Immune checkpoint inhibitor-induced inflammatory arthritis: identification and management

ABSTRACT

Introduction

Immune checkpoint inhibitors (ICIs) have proved to be groundbreaking in the field of oncology. However, immune system overactivation from ICIs has introduced a novel medical entity known as immune-related adverse events (irAEs), that can affect any organ or tissue. ICI-induced inflammatory arthritis (ICI-IIA) is the most common musculoskeletal irAE and can lead to significant morbidity and limitation in anti-cancer therapy.     

Cardiovascular effects of Leu-enkephalin in the nucleus tractus solitarius of the rat

Microinjections of Leu-enkephalin into the dorsal vagal complex induced hypotension and bradycardia. Both naloxone, given at a dose conferring selectivity for μ receptors, and the S antagonist ICI 154,129 prevented the cardiovascular effects of Leu-enkephalin. Naloxone was also found to decrease the gain of the baroreflex. These results suggest that Leu-enkephalin is involved in cardiovascular regulation through activation of δ-, and possibly μ-, opioid receptors in the dorsal vagal complex.     

Bradykinin-induced release of thromboxane B2 into bronchoalveolar lavage fluid of guinea pigs: relationship to airflow obstruction

The aim of this study was to evaluate the role of thromboxane A₂ in bradykinin-induced airflow obstruction in guinea pig in vivo. Airway insufflation pressure (P_i) was measured to assess airflow obstruction and the thromboxane B₂ (a stable metabolite of thromboxane A₂) concentration in bronchoalvelolar lavage fluid was determined by radioimmunoassay. The animals were pretreated with propranolol (1 mg/kg i.v.) and suxamethonium (5 mg i.v.) prior to bradykinin administration. Bradykinin instillation into the trachea (300 nmol) induced a P_i increase (47.5 ± 8.3 cm H₂O versus 23.8 ± 1.5 in sham) and significant thromboxane B₂ release into bronchoalveolar lavage fluid (79 ± 19 pg/ml versus 19 ± 6 in sham). A thromboxane synthase inhibitor (OKY-046, 30 mg/kg i.v.; ((E-E)-3-[p(1H-imidazole-1-yl-methyl) phenyl]-2-propenoic acid hydrochloride mono-hydrate)) or a thromboxane A₂ receptor antagonist (ICI192,605, 0.5 mg/kg i.v.; (4-(Z)-6-(2-o-chloro-phenyl-4-o-hydroxyphenyl-1,3-dioxan-cis-5-yl)hexenoic acid)) reduced the P_i increase evoked by bradykinin (38.7 ± 3.8 and 40.6 ± 3.8 cm H₂O, respectively). OKY-046 abolished the thromboxane B₂ release. A platelet-activating factor receptor antagonist, WEB2086 (1 mg/kg i.v.; (3-[4-(chlorophenyl)-9-methyl-6H-thienol [3,2-f][1,2,4]trizolo-[4,3-a][1,4] diazepin-2-yl]1-4-(4-morpholinyl)-1-propanon) did not significantly affect any measured parameter. We conclude that, in guinea pigs, bradykinin-induced airway effects are associated with a local thromboxane A₂ release.     

伍用TRH与ICI174,864对兔失血性休克心功能的影响

采用脑室给药方法研究了促甲状腺素释放激素（ＴＲＨ）与δ－阿片受体特异性拮抗剂ＩＣＩ１７４，８６４合用对失血性休克兔心功能指标的影响，旨在探讨ＴＲＨ与ＩＣＩ１７４，８６４是否可配伍用药治疗休克。ＴＲＨ、ＩＣＩ１７４，８６４两药单用剂量各为５０μｇ，合用剂量各２５μｇ。结果显示，两药半量合用改善失血性休克兔心血管功能作用不仅可达单药５０μｇ的效果，且较单用效果更佳。表明两药可配伍用药治疗失血性休克，且有一定的协同作用。     

The β2-adrenoceptor antagonist CGP 20712 A unmasks β2-adrenoceptors activated by (−)-adrenaline in rat sinoatrial node

Summary The role of sinoatrial ₁- and ₂-adrenoceptors mediating positive chronotropic effects of (–)-adrenaline and (–)-noradrenaline was investigated in rat right atria. Concentration effect curves for (–)-adrenaline, but not for (–)-noradrenaline, became biphasic in the presence of the ₁-adrenoceptors antagonist CGP 20712 A. The curves for (–)-adrenaline in the presence of 300 nmol/l CGP 20712 A (equivalent to 1,000 times its K _B, K _B=0.3 nmol/l for ₁-adrenoceptors) comprise a high-sensitivity component that saturates at 1/4 of maximum effect, and a low sensitivity component. The high-sensitivity component is blocked by the ₂-adrenoceptor-selective antagonist ICI 118,551. These results are consistent with an involvement in the rat of both ₁-adrenoceptors (to a major extent) and ₂-adrenoceptors [only at high (–)-adrenaline concentrations] in the positive chronotropic effects of (–)-adrenaline. (–)-Noradrenaline appears to activate mostly rat sinoatrial ₁-adrenoceptors.     

