Lymphocytolytic activity of glucocorticoids in vitro:51Cr release under equilibrium conditons

Summary Cytolytic activity of glucocorticoids in vitro is assessed by measuring radiochromium release from steroid-treated thymic lymphocytes under the equilibrium conditions provided by a continuous-labeling technique. Isotope release is a glucocorticoid-specific effect produced at physiological concentrations and is virtually abolished by inhibitors of RNA and protein synthesis. The relative lytic potencies of the steroids tested are comparable to those reported for glucocorticoids as measured by other methods. This procedure not only possesses the advantages typical of isotopic techniques in general, but, in addition, circumvents the problem of “spontaneous” label release associated with the pulse-labeling method. It is a useful alternative to the morphologic examination of cells or the estimation of cell viability for determination of glucocorticoid cytolytic activity. This work was supported by the Medical Research Council of Canada (MA-2996).     

Confounding by Indication Probably Distorts the Relationship between Steroid Use and Cardiovascular Disease in Rheumatoid Arthritis: Results from a Prospective Cohort Study

Objective

To evaluate the risk of cardiovascular disease in patients with rheumatoid arthritis exposed to glucocorticoids.

Methods

Retrospective analysis of exposure to glucocorticoids in a prospective cohort of 353 patients with rheumatoid arthritis followed from June 2001 up to November 2011 for incident cardiovascular disease in a hospital-based outpatient cohort in the Netherlands. Hazard ratios with 95%-confidence intervals were calculated for the association between different types of exposure to glucocorticoids and incident cardiovascular disease. Associations were adjusted for demographics, cardiovascular risk factors and disease related parameters.

Results

Recent and current exposure to glucocorticoids were associated with incident cardiovascular disease, as was a longer duration of exposure and cumulative exposure to glucocorticoids. Adjustment for disease activity and severity negated the association.

Conclusion

In observational studies the finding of incident cardiovascular disease in patients with rheumatoid arthritis exposed to glucocorticoids is strongly confounded by indication due to high disease activity. The adverse cardiovascular effects of glucocorticoids might be balanced by positive effects working through inflammation control.     

I. Stress and hepatic inflammation

Stress is an ever-present part of modern life. The "stress response" constitutes an organism's mechanism for coping with a given stress and is mediated via the release of glucocorticoids and catecholamines. Patients often complain of stress-related worsening of their liver disease; however, the interrelationship between stress and hepatic inflammation is incompletely understood and has received little scientific attention. Considering the broad impact glucocorticoids and catecholamines have on immune cell function, it is very likely that stress has a significant impact on the hepatic inflammatory response. This themes article discusses studies of the stress response and its peripheral effectors (glucocorticoids and catecholamines) in liver disease and their impact on hepatic inflammation and outlines potential areas for future scientific investigation.     

Effect of dexamethasone on arachidonate metabolism in isolated mouse thymocytes

In order to investigate the effects of glucocorticoids on arachidonate release and metabolism in mouse thymocytes, we have studied both the action of dexamethasone on arachidonate release from pre-labeled cells and its effect on tracer uptake and metabolism. Our results indicate, first, that dexamethasone failed in this experimental model to affect phospholipase activity; second, that glucocorticoids are able to inhibit the transformation of the precursor into prostaglandins and to block simultaneously its acylation into phospholipids; finally that isolated thymocytes secrete significant amounts of 12-HETE, and that this secretion is unaffected by steroid treatment.     

Biphasic effect of acute ethanol administration on rat liver tyrosine-2-oxoglutarate aminotransferase activity.

1. Acute ethanol administration causes a biphasic change in rat liver tyrosine aminotransferase activity. 2. The initial decrease is significant with a 200 mg/kg dose of ethanol, is prevented by adrenoceptor-blocking agnets and by reserpine, but not by inhibitors of ethanol metabolism, and exhibits many of the characteristics of the inhibition caused by noradrenaline. 3. The subsequent enhancement of the enzyme activity by ethanol is not associated with stabilization of the enzyme, but is sensitive to actinomycin D and cycloheximide. 4. It is suggested that the initial decrease in aminotransferase activity is caused by the release of catecholamines, whereas the subsequent enhancement may be related to the release of glucocorticoids.     

