School of Biomedical Sciences, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong, China.
Br J Pharmacol. 2010 Feb;159(4):958-69. doi: 10.1111/j.1476-5381.2009.00586.x. Epub 2010 Jan 29.
Current single drug treatments for rheumatoid arthritis have problems of limited efficacy and/or high toxicity. This study investigates the benefits of individual and combined treatments with dexamethasone and substance P and glutamate receptor antagonists in a rat model of arthritis.
Arthritis was induced in rats by unilateral intra-articular injection of Freund's complete adjuvant. Separate groups of rats were subjected to the following treatments 15 min before induction of arthritis: (i) control with no drug treatment; (ii) single intra-articular injection of a NK(1) receptor antagonist RP67580; (iii) single intra-articular injection of a NMDA receptor antagonist AP7 plus a non-NMDA receptor antagonist CNQX; (iv) daily oral dexamethasone; and (v) combined treatment with dexamethasone and all of the above receptor antagonists. Knee joint allodynia, swelling, hyperaemia and histological changes were examined over a period of 7 days.
Treatment with dexamethasone suppressed joint swelling, hyperaemia and histological changes that include polymorphonuclear cell infiltration, synovial tissue proliferation and cartilage erosion in the arthritic rat knees. Treatment with RP67580 or AP7 plus CNQX did not attenuate hyperaemia or histological changes, but reduced joint allodynia and swelling. Co-administration of dexamethasone with these receptor antagonists produced greater inhibition on joint allodynia and swelling than their individual effects.
The data suggest substance P and glutamate contribute to arthritic pain and joint swelling. The efficacy of dexamethasone in reducing arthritic pain and joint swelling can be improved by co-administration of substance P and glutamate receptor antagonists.
目前治疗类风湿关节炎的单一药物存在疗效有限和/或毒性高的问题。本研究探讨了地塞米松与 P 物质和谷氨酸受体拮抗剂单独和联合治疗在关节炎大鼠模型中的益处。
通过向大鼠单侧关节内注射完全弗氏佐剂诱导关节炎。将单独的大鼠分组进行以下治疗,在关节炎诱导前 15 分钟:(i)无药物治疗的对照;(ii)单次关节内注射 NK(1)受体拮抗剂 RP67580;(iii)单次关节内注射 NMDA 受体拮抗剂 AP7 加非 NMDA 受体拮抗剂 CNQX;(iv)每日口服地塞米松;和(v)地塞米松与所有上述受体拮抗剂联合治疗。在 7 天的时间内检查膝关节的关节过敏、肿胀、充血和组织学变化。
地塞米松治疗抑制了关节炎大鼠膝关节的肿胀、充血和组织学变化,包括多形核细胞浸润、滑膜组织增生和软骨侵蚀。RP67580 或 AP7 加 CNQX 治疗不能减轻充血或组织学变化,但减轻了关节过敏和肿胀。地塞米松与这些受体拮抗剂联合使用对关节过敏和肿胀的抑制作用大于其单独作用。
数据表明 P 物质和谷氨酸有助于关节炎疼痛和关节肿胀。地塞米松通过联合使用 P 物质和谷氨酸受体拮抗剂可提高减轻关节炎疼痛和关节肿胀的疗效。