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Wang Z, Huang J, Xie D, He D, Lu A, Liang C. Toward Overcoming Treatment Failure in Rheumatoid Arthritis. Front Immunol 2022; 12:755844. [PMID: 35003068 PMCID: PMC8732378 DOI: 10.3389/fimmu.2021.755844] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 12/06/2021] [Indexed: 12/29/2022] Open
Abstract
Rheumatoid arthritis (RA) is an autoimmune disorder characterized by inflammation and bone erosion. The exact mechanism of RA is still unknown, but various immune cytokines, signaling pathways and effector cells are involved. Disease-modifying antirheumatic drugs (DMARDs) are commonly used in RA treatment and classified into different categories. Nevertheless, RA treatment is based on a "trial-and-error" approach, and a substantial proportion of patients show failed therapy for each DMARD. Over the past decades, great efforts have been made to overcome treatment failure, including identification of biomarkers, exploration of the reasons for loss of efficacy, development of sequential or combinational DMARDs strategies and approval of new DMARDs. Here, we summarize these efforts, which would provide valuable insights for accurate RA clinical medication. While gratifying, researchers realize that these efforts are still far from enough to recommend specific DMARDs for individual patients. Precision medicine is an emerging medical model that proposes a highly individualized and tailored approach for disease management. In this review, we also discuss the potential of precision medicine for overcoming RA treatment failure, with the introduction of various cutting-edge technologies and big data.
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Affiliation(s)
- Zhuqian Wang
- Department of Biology, School of Life Sciences, Southern University of Science and Technology, Shenzhen, China.,Institute of Integrated Bioinfomedicine and Translational Science (IBTS), School of Chinese Medicine, Hong Kong Baptist University, Hong Kong, Hong Kong SAR, China.,Law Sau Fai Institute for Advancing Translational Medicine in Bone and Joint Diseases, School of Chinese Medicine, Hong Kong Baptist University, Hong Kong, Hong Kong SAR, China
| | - Jie Huang
- Department of Biology, School of Life Sciences, Southern University of Science and Technology, Shenzhen, China
| | - Duoli Xie
- Institute of Integrated Bioinfomedicine and Translational Science (IBTS), School of Chinese Medicine, Hong Kong Baptist University, Hong Kong, Hong Kong SAR, China.,Law Sau Fai Institute for Advancing Translational Medicine in Bone and Joint Diseases, School of Chinese Medicine, Hong Kong Baptist University, Hong Kong, Hong Kong SAR, China
| | - Dongyi He
- Institute of Arthritis Research in Integrative Medicine, Shanghai Academy of Traditional Chinese Medicine, Shanghai, China.,Department of Rheumatology, Shanghai Guanghua Hospital of Integrative Medicine, Shanghai, China
| | - Aiping Lu
- Institute of Integrated Bioinfomedicine and Translational Science (IBTS), School of Chinese Medicine, Hong Kong Baptist University, Hong Kong, Hong Kong SAR, China.,Law Sau Fai Institute for Advancing Translational Medicine in Bone and Joint Diseases, School of Chinese Medicine, Hong Kong Baptist University, Hong Kong, Hong Kong SAR, China.,Institute of Arthritis Research in Integrative Medicine, Shanghai Academy of Traditional Chinese Medicine, Shanghai, China.,Guangdong-Hong Kong-Macau Joint Lab on Chinese Medicine and Immune Disease Research, Guangzhou, China
| | - Chao Liang
- Department of Biology, School of Life Sciences, Southern University of Science and Technology, Shenzhen, China.,Institute of Integrated Bioinfomedicine and Translational Science (IBTS), School of Chinese Medicine, Hong Kong Baptist University, Hong Kong, Hong Kong SAR, China.,Law Sau Fai Institute for Advancing Translational Medicine in Bone and Joint Diseases, School of Chinese Medicine, Hong Kong Baptist University, Hong Kong, Hong Kong SAR, China