Nystatin increases hepatic alkaline phosphatase activity

The activity of alkaline phosphatase is increased significantly in the livers of rats after the intraperitoneal administration of nystatin. Studies with cycloheximide suggested that de novo protein synthesis was essential for the effect of nystatin on alkaline phosphatase activity. The induction of hepatic alkaline phosphatase by nystatin is not secondary to the release of glucocorticoids because the response of the enzyme to the administration of nystatin was not affected by bilateral adrenalectomy.     

Glucocorticoids reduce inflammation in cystic fibrosis bronchial epithelial cells

Reduction of lung inflammation is one of the goals of cystic fibrosis (CF) therapy. Among anti-inflammatory molecules, glucocorticoids (GC) are one of the most prescribed. However, CF patients seem to be resistant to glucocorticoid treatment. Several molecular mechanisms that contribute to decrease anti-inflammatory effects of glucocorticoids have been identified in pulmonary diseases, but the molecular actions of glucocorticoids have never been studied in CF. In the cytoplasm, glucocorticoids bind to glucocorticoid receptor (GR) and then, control NF-κB and MAPK pathways through direct interaction with AP-1 and NF-κB in the nucleus. Conversely, MAPK can regulate glucocorticoid activation by targeting GR phosphorylation. Together these pathways regulate IL-8 release in the lung. Using bronchial epithelial cell lines derived from non CF and CF patients, we analyzed GR-based effects of glucocorticoids on NF-κB and MAPK pathways, after stimulation with TNF-α. We demonstrate that the synthetic glucocorticoid dexamethasone (Dex) significantly decreases IL-8 secretion, AP-1 and NF-κB activity in CF cells in a pro-inflammatory context. Moreover, we show that p38 MAPK controls IL-8 release by determining GR activation through specific phosphorylation on serine 211. Finally, we demonstrate a synergistic effect of dexamethasone treatment and inhibition of p38 MAPK inducing more than 90% inhibition of IL-8 production in CF cells. All together, these results demonstrate the good responsiveness to glucocorticoids of CF bronchial epithelial cells and the reciprocal link between glucocorticoids and p38 MAPK in the control of CF lung inflammation.     

Corticosteroid regulation of gonadotropin secretion and induction of ovulation in the rat

In the human polycystic ovarian syndrome, glucocorticoids have been demonstrated to have beneficial effects in inducing ovulation in a number of cases. These beneficial effects were assumed to be due to suppression of adrenal overproduction of androgens. However, the possibility exists that glucocorticoids may directly regulate gonadotropin secretion and thereby improve menstrual rhythm and ovulatory activity. Herein, we report that the corticoid, deoxycorticosterone, and the synthetic glucocorticoid, triamcinolone acetonide, like progesterone (P4), are able to induce luteinizing hormone and follicle-stimulating hormone surges and facilitate ovulation in the pregnant mare serum gonadotropin-primed rat. This effect is not shared by cortisol. Prolactin release was also stimulated by deoxycorticosterone, cortisol, and progesterone, but not by triamcinolone acetonide. Similar to progesterone, triamcinolone acetonide and deoxycorticosterone administration caused a loss of fluid retention in the uterus. This effect of triamcinolone acetonide and deoxycorticosterone may be related to progesterone action as opposed to anti-inflammatory action since cortisol had no effect on uterine fluid retention. These findings raise the possibility that the beneficial effects seen with glucocorticoids in inducing ovulation in polycystic ovarian syndrome may be due in part to their direct effects upon the release of gonadotropins.     

