The calcitonin and glucocorticoids combination: mechanistic insights into their class-effect synergy in experimental arthritis.

INTRODUCTION: Previous work reported the anti-arthritic synergy afforded by combining calcitonin (CT) and glucocorticoids (GC). Here we focus on the pairing of elcatonin (eCT) and dexamethasone (Dex), querying whether: i) this was a class-effect action; ii) mechanistic insights could be unveiled; ii...

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Main Authors: Adam Al-Kashi, Trinidad Montero-Melendez, Niloufar Moradi-Bidhendi, James P Gilligan, Nozer Mehta, Mauro Perretti
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2013-01-01
Series:PLoS ONE
Online Access:http://europepmc.org/articles/PMC3564948?pdf=render
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author Adam Al-Kashi
Trinidad Montero-Melendez
Niloufar Moradi-Bidhendi
James P Gilligan
Nozer Mehta
Mauro Perretti
author_facet Adam Al-Kashi
Trinidad Montero-Melendez
Niloufar Moradi-Bidhendi
James P Gilligan
Nozer Mehta
Mauro Perretti
author_sort Adam Al-Kashi
collection DOAJ
description INTRODUCTION: Previous work reported the anti-arthritic synergy afforded by combining calcitonin (CT) and glucocorticoids (GC). Here we focus on the pairing of elcatonin (eCT) and dexamethasone (Dex), querying whether: i) this was a class-effect action; ii) mechanistic insights could be unveiled; iii) the synergy affected canonical GC adverse effects. METHODS: Using the rat collagen-induced arthritis model, different combinations of eCT and Dex, were administered from disease onset to peak (day 11 to 18). Macroscopic disease score was monitored throughout, with biochemical and histological analyses conducted on plasma and tissues at day 18. The effect on acute hyperglycaemia and liver enzyme message were also assessed. RESULTS: Whilst eCT alone was inactive, it synergised at 1 µg/kg with low doses of Dex (7.5 or 15 µg/kg) to yield an anti-arthritic efficacy equivalent to a 4- to 7-fold higher Dex dose. Mechanistically, the anti-arthritic synergy corresponded to a marked attenuation in RA-relevant analytes. CXCL5 expression, in both plasma and joint, was markedly inhibited by the co-therapy. Finally, co-administration of eCT did not exacerbate metrics of GC adverse effects, and rescued some of them. CONCLUSIONS: We present evidence of a class-effect action for the anti-arthritic synergy of CT/GC combination, underpinned by the powerful inhibition of joint destruction markers. Furthermore, we identify CXCL5 as a marker for the combination therapy with potential diagnostic and prognostic utility. Substantial GC dose reduction, together with the absence of exacerbated adverse effects, indicated a significant clinical potential for this co-therapy in RA and beyond.
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spelling doaj.art-7c108bd838b84a84b1a1f147a07fcf002022-12-22T02:09:28ZengPublic Library of Science (PLoS)PLoS ONE1932-62032013-01-0182e5429910.1371/journal.pone.0054299The calcitonin and glucocorticoids combination: mechanistic insights into their class-effect synergy in experimental arthritis.Adam Al-KashiTrinidad Montero-MelendezNiloufar Moradi-BidhendiJames P GilliganNozer MehtaMauro PerrettiINTRODUCTION: Previous work reported the anti-arthritic synergy afforded by combining calcitonin (CT) and glucocorticoids (GC). Here we focus on the pairing of elcatonin (eCT) and dexamethasone (Dex), querying whether: i) this was a class-effect action; ii) mechanistic insights could be unveiled; iii) the synergy affected canonical GC adverse effects. METHODS: Using the rat collagen-induced arthritis model, different combinations of eCT and Dex, were administered from disease onset to peak (day 11 to 18). Macroscopic disease score was monitored throughout, with biochemical and histological analyses conducted on plasma and tissues at day 18. The effect on acute hyperglycaemia and liver enzyme message were also assessed. RESULTS: Whilst eCT alone was inactive, it synergised at 1 µg/kg with low doses of Dex (7.5 or 15 µg/kg) to yield an anti-arthritic efficacy equivalent to a 4- to 7-fold higher Dex dose. Mechanistically, the anti-arthritic synergy corresponded to a marked attenuation in RA-relevant analytes. CXCL5 expression, in both plasma and joint, was markedly inhibited by the co-therapy. Finally, co-administration of eCT did not exacerbate metrics of GC adverse effects, and rescued some of them. CONCLUSIONS: We present evidence of a class-effect action for the anti-arthritic synergy of CT/GC combination, underpinned by the powerful inhibition of joint destruction markers. Furthermore, we identify CXCL5 as a marker for the combination therapy with potential diagnostic and prognostic utility. Substantial GC dose reduction, together with the absence of exacerbated adverse effects, indicated a significant clinical potential for this co-therapy in RA and beyond.http://europepmc.org/articles/PMC3564948?pdf=render
spellingShingle Adam Al-Kashi
Trinidad Montero-Melendez
Niloufar Moradi-Bidhendi
James P Gilligan
Nozer Mehta
Mauro Perretti
The calcitonin and glucocorticoids combination: mechanistic insights into their class-effect synergy in experimental arthritis.
PLoS ONE
title The calcitonin and glucocorticoids combination: mechanistic insights into their class-effect synergy in experimental arthritis.
title_full The calcitonin and glucocorticoids combination: mechanistic insights into their class-effect synergy in experimental arthritis.
title_fullStr The calcitonin and glucocorticoids combination: mechanistic insights into their class-effect synergy in experimental arthritis.
title_full_unstemmed The calcitonin and glucocorticoids combination: mechanistic insights into their class-effect synergy in experimental arthritis.
title_short The calcitonin and glucocorticoids combination: mechanistic insights into their class-effect synergy in experimental arthritis.
title_sort calcitonin and glucocorticoids combination mechanistic insights into their class effect synergy in experimental arthritis
url http://europepmc.org/articles/PMC3564948?pdf=render
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