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Lee R, Choi SJ, Moon KC, Park JW, Kim K, Yoon SY, Youn I. Fluorogenic Probe for Detecting Active Matrix Metalloproteinase-3 (MMP-3) in Plasma and Peripheral Blood Neutrophils to Indicate the Severity of Rheumatoid Arthritis. ACS Biomater Sci Eng 2019; 5:3039-3048. [DOI: 10.1021/acsbiomaterials.9b00084] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- Ruda Lee
- International Research Organization for Advanced Science and Technology (IROAST), Kumamoto University, 2-39-1 Kurokami, Chuo-ku, Kumamoto, 860-8555, Japan
- Magnesium Research Center (MRC), Kumamoto University, 2-39-1 Kurokami, Chuo-ku, Kumamoto, 860-8555, Japan
| | - Sung-Jae Choi
- Department of Internal Medicine, Division of Rheumatology, College of Medicine, Korea University, 516 Danwon-gu, Ansan, 15355, Republic of Korea
| | - Kyung Chul Moon
- Department of Laboratory Medicine, College of Medicine, Korea University, 148 Gurodong-ro, Guro-ku, Seoul, 08308, Republic of Korea
| | - Jong Woong Park
- Department of Orthopedic Surgery, College of Medicine, Korea University, Anam-dong 5-ga, Seongbuk-gu, Seoul, 02841, Republic of Korea
| | - Kwangmeyung Kim
- Biomedical Research Center, Korea Institute of Science and Technology, 5. Hwarang-ro 14-gil, Seongbuk-gu, Seoul 02792, Republic of Korea
| | - Soo-Young Yoon
- Department of Laboratory Medicine, College of Medicine, Korea University, 148 Gurodong-ro, Guro-ku, Seoul, 08308, Republic of Korea
| | - Inchan Youn
- Biomedical Research Center, Korea Institute of Science and Technology, 5. Hwarang-ro 14-gil, Seongbuk-gu, Seoul 02792, Republic of Korea
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Li S, Xiang C, Wei X, Sun X, Li R, Li P, Sun J, Wei D, Chen Y, Zhang Y, Wei L. Early supplemental α2-macroglobulin attenuates cartilage and bone damage by inhibiting inflammation in collagen II-induced arthritis model. Int J Rheum Dis 2019; 22:654-665. [PMID: 30609267 DOI: 10.1111/1756-185x.13457] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Accepted: 11/08/2018] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To determine if early supplemental intra-articular α2-macroglobulin (A2M) has a chondroprotective effect in a collagen II-induced arthritis (CIA) mice model. METHODS DBA/1 mice were randomized into four groups (n = 15/group): (a) CIA + 1.2 μg of A2M; (b) CIA + 0.8 μg of A2M; (c) CIA + 0.4 μg of A2M; (d) vehicle + phosphate-buffered saline (PBS). A2M was injected into right ankles and PBS was injected into the left ankles simultaneously as internal control at days 36, 43 and 50. The CIA inflammation clinical score and ankle thickness were recorded every other day starting on day 21 until sacrifice. Changes in inflammation were monitored by in vivo fluorescence molecular tomography (FMT). Inflammation, cartilage and bone damage were assessed with X-ray, histology and immunohistochemistry. Cartilage and inflammation-related gene expression was quantified by real-time polymerase chain reaction (PCR). RESULTS All mice showed ankle inflammation on day 33. After day 43, lower clinical scores, ankle thickness and Sharp/van der Heijde method scores in A2M-treated ankles compared with PBS-treated ankles. FMT data indicated that the inflammation markers MMPSense and ProSense were significantly elevated in the PBS-treated ankles than A2M-treated ankles. Histology and X-ray analyses indicated that A2M administration resulted in lower levels of inflammatory infiltration and synovial hyperplasia, as well as more typical cartilage and bone organization with increased COL II and Aggrecan staining when compared with PBS-treated ankles. In addition, real-time PCR showed that,matrix metalloproteinase-3, -9, -13, COL X and Runx2 were significantly less expressed in A2M-treated groups than PBS-treated animals. CONCLUSION Early supplemental intra-articular A2M exerts an anti-inflammatory effect and attenuates cartilage and bone damage in a CIA model.
