A metabolite of substance P, SP7-11 is involved in the pathogenesis of inflammatory joint disease

Neuropeptides: important regulators of joint homeostasis

PURPOSE

This review explores the mechanisms of joint pain with a special focus on the role of neuropeptides in pain transmission and their potential role in the progression of joint degeneration as seen in osteoarthritis.

METHODS

A literature search was performed on papers published between January 1990 and September 2017 using the Web of Science Core Collection, MEDLINE and Scopus databases.

RESULTS

What is seen in the subchondral bone and synovia is mirrored in the central nervous system (CNS). Substance P, calcitonin gene-related peptide, vasoactive intestinal peptide and neuropeptide Y are the major peptides involved both in the generation of pain as well as reducing pain post-joint trauma. The interplay between them and other neuropeptides and cytokines influence how noxious stimuli are transduced, transmitted and modulated for a final pain perception as part of a complex cascade of events. There is a close interaction between the different components in the joint that together cross-talk to adapt to load and catabolic factors during injury and inflammation.

CONCLUSION

The articular joint should be seen as an organ where local joint pain development and maintenance is influenced by interplay between the local transmitters in the joints as well as their dependence on the CNS. A slow-release cocktail of mixed antibodies targeted against neuropeptides and receptor blockers/stimulators involved in the events of early joint pain or any inflammatory joint disease is a future treatment target.

LEVEL OF EVIDENCE

V.

The contribution of the synovium, synovial derived inflammatory cytokines and neuropeptides to the pathogenesis of osteoarthritis

Osteoarthritis (OA) is one of the most common and disabling chronic joint disorders affecting horses, dogs and humans. Synovial inflammation or synovitis is a frequently observed phenomenon in osteoarthritic joints and contributes to the pathogenesis of OA through formation of various catabolic and pro-inflammatory mediators altering the balance of cartilage matrix degradation and repair. Catabolic mediators produced by the inflamed synovium include pro-inflammatory cytokines, nitric oxide, prostaglandin E(2) and several neuropeptides, which further contribute to the pathogenesis of OA by increasing cartilage degradation. Recent studies suggest that substance P, corticotropin-releasing factor, urocortin and vasoactive intestinal peptide may also be involved in OA development, but the precise role of these neuropeptides in the pathogenesis of OA is not known. Since increased production of matrix metalloproteinases by the synovium is stimulated by pro-inflammatory cytokines, future anti-inflammatory therapies should focus on the synovium as a means of controlling subsequent inflammatory damage.

The pathophysiology of osteoarthritis

Osteoarthritis (OA) is a complex disease whose pathogenesis includes the contribution of biomechanical and metabolic factors which, altering the tissue homeostasis of articular cartilage and subchondral bone, determine the predominance of destructive over productive processes. A key role in the pathophysiology of articular cartilage is played by cell/extra-cellular matrix (ECM) interactions, which are mediated by cell surface integrins. In a physiologic setting, integrins modulate cell/ECM signaling, essential for regulating growth and differentiation and maintaining cartilage homeostasis. During OA, abnormal integrin expression alters cell/ECM signaling and modifies chondrocyte synthesis, with the following imbalance of destructive cytokines over regulatory factors. IL-1, TNF-alpha and other pro-catabolic cytokines activate the enzymatic degradation of cartilage matrix and are not counterbalanced by adequate synthesis of inhibitors. The main enzymes involved in ECM breakdown are metalloproteinases (MMPs), which are sequentially activated by an amplifying cascade. MMP activity is partially inhibited by the tissue inhibitors of MMPs (TIMPs), whose synthesis is low compared with MMP production in OA cartilage. Intriguing is the role of growth factors such as TGF-beta, IFG, BMP, NGF, and others, which do not simply repair the tissue damage induced by catabolic factors, but play an important role in OA pathogenesis.

Respiratory syncytial virus infection and G and/or SH protein expression contribute to substance P, which mediates inflammation and enhanced pulmonary disease in BALB/c mice

A distinct clinical presentation of respiratory syncytial virus (RSV) infection of humans is bronchiolitis, which has clinical features similar to those of asthma. Substance P (SP), a tachykinin neuropeptide, has been associated with neurogenic inflammation and asthma; therefore, we chose to examine SP-induced inflammation with RSV infection. In this study, we examined the production of pulmonary SP associated with RSV infection of BALB/c mice and the effect of anti-SP F(ab)(2) antibodies on the pulmonary inflammatory response. The peak production of pulmonary SP occurred between days 3 and 5 following primary RSV infection and day 1 after secondary infection. Treatment of RSV-infected mice with anti-SP F(ab)(2) antibodies suggested that SP may alter the natural killer cell response to primary and secondary infection. In mice challenged after formalin-inactivated RSV vaccination, SP appears to markedly enhance pulmonary eosinophilia as well as increase polymorphonuclear cell trafficking to the lung. Based on studies with a strain of RSV that lacks the G and SH genes, the SP response to RSV infection appears to be associated with G and/or SH protein expression. These data suggest that SP may be an important contributor to the inflammatory response to RSV infection and that anti-SP F(ab)(2) antibodies might be used to ameliorate RSV-associated disease.

