Can we treat arthritis without the side effects of heavy immunosuppressants?
A naturally occurring immunopeptide called PEPITEM (Peptide Inhibitor of Trans-Endothelial Migration) can now help treat inflammatory arthritis.()
The replacement therapy was discovered by researchers from the University of Birmingham. The novel peptide therapy targets the Adiponectin-PEPITEM pathway, a vital biological process that maintains immune system balance.
By regulating immune cell trafficking, PEPITEM acts as a natural brake to prevent excessive inflammation. Recent studies show it reduces joint swelling as effectively as current standard of care treatments. Most importantly, it restores homeostasis, protecting synovial tissue from the chronic damage and bone erosion typically seen in rheumatoid arthritis and
In the most recent study, led by Professor Helen McGettrick from the University of Birmingham, UK with collaborators from the University of Federico III, Naples, Italy, researchers investigated how this pathway is dysregulated in inflammatory arthritis, and the efficacy of PEPITEM in pre-clinical animal models.
Understanding the Role of PEPITEM in Rheumatoid and Psoriatic Arthritis
Inflammatory arthritis is a group of diseases including rheumatoid arthritis (RA) and psoriatic arthritis (PsA), where the immune system attacks the joints, causing severe joint damage,
Under normal conditions, adiponectin the bloodstream stimulates white blood cells to produce PEPITEM, which in turn reduces white blood cell migration in the tissues, so preventing an unregulated inflammatory response. However, in inflammatory arthritis, white blood cells fail to respond to adiponectin, and secrete less PEPITEM in the joint. The natural ‘break’ that prevents white cell migration into the joint cavity is lost, and the inflammatory response becomes unregulated.
The researchers examined the effect of PEPITEM in human and animal studies, and the results, published in Arthritis and Rheumatology showed promise.
Why PEPITEM Outperforms Existing Immunosuppressive Therapies
Professor Helen McGettrick said: “We have shown observable reversal of clinical disease manifestation, and PEPITEM has the potential to provide an alternative therapy to limit disease severity and progression in early-stage inflammatory arthritis.”
“There could be significant benefits over existing therapies, which are immunosuppressive in otherwise healthy populations, the risk of toxicity from natural peptide is extremely low, and administration in early disease could reduce reliance on steroids in the earliest phases of rheumatoid arthritis and psoriatic arthritis.”
The initial study of peripheral blood mononuclear (PBMCs, white blood cells) harvested from treatment naïve human donors with suspected inflammatory
Further examination of whole blood indicated a lower bioavailability of PEPITEM in patients with early RA, leading the researchers to hypothesize that supplementation with PEPITEM could restore immune-regulation, and reduce the inflammatory changes seen in early-stage disease.
Beyond Inflammation, PEPITEM Promotes Bone Repair and Strength
Their work in animal (mouse) models of inflammatory arthritis conducted in Birmingham and gouty arthritis conducted by collaborators in Naples, showed that injection of synthetic PEPITEM, could prevent the onset of inflammatory arthritis, with significant reductions in disease incidence. In addition, joint swelling was reduced by PEPITEM when compared with infliximab – the current standard of care.
Tissue studies confirmed that these changes were mirrored in synovial tissue (tissue inside the joints), with significantly less joint inflammation, cartilage damage and bone erosion observed in PEPITEM treated mice, and significantly fewer leukocytes (white blood cells) infiltrating the joints.
Molecular studies showed significant down regulation of inflammatory mediators (NF-kB and COX2 protein) within the synovial tissue in PEPITEM-treated mice compared to controls, and a significant increase in the foxp3 transcript, which is crucial for the development of a type of white blood cell that suppresses the immune response, to prevent excessive
Professor McGettrick added: “Previous work has shown PEPITEM has promise as new therapeutic agent for bone repair, enhancing bone mineralization, formation and strength, while reversing bone loss. Even when inflammation is therapeutically well controlled, existing Disease-Modifying Anti-Rheumatic Drugs (DMARDs) do not reverse joint damage.”
Reference:
- PEPITEM regulates the synovial microenvironment during immune-mediated inflammatory arthritis to limit disease – (https://acrjournals.onlinelibrary.wiley.com/doi/10.1002/art.70108)
Source-Eurekalert