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Affiliation(s)
- Shengchun Li
- The Second Hospital of Shanxi Medical University, Taiyuan, China
| | - Chuan Xiang
- The Second Hospital of Shanxi Medical University, Taiyuan, China
| | - Xiaochun Wei
- The Second Hospital of Shanxi Medical University, Taiyuan, China
| | - Xiaojuan Sun
- The Second Hospital of Shanxi Medical University, Taiyuan, China
| | - Ruifang Li
- The Third people's Hospital of Hubei Province, Wuhan, China
| | - Pengcui Li
- The Second Hospital of Shanxi Medical University, Taiyuan, China
| | - Jian Sun
- The Second Hospital of Shanxi Medical University, Taiyuan, China
| | - Dinglu Wei
- The Second Hospital of Shanxi Medical University, Taiyuan, China
| | - Yong Chen
- The Second Hospital of Shanxi Medical University, Taiyuan, China
| | - Yanxiang Zhang
- The Third people's Hospital of Hubei Province, Wuhan, China
| | - Lei Wei
- The Second Hospital of Shanxi Medical University, Taiyuan, China.,Department of Orthopedics, Warren Alpert Medical School of Brown University/RIH, Providence, Rhode Island
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Tong Z, Liu Y, Chen B, Yan L, Hao D. Association between MMP3 and TIMP3 polymorphisms and risk of osteoarthritis. Oncotarget 2017; 8:83563-83569. [PMID: 29137364 PMCID: PMC5663536 DOI: 10.18632/oncotarget.18745] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2016] [Accepted: 03/08/2017] [Indexed: 12/29/2022] Open
Abstract
Osteoarthritis (OA) is the most commonly occurring degenerative joint disease worldwide, and its incidence has increased in recent years. We evaluated whether there is the association between MMP-3 and TIMP-3 variants and susceptibility to OA in a Chinese population. Venous blood samples were collected from 431 female participants (200 cases and 231 controls) at Hong Hui Hospital, Xi’an Jiaotong University College of Medicine between 2015 and 2016. After genotyping the samples using standard protocols, the association between MMP-3 and TIMP-3 single nucleotide polymorphisms and risk of OA was assessed by calculating odds ratios (ORs) and 95% confidence intervals (95% CIs) using unconditional logistic regression analysis. The minor G allele of rs650108 was associated with OA risk in a recessive model (p = 0.034, OR = 1.82, 95%CI = 1.04-3.18), while the minor A allele of rs715572 was associated with OA risk in a recessive model (p = 0.030, OR = 1.88, 95%CI = 1.05-3.34). Thus a suggestive association was observed in a discovery case-control study between OA and two common SNPs, rs650108 in MMP-3 and rs715572 in TIMP-3.
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Affiliation(s)
- Zhichao Tong
- Department of Bone Diesase and Bone Tumor, Hong Hui Hospital, Xi'an Jiaotong University College of Medicine, Shaanxi 710054, China
| | - Yang Liu
- Department of Orthopaedics, Hong Hui Hospital, Xi'an Jiaotong University College of Medicine, Shaanxi 710054, China
| | - Bo Chen
- Department of Bone Diesase and Bone Tumor, Hong Hui Hospital, Xi'an Jiaotong University College of Medicine, Shaanxi 710054, China
| | - Liang Yan
- Department of Spinal Surgery, Hong Hui Hospital, Xi'an Jiaotong University College of Medicine, Shaanxi 710054, China
| | - Dingjun Hao
- Department of Spinal Surgery, Hong Hui Hospital, Xi'an Jiaotong University College of Medicine, Shaanxi 710054, China
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Zhai T, Gao C, Huo R, Sheng H, Sun S, Xie J, He Y, Gao H, Li H, Zhang J, Li H, Sun Y, Lin J, Shen B, Xiao L, Li N. Cyr61 participates in the pathogenesis of rheumatoid arthritis via promoting MMP-3 expression by fibroblast-like synoviocytes. Mod Rheumatol 2016; 27:466-475. [PMID: 27585710 DOI: 10.1080/14397595.2016.1220447] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVES The aim of this study was to investigate the effect and potential mechanism of Cysteine-rich 61 (Cyr61) on stimulating MMP-3 expression by fibroblast-like synoviocytes (FLS) from rheumatoid arthritis (RA) patients. METHODS Primarily cultured RA FLS were treated with exogenous Cyr61 protein or Cyr61-siRNA, then, MMP-3 expression was analyzed by real-time PCR, western blotting and ELISA. Signal transduction pathways in Cyr61-induced MMP-3 production were examined by real-time PCR, western blotting, confocal microscopy, luciferase reporter assay. Mice with collagen-induced arthritis (CIA) were treated with anti-Cyr61 monoclonal antibodies (mAb), or IgG1 as control and MMP-3 in the joint was detected by IHC, real-time PCR and western blotting. RESULTS High expressed MMP-3 and Cyr61 were positively correlated in RA ST; Cyr61 stimulated MMP-3 production in FLS of RA patients in an IL-1β and TNF-α independent manner. Cyr61 induced MMP-3 could further enhance the invasive ability of RA FLS. Mechanistically, we found that Cyr61 promoted MMP-3 production via the P38, JNK-dependent AP-1 signaling pathway. Blockage of Cyr61 function with monoclonal antibody could decrease MMP-3 expression in the joints of CIA mice. CONCLUSION This study provides new evidence that Cyr61 participates in RA pathogenesis not only as a pro-inflammatory factor but also plays a key role in bone erosion via promoting MMP-3 expression. We suggest that targeting of Cyr61 may represent a potential strategy in RA treatment.