Regulation of prostaglandin formation by glucocorticoids and their second messenger, lipocortins

Glucocorticoids induce the synthesis of a family of phospholipase inhibitory proteins, lipocortins. This family of lipocortins includes inhibitory proteins on phospholipase A2, phospholipase C and phosphatidylinositol phospholipase C. Hence, glucocorticoids reduce the formation of prostaglandins and leukotrienes by inhibiting cellular phospholipases, enzymes that degrade membrane phospholipids to release arachidonic acid, a precursor. The induction by glucocorticoids requires 1 h for the synthesis of mRNA and 5 h for the synthesis of proteins in various tissues and cells. However, glucocorticoids often exert their suppressive effects before the induction of lipocortins. This is now attributed to the nonenzymic formation of the adducts between glucocorticoids and lipocortins. These adducts are easily inserted into the membranes and more resistant to digestion of proteases, thus being more biologically potent with respect to suppression of the release of arachidonic acid, a precursor of prostaglandins and leukotrienes.     

Inhibition of macrophage tumoricidal activity by glucocorticoids

In this study, the effect of corticosteroids on the activation of macrophages to a fully tumoricidal state was examined. Thioglycolate-elicited peritoneal exudate macrophages from C3H/HeJ mice were rendered cytolytic for P815 mastocytoma cells in a two-signal tumoricidal assay that used recombinant interferon-gamma (rIFN-gamma; 1 to 10 U/ml) as a "priming" signal and butanol-extracted lipopolysaccharide (But-LPS; 0.1 to 5 micrograms/ml) as a "trigger" signal. Treatment of macrophages with either rIFN-gamma alone or But-LPS alone failed to result in significant cytolytic ability. Tumoricidal activity was markedly inhibited in a dose-dependent fashion when glucocorticoids were added simultaneously to the cultures with rIFN-gamma and But-LPS at concentrations ranging from 1 X 10(-10) to 1 X 10(-5) M. Nonglucocorticoid sex hormones failed to inhibit tumoricidal activity in this system under identical culture conditions. Inhibition was most effective if the glucocorticoids were added simultaneously with the priming and triggering signals (rIFN-gamma and But-LPS); however, if the glucocorticoids were added 24 hr after the signals were provided to the cultures, suboptimal inhibition was observed. Experiments that dissociated the priming phase of activation from the triggering phase showed that glucocorticoids inhibited both the rIFN-gamma-induced priming stage as well as the But-LPS-induced triggering stage of activation. These observations provide evidence that glucocorticoids, but not other steroid hormones, inhibit the activation of macrophages to a fully tumoricidal state by interfering with either the priming or triggering signals in this two-signal model of macrophage activation.     

Glucocorticoids promote nonphlogistic phagocytosis of apoptotic leukocytes

Phagocyte recognition, uptake, and nonphlogistic degradation of neutrophils and other leukocytes undergoing apoptosis promote the resolution of inflammation. This study assessed the effects of anti-inflammatory glucocorticoids on this leukocyte clearance mechanism. Pretreatment of "semimature" 5-day human monocyte-derived macrophages (M phi) for 24 h with methylprednisolone, dexamethasone, and hydrocortisone, but not the nonglucocorticoid steroids aldosterone, estradiol, and progesterone, potentiated phagocytosis of apoptotic neutrophils. These effects were specific in that the potentiated phagocytosis of apoptotic neutrophils was completely blocked by the glucocorticoid receptor antagonist RU38486, and glucocorticoids did not promote 5-day M phi ingestion of opsonized erythrocytes. Similar glucocorticoid-mediated potentiation was observed with 5-day M phi uptake of alternative apoptotic "targets" (eosinophils and Jurkat T cells) and in uptake of apoptotic neutrophils by alternative phagocytes (human glomerular mesangial cells and murine M phi elicited into the peritoneum or derived from bone marrow). Importantly, methylprednisolone-mediated enhancement of the uptake of apoptotic neutrophils did not trigger the release of the chemokines IL-8 and monocyte chemoattractant protein-1. Furthermore, longer-term potentiation by methylprednisolone was observed in maturing human monocyte-derived M phi, with greater increases in 5-day M phi uptake of apoptotic cells being observed the earlier glucocorticoids were added during monocyte maturation into M phi. We conclude that potentiation of nonphlogistic clearance of apoptotic leukocytes by phagocytes is a hitherto unrecognized property of glucocorticoids that has potential implications for therapies aimed at promoting the resolution of inflammatory diseases.     

Effect of adrenal glucocorticoids on beta-lipoprotein production by resected liver.

