血液诱导的血友病性关节炎中的骨丢失可通过阻断 iRhom2/ADAM17/TNF-α 通路来预防。

Blood-induced bone loss in murine hemophilic arthropathy is prevented by blocking the iRhom2/ADAM17/TNF-α pathway.

机构信息

Arthritis and Tissue Degeneration Program and.

Autoimmunity and Inflammation Program, Hospital for Special Surgery, New York, NY.

出版信息

Blood. 2018 Sep 6;132(10):1064-1074. doi: 10.1182/blood-2017-12-820571. Epub 2018 May 18.

Abstract

Hemophilic arthropathy (HA) is a debilitating degenerative joint disease that is a major manifestation of the bleeding disorder hemophilia A. HA typically begins with hemophilic synovitis that resembles inflammatory arthritides, such as rheumatoid arthritis, and frequently results in bone loss in patients. A major cause of rheumatoid arthritis is inappropriate release of the proinflammatory cytokine tumor necrosis factor-α (TNF-α) by the TNF-α convertase (TACE; also referred to as ADAM17) and its regulator, iRhom2. Therefore, we hypothesized that iRhom2/ADAM17-dependent shedding of TNF-α also has a pivotal role in mediating HA. Here, we show that addition of blood or its components to macrophages activates iRhom2/ADAM17-dependent TNF-α shedding, providing the premise to study the activation of this pathway by blood in the joint in vivo. For this, we turned to hemophilic deficient mice ( mice), which develop a hemarthrosis following needle puncture injury with synovial inflammation and significant osteopenia adjacent to the affected joint. We found that needle puncture-induced bleeding leads to increased TNF-α levels in the affected joint of mice. Moreover, inactivation of TNF-α or iRhom2 in mice reduced the osteopenia and synovial inflammation that develops in this mouse model for HA. Taken together, our results suggest that blood entering the joint activates the iRhom2/ADAM17/TNF-α pathway, thereby contributing to osteopenia and synovitis in mice. Therefore, this proinflammatory signaling pathway could emerge as an attractive new target to prevent osteoporosis and joint damage in HA patients.

摘要

血友病性关节病(HA)是一种使人虚弱的退行性关节疾病,是血友病 A 出血性疾病的主要表现。HA 通常始于血友病性滑膜炎,类似于类风湿性关节炎等炎症性关节炎,并且经常导致患者骨质流失。类风湿性关节炎的一个主要原因是促炎性细胞因子肿瘤坏死因子-α(TNF-α)的 TNF-α 转化酶(TACE;也称为 ADAM17)及其调节剂 iRhom2 的不当释放。因此,我们假设 iRhom2/ADAM17 依赖性 TNF-α 的脱落也在介导 HA 中起关键作用。在这里,我们表明血液或其成分添加到巨噬细胞中会激活 iRhom2/ADAM17 依赖性 TNF-α 的脱落,为研究血液在体内关节中激活该途径提供了前提。为此,我们转向血友病缺乏症小鼠( mice),这些小鼠在接受关节内注射损伤后会发生关节积血,伴有滑膜炎和受影响关节附近的明显骨质疏松症。我们发现,针穿刺引起的出血会导致受影响的关节中 TNF-α水平升高 mice。此外,在 mice 中灭活 TNF-α 或 iRhom2 可减少这种 HA 小鼠模型中发展的骨质疏松症和滑膜炎。总之,我们的结果表明,进入关节的血液会激活 iRhom2/ADAM17/TNF-α 途径,从而导致小鼠的骨质疏松症和滑膜炎。因此,这种促炎信号通路可能成为预防血友病患者骨质疏松症和关节损伤的有吸引力的新靶点。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9e92/6128089/b31544e47150/blood820571absf1.jpg

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