Metabolism and degradation products of recombinant human insulin-like growth factor-I in lysosomes of rat kidney

1. The degradation of recombinant human insulin-like growth factor-I (rhIGF-I) by purified lysosomes of rat kidney was examined in vitro. The peptide structures of the 13 degradation products were deduced from the sequence analysis and the molecular mass. Rat kidney lysosomal cathepsins efficiently cleave rhIGF-I to two chain peptides, like insulin. The cleavages mainly occur at the C-peptide/A-chain junction, D-peptide/A-chain junction and B21-22 or B22-23. 2. The effect of inhibitors on the lysosomal degradation of rhIGF-I was examined semiquantitatively by the rate of formation of the degradation products. The degradation of rhIGF-I was almost completely inhibited by the lysosomal cysteine protease inhibitors, leupeptin and leucine chloromethyl ketone, and a serine protease inhibitor, phenylmethylsulphonyl fluoride. On the other hand, the degradation was enhanced by the addition of a reducing agent, glutathione.

The effect of substance P on proliferation and proteoglycan deposition of cells derived from rabbit intervertebral disc

STUDY DESIGN

This study is an in vitro investigation of the effects of substance P on intervertebral disc cell metabolism.

OBJECTIVES

To determine whether the neuropeptide, substance P, affects cells isolated from the intervertebral disc.

SUMMARY OF THE BACKGROUND DATA

Nerve fibers containing substance P are present in the anulus fibrosus and may be released from the nerve terminals as in other tissues. Substance P is mitogenic for a variety of immune and connective tissue cells, and a fragment of the peptide affects the metabolism of articular chondrocytes.

METHODS

Cells were isolated enzymically from the anulus fibrosus of intervertebral disc of 8-week-old rabbits. The effects of substance P and the C-terminal pentapeptide fragment SP7-11 on cell proliferation and proteoglycan deposition were determine by crystal violet and Alcian blue staining, respectively.

RESULTS

Substance P ((10)-11-(10)-7 mol/l) had a small stimulatory effect on disc cell proliferation. Proteoglycan deposition in the cell layer increased concomitantly. A greater proliferative effect was observed with substance P fragment 7-11 or with the addition of the neutral endopeptidase inhibitor, phosphoramidon.

CONCLUSIONS

Substance P has small mitogenic effects on rabbit intervertebral disc cells in vitro. Further investigation is required to establish whether this might have biologic relevance in relation to the maintenance or repair of the intervertebral disc.

Neuroimmunomodulation: classical and non-classical cellular activation

As neuroimmunologists, we are often faced with the fact that some substances can either enhance or inhibit particular immune/inflammatory cell functions. This 'duality' could only partially be explained by dose-dependency and the fact that in a variety of systems, heterogenous cell populations are commonly used. For example it has been repetitively shown that cell proliferation, immunoglobulin synthesis and NK (natural killer) activity could be enhanced, inhibited or not affected at all by such neuropeptides as somatostatin (SOM) or vasoactive intestinal peptide (VIP), depending on the experimental conditions. Even substance P (SP), which, in general, stimulates lymphocyte activity, can, under certain conditions, possess an inhibitory activity. These apparent discrepancies between various groups and experimental conditions met with a strong reservation among 'classical' immunologists as they questioned the true physiological role that neuro-immune interactions play in normal and disease states. However, upon a detailed analysis of the data, it become obvious why such discrepancies abounded. Not only are we comparing totally different responses in different species, but almost always we compare different experimental conditions. In lieu of this, the reproducibility of the experiments within the same laboratory is in fact very high. One fundamental and striking observation is the fact that at the level of a homogeneous cell population, a differential response could be evoked by the same neuropeptide over a range of concentrations. For the purpose of this brief report we will focus on the cellular responses to the neuropeptide substance P and we will try to illustrate why such differential responses are possible. Some of the physiological data relating to the effects of SP on cell function will be discussed. This will be followed by a synopsis of SP receptor mechanisms on effector cells and finally the mechanism by which SP activates secondary messenger systems in these cells.