Fernandes J C, Caron J P, Martel-Pelletier J, Jovanovic D, Mineau F, Tardif G, Otterness I G, Pelletier J P
Louis-Charles Simard Research Center, Osteoarthritis Research Unit, Notre-Dame Hospital, Montreal, Quebec, Canada.
Arthritis Rheum. 1997 Feb;40(2):284-94. doi: 10.1002/art.1780400213.
To study, in vivo, the therapeutic effectiveness of tenidap, an antirheumatic drug, on the progression of lesions in an experimental osteoarthritis (OA) dog model. The action of tenidap on the activity and expression of metalloproteases in cartilage, as well as on the bioactivity of interleukin-1 (IL-1) in synovial fluid, was determined.
The anterior cruciate ligament of the right stifle joint of 20 mongrel dogs was sectioned through a stab wound. Dogs were divided into 3 groups: group I (n = 7) received no treatment, group II (n = 6) was treated with oral omeprazole (20 mg/day), and group III (n = 7) received oral omeprazole (20 mg/day) and a therapeutic dosage of oral tenidap (3 mg/kg twice daily). Four weeks following surgery, the untreated dogs (group I) were killed, and drug treatments were begun for the other dogs (groups II and III). These dogs received medications for 8 weeks (weeks 4-12) and then were killed. Evaluations were made of the incidence and size of osteophytes as well as of the size and grade of cartilage erosions on both the condyles and plateaus. Histologic examination of the severity of the cartilage lesions and synovial inflammation was also performed. Activity levels of collagenase, stromelysin, and gelatinase as well as collagenase-1, collagenase-3, and stromelysin-1 messenger RNA were determined in the cartilage. The level of IL-1 activity in the synovial fluid was also measured.
Among the dogs with OA, lesions were more severe at 12 weeks than at 4 weeks. Group III (tenidap-treated) dogs had a slightly reduced incidence of osteophytes compared with the group II (12-week OA) dogs (71% versus 100%), and the size of the osteophytes was significantly diminished (mean +/- SEM 1.75 +/- 0.69 mm versus 4.38 +/- 0.64 mm). Macroscopically, tenidap decreased the size (condyles 6.00 +/- 2.18 mm2 versus 21.08 +/- 6.70 mm2, plateaus 15.50 +/- 4.77 mm2 versus 35.0 +/- 3.64 mm2) and the grade (condyles 0.57 +/- 0.20 versus 1.17 +/- 0.21, plateaus 1.07 +/- 0.22 versus 2.00 +/- 0.25) of the cartilage lesions compared with the 12-week OA dogs. At the histologic level, the severity of cartilage lesions was also decreased in the tenidap-treated dogs versus the 12-week OA dogs, both on the condyles (3.43 +/- 0.54 versus 5.55 +/- 0.38) and on the plateaus (3.39 +/- 0.35 versus 5.54 +/- 0.60). All 3 OA groups showed a significant and similar level of synovial inflammation. Tenidap markedly decreased collagenase, stromelysin, and gelatinase activity, as well as the level of expression of collagenase-3 in the cartilage. Interestingly, the activity level of IL-1 in synovial fluid was also significantly reduced in the tenidap-treated dogs.
Tenidap markedly reduced the severity of OA lesions, indicating the effect of this drug in decreasing the progression of disease. It appears that the drug acts by reducing the activity and/or expression of metalloproteases in cartilage, a process known to play a major role in the pathophysiology of OA lesions. This effect could be mediated by the suppressive effect of tenidap on IL-1 activity.
在体内研究抗风湿药物替硝唑对实验性骨关节炎(OA)犬模型病变进展的治疗效果。测定替硝唑对软骨中金属蛋白酶活性和表达的作用,以及对滑液中白细胞介素-1(IL-1)生物活性的作用。
通过刺伤切断20只杂种犬右膝关节的前交叉韧带。将犬分为3组:I组(n = 7)不接受治疗,II组(n = 6)口服奥美拉唑(20 mg/天)治疗,III组(n = 7)口服奥美拉唑(20 mg/天)并给予治疗剂量的口服替硝唑(3 mg/kg,每日两次)。手术后4周,处死未治疗的犬(I组),开始对其他犬(II组和III组)进行药物治疗。这些犬接受药物治疗8周(第4 - 12周),然后处死。评估骨赘的发生率和大小以及髁和平台上软骨侵蚀的大小和等级。还对软骨病变和滑膜炎症的严重程度进行了组织学检查。测定软骨中胶原酶、基质溶解素和明胶酶的活性水平以及胶原酶-1、胶原酶-3和基质溶解素-1信使核糖核酸的水平。还测量了滑液中IL-1的活性水平。
在患有OA的犬中,12周时的病变比4周时更严重。与II组(12周OA)犬相比,III组(接受替硝唑治疗)犬的骨赘发生率略有降低(71%对100%),且骨赘大小显著减小(平均±标准误1.75±0.69 mm对4.38±0.64 mm)。宏观上,与12周OA犬相比,替硝唑减小了软骨病变的大小(髁6.00±2.18 mm²对21.08±6.70 mm²,平台15.50±4.77 mm²对35.0±3.64 mm²)和等级(髁0.57±0.20对1.17±0.21,平台1.07±0.22对2.00±0.25)。在组织学水平上,与12周OA犬相比,接受替硝唑治疗的犬在髁(3.43±0.54对5.55±0.38)和平台(3.39±0.35对5.54±0.60)上软骨病变的严重程度也降低了。所有3个OA组的滑膜炎症水平均显著且相似。替硝唑显著降低了软骨中胶原酶、基质溶解素和明胶酶的活性,以及胶原酶-3的表达水平。有趣的是,接受替硝唑治疗的犬滑液中IL-1的活性水平也显著降低。
替硝唑显著降低了OA病变的严重程度,表明该药物在减缓疾病进展方面的作用。看来该药物通过降低软骨中金属蛋白酶的活性和/或表达起作用,这一过程在OA病变的病理生理学中起主要作用。这种作用可能由替硝唑对IL-1活性的抑制作用介导。