原活化蛋白激酶(MAPK)途径激活的影响。
氢化可的松和地塞米松浓度依赖性地抑制HAS2和HAS3 mRNA的积累。与HAS2和HAS3相反,FS中的HAS1不是组成性激活的。当细胞用TGF-β刺激时,TGF-β是HAS1 mRNA转录的有效激活剂,用氢化可的松处理细胞可浓度和时间依赖性地抑制HAS1的诱导激活。当使用从炎症关节滑液中分离的白细胞代替培养的FS时,观察到氢化可的松有类似的抑制作用。此外,蛋白质印迹实验证实氢化可的松阻断了TGF-β诱导的p38 MAPK磷酸化,p38 MAPK是TGF-β诱导HAS激活所必需的激酶。
我们的数据表明糖皮质激素抑制所有编码透明质酸的基因。我们推测抑制HAS基因可能解释了糖皮质激素治疗的有益效果,也解释了长期使用的有害影响。