Abstract

ObjectivesTo compare phagocytic activities of monocytes in peripheral blood mononuclear cells (PBMCs) from acute gout patients and normal subjects, examine monosodium urate monohydrate (MSU) crystal-induced IL-1β secretion ± recombinant human proteoglycan 4 (rhPRG4) or interleukin-1 receptor antagonist (IL-1RA), and study the anti-inflammatory mechanism of rhPRG4 in MSU stimulated monocytes.MethodsAcute gout PBMCs were collected from patients in the Emergency Department and normal PBMCs were obtained from a commercial source. Monocytes in PBMCs were identified by flow cytometry. PBMCs were primed with Pam3CSK4 (1μg/mL) for 24h and phagocytic activation of monocytes was determined using fluorescently labeled latex beads. MSU (200μg/mL) stimulated IL-1β secretion was determined by ELISA. Reactive oxygen species (ROS) generation in monocytes was determined fluorometrically. PBMCs were incubated with IL-1RA (250ng/mL) or rhPRG4 (200μg/mL) and bead phagocytosis by monocytes was determined. THP-1 monocytes were treated with MSU crystals ± rhPRG4 and cellular levels of NLRP3 protein, pro-IL-1β, secreted IL-1β, and activities of caspase-1 and protein phosphatase-2A (PP2A) were quantified. The peritoneal influx of inflammatory and anti-inflammatory monocytes and neutrophils in Prg4 deficient mice was studied and the impact of rhPRG4 on immune cell trafficking was assessed.ResultsEnhanced phagocytic activation of gout monocytes under basal conditions (p<0.001) was associated with ROS generation and MSU stimulated IL-1β secretion (p<0.05). rhPRG4 reduced bead phagocytosis by normal and gout monocytes compared to IL-1RA and both treatments were efficacious in reducing IL-1β secretion (p<0.05). rhPRG4 reduced pro-IL-1β content, caspase-1 activity, conversion of pro-IL-1β to mature IL-1β and restored PP2A activity in monocytes (p<0.05). PP2A inhibition reversed rhPRG4’s effects on pro-IL-1β and mature IL-1β in MSU stimulated monocytes. Neutrophils accumulated in peritoneal cavities of Prg4 deficient mice (p<0.01) and rhPRG4 treatment reduced neutrophil accumulation and enhanced anti-inflammatory monocyte influx (p<0.05).ConclusionsMSU phagocytosis was higher in gout monocytes resulting in higher ROS and IL-1β secretion. rhPRG4 reduced monocyte phagocytic activation to a greater extent than IL-1RA and reduced IL-1β secretion. The anti-inflammatory activity of rhPRG4 in monocytes is partially mediated by PP2A, and in vivo, PRG4 plays a role in regulating the trafficking of immune cells into the site of a gout flare.

Highlights

  • Gout is the most common form of crystal induced arthritis with an estimated 2012 global prevalence of 0.6% [1]

  • RhPRG4 But Not interleukin-1 receptor antagonist (IL-1RA) Reduced Basal and TLR2 Ligand Stimulated Bead Uptake by Gout Monocytes and the AntiInflammatory Effects of Both IL-1RA and Recombinant human PRG4 (rhPRG4) Were Dependent on the Magnitude of IL-1b Secretion by Gout peripheral blood mononuclear cells (PBMCs) rhPRG4 (200 mg/mL) reduced basal and TLR2 stimulated bead uptake by gout monocytes compared to IL-1RA (250 ng/mL) treatment (p

  • Antibody-driven phagocytosis of latex beads typically occurs via the FCg receptor [33], while urate crystals are internalized by a receptor-mediated mechanism with CD44, TLR2 and TLR4 being the most prominent mediating receptors [23, 24, 34]

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Summary

Introduction

Gout is the most common form of crystal induced arthritis with an estimated 2012 global prevalence of 0.6% [1]. Acute gout flares are treated with anti-inflammatory agents e.g., colchicine, nonsteroidal anti-inflammatory drugs (NSAIDs) and corticosteroids, either alone or in combination [9, 10]. None of these pharmacological agents have demonstrated superiority in controlling acute gout inflammation and their use is complicated by considerable side effects, toxicities, and relative contraindications [7, 11, 12]. Suboptimal clinical treatment outcomes are prevalent, with significant economic and humanistic burdens and the development of novel and safer therapeutics remains an unmet clinical need

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