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Affiliation(s)
- Tianhang Zhai
- a Department of Autoimmune Disease, Shanghai Institute of Immunology, Institute of Medical Sciences , Shanghai Jiao Tong University School of Medicine , Shanghai , China
| | - Chenxin Gao
- b Department of Bone Surgery, Institute of Arthritis Research , Shanghai Academy of Chinese Medical Sciences , Shanghai , China
| | - Rongfen Huo
- a Department of Autoimmune Disease, Shanghai Institute of Immunology, Institute of Medical Sciences , Shanghai Jiao Tong University School of Medicine , Shanghai , China
| | - Huiming Sheng
- c Department of Laboratory Medicine , Affiliated Tongren Hospital of Shanghai Jiao Tong University School of Medicine , Shanghai , China
| | - Songtao Sun
- b Department of Bone Surgery, Institute of Arthritis Research , Shanghai Academy of Chinese Medical Sciences , Shanghai , China
| | - Jun Xie
- b Department of Bone Surgery, Institute of Arthritis Research , Shanghai Academy of Chinese Medical Sciences , Shanghai , China
| | - Yong He
- b Department of Bone Surgery, Institute of Arthritis Research , Shanghai Academy of Chinese Medical Sciences , Shanghai , China
| | - Huali Gao
- b Department of Bone Surgery, Institute of Arthritis Research , Shanghai Academy of Chinese Medical Sciences , Shanghai , China
| | - Huidan Li
- a Department of Autoimmune Disease, Shanghai Institute of Immunology, Institute of Medical Sciences , Shanghai Jiao Tong University School of Medicine , Shanghai , China
| | - Jie Zhang
- a Department of Autoimmune Disease, Shanghai Institute of Immunology, Institute of Medical Sciences , Shanghai Jiao Tong University School of Medicine , Shanghai , China
| | - Haichuan Li
- a Department of Autoimmune Disease, Shanghai Institute of Immunology, Institute of Medical Sciences , Shanghai Jiao Tong University School of Medicine , Shanghai , China
| | - Yue Sun
- a Department of Autoimmune Disease, Shanghai Institute of Immunology, Institute of Medical Sciences , Shanghai Jiao Tong University School of Medicine , Shanghai , China.,d Department of Rheumatoloy , Affiliated Ruijin Hospital of Shanghai Jiao Tong University School of Medicine , Shanghai , China , and
| | - Jinpiao Lin
- a Department of Autoimmune Disease, Shanghai Institute of Immunology, Institute of Medical Sciences , Shanghai Jiao Tong University School of Medicine , Shanghai , China.,e Department of Laboratory Medicine , The First Affiliated Hospital of Fujian Medical University , Fuzhou , China
| | - Baihua Shen
- a Department of Autoimmune Disease, Shanghai Institute of Immunology, Institute of Medical Sciences , Shanghai Jiao Tong University School of Medicine , Shanghai , China
| | - Lianbo Xiao
- b Department of Bone Surgery, Institute of Arthritis Research , Shanghai Academy of Chinese Medical Sciences , Shanghai , China
| | - Ningli Li
- a Department of Autoimmune Disease, Shanghai Institute of Immunology, Institute of Medical Sciences , Shanghai Jiao Tong University School of Medicine , Shanghai , China
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Shiozawa K, Yamane T, Murata M, Yoshihara R, Tsumiyama K, Imura S, Shiozawa S. MMP-3 as a predictor for structural remission in RA patients treated with MTX monotherapy. Arthritis Res Ther 2016; 18:55. [PMID: 26922083 PMCID: PMC4769545 DOI: 10.1186/s13075-016-0948-7] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2015] [Accepted: 02/02/2016] [Indexed: 01/08/2023] Open
