Fiehn C, Müller-Ladner U, Gay S, Krienke S, Freudenberg-Konrad S, Funk J, Ho A D, Sinn H, Wunder A
Department of Internal Medicine I, University of Regensburg, D-93042 Regensburg, Germany.
Rheumatology (Oxford). 2004 Sep;43(9):1097-105. doi: 10.1093/rheumatology/keh254. Epub 2004 Jun 15.
To evaluate the anti-arthritic effects of the new inflammation-targeted drug MTX-HSA and to investigate whether peripheral blood mononuclear cells (PBMC) are potential target cells for albumin-mediated drug delivery.
The murine model of collagen-induced arthritis (CIA) was used to measure the anti-arthritic effect of MTX, MTX-HSA or a combination of both (n = 30 to 35 per group). In addition, the uptake of fluorescence-labelled albumin (AFLc-HSA) in PBMC of 14 patients with RA was measured by fluorescence-activated cell sorting (FACS).
In equivalent doses of 7.5 mg/kg intravenously (IV) twice a week, MTX-HSA is significantly (P<0.02) superior to MTX in inhibiting the development of CIA and reducing the joint count as well as the number of affected paws. When given in lower doses as combination therapy, both drugs act synergistically (P<0.03). A mean of 96, 72 and 64% of the CD14-, CD16- and CD20-positive cells from peripheral blood of rheumatoid arthritis (RA) patients showed an uptake of albumin after incubation with AFLc-HSA in vitro. This finding was not significantly different in comparison to healthy controls. In contrast, the number of CD3-positive cells taking up albumin is increased significantly in RA patients in comparison to controls (26.3 +/- 12.9% s.d. vs 11.6 +/- 7.3% s.d.; P = 0.005).
The data show that the effectiveness of MTX-HSA in CIA is superior to MTX and that both drugs act synergistically. In addition, albumin appears to be taken up by peripheral blood cells, suggesting that they might be one of the potential target cells of this novel anti-arthritic treatment approach.
评估新型炎症靶向药物甲氨蝶呤-人血清白蛋白(MTX-HSA)的抗关节炎作用,并研究外周血单个核细胞(PBMC)是否为白蛋白介导的药物递送的潜在靶细胞。
采用胶原诱导性关节炎(CIA)小鼠模型来测定甲氨蝶呤(MTX)、MTX-HSA或两者联合使用的抗关节炎作用(每组n = 30至35)。此外,通过荧光激活细胞分选(FACS)测定14例类风湿关节炎(RA)患者PBMC中荧光标记白蛋白(AFLc-HSA)的摄取情况。
在每周两次静脉注射(IV)等效剂量7.5 mg/kg时,MTX-HSA在抑制CIA发展、减少关节计数以及患爪数量方面显著优于MTX(P<0.02)。当以较低剂量联合治疗时,两种药物具有协同作用(P<0.03)。类风湿关节炎(RA)患者外周血中平均96%、72%和64%的CD14、CD16和CD20阳性细胞在体外与AFLc-HSA孵育后显示摄取白蛋白。与健康对照相比,这一发现无显著差异。相反,与对照组相比,RA患者摄取白蛋白的CD3阳性细胞数量显著增加(标准差分别为26.3±1 + /-12.9%与11.6±7.3%;P = 0.005)。
数据表明MTX-HSA在CIA中的有效性优于MTX,且两种药物具有协同作用。此外,白蛋白似乎被外周血细胞摄取,提示它们可能是这种新型抗关节炎治疗方法的潜在靶细胞之一。