大鼠砷暴露致雌激素效应及对甲状腺功能的影响

目的 探讨大鼠砷暴露和雌激素受体(estrogen receptor α, ERα)抑制剂干预后,对雌激素及其受体和甲状腺相关激素及受体的影响,阐释砷的甲状腺毒性作用途径。 方法 大鼠亚砷酸钠饮水染毒,并给予雌激素受体抑制剂(ICI182780)干预。通过ELISA检测大鼠血清雌二醇(estradiol, E2)、总三碘甲状腺原氨酸(total triiodothyronine, TT3)、总甲状腺素(total thyroxine, TT4)、促甲状腺激素(thyroid stimulating hormone, TSH)水平;透射电镜观察大鼠甲状腺组织病理形态学结构改变;实时荧光定量法检测甲状腺组织ERα、甲状腺激素受体α(thyroid hormone receptor α, TRα)相对表达量。蛋白免疫印迹法检测甲状腺组织TRα蛋白水平。 结果 砷暴露后雌性大鼠E2表达水平较对照组上升(P<0.05),雌雄大鼠低砷组ERα、TRα相对表达量较对照组均下降(P<0.05)。高剂量砷暴露后雌性大鼠TSH、TT3及TRα表达水平较对照组上升,TT4较对照组下降(P<0.05)。ICI182780可降低雌性大鼠E2表达水平的上升,也对砷暴露大鼠TT4、TSH、ERα、TRα表达的改变有反向调节作用(P<0.05)。 结论 低砷暴露对雌性大鼠有明显的雌激素效应,高砷暴露可造成大鼠甲状腺功能紊乱或损伤。ERα可能是体内砷暴露发挥雌激素效应的主要途径之一。ICI182780可拮抗砷暴露导致的雌激素效应并缓解甲状腺功能的损伤。     

Seroquel (ICI 204 636), a putative “atypical” antipsychotic,in schizophrenia with positive symptomatology: results of an open clinical trial and changes of neuroendocrinological and EEG parameters

Preclinical data indicated that seroquel (ICI 204 636), a dibenzothiazepine with 5-HT₂ and D₂-like receptor antagonistic properties, might be an effective antipsychotic agent, causing fewer extrapyramidal side effects than typical neuroleptics. In the present study, 12 patients suffering from schizophrenia or schizophreniform disorder with predominantly positive symptomatology were treated in an open clinical trial for 4 weeks with seroquel at a maximum dosage of 750 mg/day. The drug was generally well tolerated, and virtually no adverse extrapyramidal side effects such as acute dystonia, parkinsonism or akathisia were observed. Total scores for BPRS (item score 0–6; baseline: 42.0±2.3; mean±SeM), SAPS (64.5±4.8) and SANS (55.0±4.3) showed a moderate decrease at the end of treatment (BPRS: 30.0±3.5; SAPS: 36.1±6.7; SANS: 42.5±5.9), when intention-to-treat analysis was applied. There were considerable interindividual differences in treatment response, with some subjects showing almost full remission of positive symptoms, in contrast to about half of the patients who showed no satisfactory clinical improvement. Interestingly, patients showing good antipsychotic response reported slight initial side effects like mild sedation. Prolactin and TSH levels were not altered during seroquel administration. As to pharmaco-EEG investigations, seroquel caused a moderate increase of the absolute power in the alpha, theta, and beta frequency bands, paralleled by a decrease of delta activity. There were no signs of paroxysmal EEG activity under seroquel. Our results suggest that seroquel may be a well tolerated drug with some antipsychotic properties, exhibiting no extrapyramidal side effects that could be of use in the treatment of schizophrenic patients with positive symptomatology. Further double-blind studies with higher doses, in order to test presumably better efficacy, and with monitoring of plasma levels, are needed to extend the present results.     