Abstract
Background The study was undertaken to assess the efficacy of methotrexate (MTX) monotherapy on the radiographic progression of individual rheumatoid arthritis (RA) patients, each of whom had received MTX monotherapy for 3 years with an option to change to biological disease-modifying anti-rheumatic drugs (bDMARDs). We also looked for predictors of radiographic non-progression in these patients. Methods Rheumatoid patients (n = 161) were prospectively followed for 3 years while receiving low-dose MTX monotherapy unless disease was otherwise active and/or adverse events appeared. Their disease activity and radiographic progression were evaluated with reference to disease activity score 28 (DAS28), modified health assessment of questionnaire (mHAQ) and other indices. The change in van der Heijde-modified total Sharp score per year (∆TSS) was assessed using probability plots, in which the patients were classified into the subgroups showing structural remission (REM; ∆TSS ≤0.5), radiographic progression (∆TSS >3) or rapid radiographic progression (RRP; ∆TSS >5). Results MTX monotherapy, continued until disease became active and/or adverse event appeared, was associated with a significant improvement (p <0.0001) in the DAS28-ESR (3) scores, % DAS28 remission, and mHAQ scores each year, from baseline to 3 years. The mHAQ remission rate (∆mHAQ <0.5) and Boolean remission were also improved from 16 to 60 % and 0.8 to 24.0 %, respectively. We found that the ratio of patients classified as REM increased yearly from 62/161 (38.5 %) to 69/137 (50.4 %), while those classified as ∆TSS >3 decreased from 55/161 (34.2 %) to 28/137 (20.4 %) and those in RRP decreased from 35/161 (21.7 %) to 15/137 (10.9 %). Receiver operating characteristic (ROC) curve analyses showed that serum matrix metalloproteinase-3 (MMP-3) <103.7 ng/ml at outset predicts a patient subgroup that exhibits no radiographic progression. Conclusions Half of rheumatoid patients treated with MTX monotherapy for 3 years exhibited structural remission, and this outcome can be predicted at the outset by lower serum MMP-3. Electronic supplementary material The online version of this article (doi:10.1186/s13075-016-0948-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Kazuko Shiozawa
- The Rheumatic Diseases Center, Kohnan Kakogawa Hospital, 1545-1 Saijo, Kannocho, Kakogawa, 675-8545, Japan.
| | - Takashi Yamane
- The Rheumatic Diseases Center, Kohnan Kakogawa Hospital, 1545-1 Saijo, Kannocho, Kakogawa, 675-8545, Japan.
| | - Miki Murata
- The Rheumatic Diseases Center, Kohnan Kakogawa Hospital, 1545-1 Saijo, Kannocho, Kakogawa, 675-8545, Japan.
| | - Ryosuke Yoshihara
- The Rheumatic Diseases Center, Kohnan Kakogawa Hospital, 1545-1 Saijo, Kannocho, Kakogawa, 675-8545, Japan.
| | - Ken Tsumiyama
- Department of Medicine, Rheumatic Diseases Unit, Kyushu University Beppu Hospital, 4546 Tsurumihara, Beppu, 874-0838, Japan.
| | - Shigeaki Imura
- The Rheumatic Diseases Center, Kohnan Kakogawa Hospital, 1545-1 Saijo, Kannocho, Kakogawa, 675-8545, Japan.
| | - Shunichi Shiozawa
- Department of Medicine, Rheumatic Diseases Unit, Kyushu University Beppu Hospital, 4546 Tsurumihara, Beppu, 874-0838, Japan.
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