Virakul Sita, Dalm Virgil A S H, Paridaens Dion, van den Bosch Willem A, Hirankarn Nattiya, van Hagen P Martin, Dik Willem A
Department of Immunology, Erasmus MC, University Medical Center, PO Box 2040, 3000, CA, Rotterdam, The Netherlands.
Graefes Arch Clin Exp Ophthalmol. 2014 Jul;252(7):1101-9. doi: 10.1007/s00417-014-2674-7. Epub 2014 May 30.
Graves' ophthalmopathy (GO) remains hard to treat. Excessive orbital fibroblast activation by platelet-derived growth factor (PDGF)-BB contributes to GO. The tyrosine kinase inhibitors (TKIs) imatinib mesylate and dasatinib both target PDGF-receptor tyrosine kinase activity, albeit with a different potency. We compared the efficacy of these TKIs on PDGF-BB-induced proliferation, and on cytokine and hyaluronan production by orbital fibroblasts. Also the capacity of dasatinib to suppress GO-associated gene expression in orbital tissue was examined.
Orbital fibroblasts from four GO patients and five control subjects were used. The efficacy of the two TKIs was tested by: 1) pre-incubating orbital fibroblasts overnight with different TKI concentrations, followed by 24 h stimulation with PDGF-BB, 2) adding TKI and PDGF-BB simultaneously to the orbital fibroblasts in 24 h cultures. Proliferation was assessed by colorimetric assay. Hyaluronan and cytokine production were measured by ELISA. Furthermore, orbital tissue was obtained from a patient with active GO, and the effect of dasatinib on the expression levels of HAS2-, CCL2-, IL6-, and IL8-mRNA expression was examined by real-time quantitative PCR.
Pre-incubation of orbital fibroblasts with imatinib mesylate or dasatinib resulted in significant and dose-dependent inhibition of PDGF-BB-induced orbital fibroblast proliferation, and hyaluronan and cytokine production. Dasatinib exhibited these effects at far lower concentrations. The same results were observed in the setting where TKI and PDGF-BB treatments were commenced simultaneously. In orbital tissue from active GO, dasatinib significantly suppressed HAS2-, CCL2-, IL6- and IL8-mRNA levels.
Dasatinib may be a promising alternative to high-dose steroids in the treatment of GO.
格雷夫斯眼病(GO)仍然难以治疗。血小板衍生生长因子(PDGF)-BB过度激活眼眶成纤维细胞会导致GO。甲磺酸伊马替尼和达沙替尼这两种酪氨酸激酶抑制剂(TKIs)均靶向PDGF受体酪氨酸激酶活性,尽管其效力不同。我们比较了这些TKIs对PDGF-BB诱导的增殖以及眼眶成纤维细胞产生细胞因子和透明质酸的疗效。此外,还研究了达沙替尼抑制眼眶组织中GO相关基因表达的能力。
使用来自4例GO患者和5例对照受试者的眼眶成纤维细胞。通过以下方式测试两种TKIs的疗效:1)将眼眶成纤维细胞与不同浓度的TKIs预孵育过夜,然后用PDGF-BB刺激24小时;2)在24小时培养中同时向眼眶成纤维细胞中加入TKI和PDGF-BB。通过比色法评估增殖情况。通过酶联免疫吸附测定法测量透明质酸和细胞因子的产生。此外,从一名活动性GO患者获取眼眶组织,通过实时定量PCR检测达沙替尼对HAS2、CCL2、IL6和IL8 mRNA表达水平的影响。
用甲磺酸伊马替尼或达沙替尼预孵育眼眶成纤维细胞会导致对PDGF-BB诱导的眼眶成纤维细胞增殖、透明质酸和细胞因子产生产生显著的剂量依赖性抑制。达沙替尼在低得多的浓度下就表现出这些作用。在同时开始TKI和PDGF-BB治疗的情况下也观察到了相同的结果。在活动性GO的眼眶组织中,达沙替尼显著抑制HAS2、CCL2、IL6和IL8 mRNA水平。
在GO的治疗中,达沙替尼可能是高剂量类固醇的一种有前景的替代药物。