Reduced brain serotonergic activity after repeated treatment with β-adrenoceptor antagonists

Rats were treated subchronically (14 days) or acutely (single dose) with the ₁-selective adrenoceptor antagonist metoprolol or the ₂-selective adrenoceptor antagonist ICI 118,551. Metoprolol (350 mg/kg/day for 14 days, orally) significantly reduced the 5-hydroxytryptophan (5-HTP) accumulation when measured 30 min after inhibition of L-amino acid decarboxylase by NSD 1015 (100 mg/kg IP) in the limbic forebrain, the corpus striatum, the cerebral cortex, the brain stem, and in the cerebellum. ICI 118,551 (0.5 mg/kg, twice daily for 14 days, SC) also significantly reduced the 5-HTP accumulation in the same brain regions except in the corpus striatum and the brain stem. Simultaneously assayed tryptophan levels were largely unaffected. Thus sustained -adrenoceptor blockade causes a decrease in the in vivo rate of tryptophan hydroxylation in various rat brain regions. The subchronic treatments with metoprolol or ICI 118,551 also significantly reduced the endogenous levels of 5-hydroxytryptamine (5-HT) in the various rat brain regions studied. Acute treatment with either metoprolol (2 mg/kg SC) or ICI 118,551 (0.5 mg/kg SC) did not affect the 5-HTP accumulation or the endogenous 5-HT levels in the brain regions studied. This inhibitory effect on brain 5-HT systems produced by sustained -adrenoceptor blockade may be of significance both for the long-term cardiovascular action and for occasional neuropsychiatric side effects during -blocking therapy.     

Modulation of Isoflavones on Bone—nodule Formation in Rat Calvaria Osteoblasts in vitro

Objective:to observe the effects of two main isoflavones,daidzein and genistein on the bone-nodule formation in rat calvaria osteoblasts in vitro.Methods:Osteoblasts obtained from newborn Sprague-dawley rat calvarias were cultured for several generations.The second generation cells were cultured in Minimum Essential Medium supplemenmted with ascorbic acid and Na-beta-glycerophosphate for several days,in the presence of daidzein and genistein,with or without the estrogen receptor antagonist ICI 182780.Number of nodules was counted at the end of the incubation period(day 20) by staining with Alizarin Red S calcium stain.The release of osteocalcin,as a marker of osteoblast activity,was also determined on day 7 and 12 during the incubation period.Results:compared with the control,the numbers of nodules were both increased by incubation with daidzin and genistein,17β-estradiol was used as a positive control and proved to be a more effective inducer of the increase in bone-nodules formation than daidzein and genisterin.The release of osteocalcin into culture media was also increased in the presence of daidzein and genistein,as well as 17β-estradiol on day 7 and day 12(day 12 were higher).The estrogen receptor antagonist ICI 182780 completely blocked the genistein-and 17β0estradiol-induced increase of nodule numbers and osteocalcin release in osteoblasts.Howerver,the effects induced by daidzein could not be inhibited by ICI 182780.Conclusion:These findings suggest that geinistein can stimulate bone-nodule formation and increase the release of osteocalcin in rat osteoblasts.The effects,like those induced by 17β-estradiol,are mediated by the estrogen receptor dependent pathway,Daidzin also can stimulate bone-nodule formation and increase the release of osteocalcin in rat osteoblasts,but it is not,at least not merely,mediated by the estrogen receptor dependent pathway.     

κ-阿片受体与β1-肾上腺素受体交互作用抑制异丙肾上腺素诱导的心肌肥大

目的:观察选择性kappa阿片受体(kappaopioidreceptor,κOR)与β肾上腺素受体(βadrenergicreceptor,βAR)在心肌细胞肥大方面的交互作用。方法:以体外培养的乳鼠心肌细胞为模型,10μmol·L-1的异丙肾上腺素(β肾上腺素受体激动剂,βAR)诱导心肌肥大,观察1μmol·L-1的U50,488H(κOR激动剂,U50)对其作用。进一步探索在100nmol·L-1ICI118,551(β2AR阻断剂)存在情况下,κOR的激活对心肌肥大的作用。用Lowry’s法测心肌细胞的蛋白质含量;用消化分离法,并利用计算机图象分析系统测心肌细胞的体积;用[3H]leucine掺入法测定心肌细胞蛋白的合成。结果:异丙肾上腺素使心肌细胞总蛋白含量、体积、蛋白合成明显增加;1μmol·L-1的U50,488H使ISO诱导的心肌细胞总蛋白含量、体积、蛋白合成减少,这种作用可被选择性κOR阻断剂norBNI(norbinaltorphimine)抑制。在ICI118,551存在的情况下,U50也能起到减弱ISO诱导心肌细胞肥大的作用。结论:U50,488H通过激活κOR与β1AR交互作用抑制ISO所诱导的心肌细胞肥大。