Intermittent pulses of methylprednisolone with low-dose prednisone attenuate lupus symptoms in B6.MRL-Faslpr/J mice with fewer glucocorticoid side effects - 23/07/24
Abstract |
Glucocorticoids (GCs) are potent anti-inflammatory and immunosuppressant medications and remain the cornerstone of systemic lupus erythematosus (SLE) therapy. However, ongoing exposure to GCs has the potential to elicit multiple adverse effects. Considering the irreplaceability of GCs in SLE therapy, it is important to explore the optimal regimen of GCs. Here, we compared the long-term efficacy and safety of pulsed and oral GC therapy in a lupus-prone mouse model. Mice were grouped using a randomized block design. We monitored survival rates, proteinuria, serum autoantibodies, and complement 3 (C3) levels up to 28 weeks of age, and assessed renal damage, bone quality, lipid deposition in the liver and marrow, glucose metabolic parameters, and levels of hormones of the hypothalamic-pituitary-adrenal (HPA) axis. Finally, we explored the mechanisms underlying the superior efficacy of the pulse regimen over oral prednisone regimen. We found that both GC regimens alleviated the poor survival rate, proteinuria, and glomerulonephritis, while also reducing serum autoantibodies and increasing the level of C3. The pulsed GC regimen showed less resistance to insulin, less suppression of the HPA axis, less bone loss, and less bone marrow fat deposition than the oral GC regimen. Additionally, GC-induced leucine zipper (GILZ) was significantly overexpressed in the GC pulse group. These results suggest that the GC pulse regimen ameliorated symptoms in lupus-prone mice, with fewer side effects, which may be related to GILZ overexpression. Our findings offer a potentially promising GC treatment option for SLE.
Le texte complet de cet article est disponible en PDF.Graphical Abstract |
Highlights |
• | Methylprednisolone (MP) pulse regimen has fewer side effects than oral prednisone regimen. |
• | MP pulse regimen and oral prednisone regimen have similar efficacy. |
• | GILZ overexpression may be a potential mechanism for MP pulse regimen’s fewer side effects. |
• | MP pulse regimen is a potentially promising GC treatment option for SLE. |
Abbreviations : ANOVA, CRH, ELISA, GILZ, H&E, HPA, IOD, ITT, LN, PAS, SD, SLE, TRAP, WT, Pred, MP
Keywords : Systemic lupus erythematosus, Glucocorticoid-related side effects, Methylprednisolone pulse, Glucocorticoid-induced leucine zipper
Plan
Vol 177
Article 117138- août 2024 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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