The action of adrenal glucocorticoids on the level of liver beta-lipoprotein (LP) production was studied. Their effect was verified by studying LP synthesis and release from liver after the administration of various doses of glucocorticoids, after the administration of ACTH and in cases in which the effect of glucocorticoids was precluded by adrenalectomy (in vivo and in vitro). Adrenal glucocorticoids were found to limit triglyceride release in the form of beta-LP from the liver into the blood stream during the first 6 hours after partial hepatectomy (PHE). A direct study of beta-LP synthesis in the liver tissue showed that glucocorticoids inhibit liver lipid secretion by interfering with the process of beta-LP release by the liver rather than by influencing actual beta-LP synthesis in the liver.     

H-2 histocompatibility region influences the inhibition of arachidonic acid cascade by dexamethasone and phenytoin in mouse embryonic palates

We have reported that susceptibility to glucocorticoid- and phenytoin-induced cleft palate and glucocorticoid receptor levels in mice are influenced by the H-2 histocompatibility complex on chromosome 17. Phenytoin competes with glucocorticoids for the glucocorticoid receptor and inhibits production of prostaglandins and thromboxanes. In this paper, we have investigated whether glucocorticoids and phenytoin inhibit arachidonic acid release and prostaglandin biosynthesis directly in the embryonic palates and whether the H-2 gene complex influences the degree of inhibition. Using congenic strains varying only in the H-2 region, we demonstrate here that both glucocorticoids and phenytoin inhibit the release of 3H-arachidonic acid and prostaglandin biosynthesis from embryonic palatal tissue, prelabeled with 3H-arachidonic acid. The degree of inhibition of arachidonic acid release and of prostaglandin biosynthesis is greater in the strain with H-2a (A/Wy) than in its corresponding congenic partner H-2b (A.BY). Thus, these results provide further evidence for a similar genetic and biochemical pathway for the teratogenic action of both phenytoin and glucocorticoids.     

Colchicine increases hepatic alkaline phosphatase activity

In vivo administration of colchicine increases the activity of alkaline phosphatase significantly in the livers of rats. Prior treatment with cycloheximide prevented the induction of the enzyme by colchicine suggesting that de novo protein synthesis was essential for the effect of colchicine on alkaline phosphatase activity. Bilateral adrenalectomy did not affect the response of alkaline phosphatase following the administration of colchicine. This indicates that the rise in the level of alkaline phosphatase in liver caused by colchicine is not secondary to the release of glucocorticoids.     

Sustained mitogen-activated protein kinase (MAPK) and cytoplasmic phospholipase A2 activation by macrophage migration inhibitory factor (MIF). Regulatory role in cell proliferation and glucocorticoid action.

Macrophage migration inhibitory factor (MIF) is an important pro-inflammatory mediator with the unique ability to counter-regulate the inhibitory effects of glucocorticoids on immune cell activation. MIF is released from cells in response to glucocorticoids, certain pro-inflammatory stimuli, and mitogens and acts to regulate glucocorticoid action on the ensuing inflammatory response. To gain insight into the molecular mechanism of MIF action, we have examined the role of MIF in the proliferation and intracellular signaling events of the well characterized, NIH/3T3 fibroblast cell line. Both endogenously secreted and exogenously added MIFs stimulate the proliferation of NIH/3T3 cells, and this response is associated with the activation of the p44/p42 extracellular signal-regulated (ERK) mitogen-activated protein kinases (MAP). The MIF-induced activation of these kinases was sustained for a period of at least 24 h and was dependent upon protein kinase A activity. We further show that MIF regulates cytosolic phospholipase A2 activity via a protein kinase A and ERK dependent pathway and that the glucocorticoid suppression of cytokine-induced cytoplasmic phospholipase A2 activity and arachidonic acid release can be reversed by the addition of recombinant MIF. These studies indicate that the sustained activation of p44/p42 MAP kinase and subsequent arachidonate release by cytoplasmic phospholipase A2 are important features of the immunoregulatory and intracellular signaling events initiated by MIF and provide the first insight into the mechanisms that underlie the pro-proliferative and inflammatory properties of this mediator.