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Combination of 4-hydroperoxy cyclophosphamide and methotrexate inhibits IL-6/sIL-6R-induced RANKL expression in fibroblast-like synoviocytes via suppression of the JAK2/STAT3 and p38MAPK signaling pathway.

Abstract
Although conventional combination therapy is effective for most patients with rheumatoid arthritis (RA), many still do not respond to current therapies. Therefore, novel combination regimens that better target cellular processes involved in RA pathogenesis are required. Preliminary studies have demonstrated the beneficial effects of a combination of cyclophosphamide (CTX) and methotrexate (MTX) in models of RA. Using western blotting, real-time polymerase chain reaction, enzyme-linked immunosorbent assays, and immunofluorescent staining, we demonstrated that the combination of 4-hydroperoxy CTX (4-H-CTX) and MTX inhibited the expression of receptor activator of nuclear factor-κB ligand (RANKL) in fibroblast-like synoviocytes (FLS) treated with the interleukin (IL)-6/soluble IL-6 receptor (sIL-6R) complex. To elucidate the mechanisms underlying this effect, we treated RA-FLS with the JAK2/STAT3 inhibitor AG490 or p38MAPK inhibitor SB203580. The results showed that IL-6/sIL-6R-induced RANKL upregulation required phosphorylation-mediated activation of STAT3 and p38 signaling, and that 4-H-CTX and/or MTX inhibited RANKL expression in IL-6/sIL-6R-stimulated FLS by suppressing JAK2/STAT3 and p38MAPK signaling. This study demonstrated for the first time the inhibitory effects of 4-H-CTX and MTX on RANKL expression in IL-6/sIL-6R-stimulated FLS via suppression of STAT3 and p38MAPK phosphorylation. These results identify promising therapeutic agents that might have clinical applications in patients with RA who are at high risk of bone erosion or do not respond well to conventional therapy.
AuthorsHong-Qing Niu, Wen-Peng Zhao, Xiang-Cong Zhao, Jing Luo, Kai-Li Qin, Kai-Lin Chen, Xiao-Feng Li
JournalInternational immunopharmacology (Int Immunopharmacol) Vol. 61 Pg. 45-53 (Aug 2018) ISSN: 1878-1705 [Electronic] Netherlands
PMID29803913 (Publication Type: Journal Article)
CopyrightCopyright © 2018 Elsevier B.V. All rights reserved.
Chemical References
  • IL6R protein, human
  • Imidazoles
  • Interleukin-6
  • Pyridines
  • RANK Ligand
  • Receptors, Interleukin-6
  • STAT3 Transcription Factor
  • Tyrphostins
  • alpha-cyano-(3,4-dihydroxy)-N-benzylcinnamide
  • Cyclophosphamide
  • Janus Kinase 2
  • p38 Mitogen-Activated Protein Kinases
  • SB 203580
  • perfosfamide
  • Methotrexate
Topics
  • Arthritis, Rheumatoid (drug therapy)
  • Cells, Cultured
  • Cyclophosphamide (analogs & derivatives, pharmacology)
  • Drug Therapy, Combination
  • Fibroblasts (drug effects, physiology)
  • Gene Expression Regulation
  • Humans
  • Imidazoles (pharmacology)
  • Interleukin-6 (immunology)
  • Janus Kinase 2 (metabolism)
  • Methotrexate (pharmacology)
  • Pyridines (pharmacology)
  • RANK Ligand (genetics, metabolism)
  • Receptors, Interleukin-6 (immunology)
  • STAT3 Transcription Factor (metabolism)
  • Signal Transduction
  • Synoviocytes (drug effects, physiology)
  • Tyrphostins (pharmacology)
  • p38 Mitogen-Activated Protein Kinases (metabolism)

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