Skip to main content

Advertisement

Log in

Reduction in serum levels of substance P in patients with rheumatoid arthritis by etanercept, a tumor necrosis factor inhibitor

  • Original Article
  • Published:
Modern Rheumatology

Abstract

We determined the effects of etanercept on the serum concentrations of neuropeptides in RA patients. In a total of 11 patients who had been injected with etanercept, the serum levels of substance P, calcitonin gene-related peptide (CGRP), and gastrin-releasing peptide (GRP) were analyzed. Average levels of serum substance P were significantly reduced from 1.53 to 0.62 ng/ml after the injection of etanercept. In the CGRP and GRP analyses, these average levels dropped from 1.57 and 0.51 ng/ml to 0.44 and 0.04 ng/ml, respectively. Etanercept appears to decrease substance P levels with an improvement in disease activities.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Roberts LJ. New drugs for rheumatoid arthritis. N Engl J Med. 2004;351:2659–61.

    Article  PubMed  CAS  Google Scholar 

  2. Klareskog L, van der Heijde D, de Jager JP, Gough A, Kalden J, Malaise M, et al. Therapeutic effect of the combination of etanercept and methotrexate compared with each treatment alone in patients with rheumatoid arthritis: double-blind randomised controlled trial. Lancet. 2004;363:675–81.

    Article  PubMed  CAS  Google Scholar 

  3. Weinblatt ME, Kremer JM, Bankhurst AD, Bulpitt KJ, Fleischmann RM, Fox RI, et al. A trial of etanercept, a recombinant tumor necrosis factor receptor: Fc fusion protein, in patients with rheumatoid arthritis receiving methotrexate. N Engl J Med. 1999;340(4):253–9.

    Article  PubMed  CAS  Google Scholar 

  4. Iwasaki A, Inoue K, Hukuda S. Distribution of neuropeptide-containing nerve fibers in the synovium and adjacent bone of the rat knee joint. Clin Exp Rheumatol. 1995;13:173–8.

    PubMed  CAS  Google Scholar 

  5. Im HJ, Li X, Muddasani P, Kim GH, Davis F, Rangan J, Forsyth CB, et al. Basic fibroblast growth factor accelerates matrix degradation via a neuro-endocrine pathway in human adult articular chondrocytes. J Cell Physiol. 2008;215(2):452–63.

    Article  PubMed  CAS  Google Scholar 

  6. Brain SD, Williams TJ, Tippins JR, Morris HR, MacIntyre I. Calcitonin gene-related peptide is a potent vasodilator. Nature. 1985;313:54–6.

    Article  PubMed  CAS  Google Scholar 

  7. McCulloch J, Uddman R, Kingman TA, Edvinsson L. Calcitonin gene-related peptide: functional role in cerebrovascular regulation. Proc Natl Acad Sci USA. 1986;83:5731–5.

    Article  PubMed  CAS  Google Scholar 

  8. Rosenfeld MG, Mermod JJ, Amara SG, Swanson LW, Sawchenko PE, Rivier J, et al. Production of a novel neuropeptide encoded by the calcitonin gene via tissue-specific RNA processing. Nature. 1983;304:129–35.

    Article  PubMed  CAS  Google Scholar 

  9. Arnalich F, de Miguel E, Perez-Ayala C, Martinez M, Vazquez JJ, Gijon-Banos J, et al. Neuropeptides and interleukin-6 in human joint inflammation relationship between intraarticular substance P and interleukin-6 concentrations. Neurosci Lett. 1994;170:251–4.

    Article  PubMed  CAS  Google Scholar 

  10. Lygren I, Ostensen M, Burhol PG, Husby G. Gastrointestinal peptides in serum and synovial fluid from patients with inflammatory joint disease. Ann Rheum Dis. 1986;45:637–40.

    Article  PubMed  CAS  Google Scholar 

  11. Pert A, Moody TW, Pert CB, Dewald LA, Rivier J. Bombesin: receptor distribution in brain and effects on nociception and locomotor activity. Brain Res. 1980;193:209–20.

    Article  PubMed  CAS  Google Scholar 

  12. Okuma Y, Yokotani K, Osumi Y. Centrally applied bombesin increases nerve activity of both sympathetic and adrenal branch of the splanchnic nerves. Jpn J Pharmacol. 1995;68:227–30.

    Article  PubMed  CAS  Google Scholar 

  13. Westermark T, Rantapaa-Dahlqvist S, Wallberg-Jonsson S, Kjorell U, Forsgren S. Increased content of bombesin/GRP in human synovial fluid in early arthritis: different pattern compared with substance P. Clin Exp Rheumatol. 2001;19:715–20.

    PubMed  CAS  Google Scholar 

  14. Arnett FC, Edworthy SM, Bloch DA, McShane DJ, Fries JF, Cooper NS. The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis. Arthritis Rheum. 1988;31:315–24.

    Article  PubMed  CAS  Google Scholar 

  15. Lotz M, Carson DA, Vaughan JH. Substance P activation of rheumatoid synoviocytes: neural pathway in pathogenesis of arthritis. Science. 1987;235:893–5.

    Article  PubMed  CAS  Google Scholar 

  16. Cerinic MM, Konttinen Y, Generini S, Cutolo M. Neuropeptides and steroid hormones in arthritis. Curr Opin Rheumatol. 1998;10:220–35.

    Article  PubMed  CAS  Google Scholar 

  17. Alstergren P, Appelgren A, Appelgren B, Kopp S, Lundeberg T, Theodorsson E. Co-variation of neuropeptide Y, calcitonin gene-related peptide, substance P and neurokinin A in joint fluid from patients with temporomandibular joint arthritis. Arch Oral Biol. 1995;40:127–35.

    Article  PubMed  CAS  Google Scholar 

  18. Appelgren A, Appelgren B, Eriksson S, Kopp S, Lundeberg T, Nylander M, et al. Neuropeptides in temporomandibular joints with rheumatoid arthritis: a clinical study. Scand J Dent Res. 1991;99:519–21.

    PubMed  CAS  Google Scholar 

  19. Hernanz A, De Miguel E, Romera N, Perez-Ayala C, Gijon J, Arnalich F. Calcitonin gene-related peptide II, substance P and vasoactive intestinal peptide in plasma and synovial fluid from patients with inflammatory joint disease. Br J Rheumatol. 1993;32:31–5.

    Article  PubMed  CAS  Google Scholar 

  20. Grimsholm O, Rantapaa-Dahlqvist S, Forsgren S. Levels of gastrin-releasing peptide and substance P in synovial fluid and serum correlate with levels of cytokines in rheumatoid arthritis. Arthritis Res Ther. 2005;7:R416–26.

    Article  PubMed  Google Scholar 

  21. Levine JD, Clark R, Devor M, Helms C, Moskowitz MA, Basbaum AI. Intraneuronal substance P contributes to the severity of experimental arthritis. Science. 1984;226:547–9.

    Article  PubMed  CAS  Google Scholar 

  22. Seegers HC, Avery PS, McWilliams DF, Haywood L, Walsh DA. Combined effect of bradykinin B2 and neurokinin-1 receptor activation on endothelial cell proliferation in acute synovitis. FASEB J. 2004;18:762–4.

    PubMed  CAS  Google Scholar 

  23. Zhang B, Muneta T, Yagishita K, Sekiya I. Substance P immunoreactive fibers of synovial tissue in patients with anterior cruciate ligament injury. Knee Surg Sports Traumatol Arthrosc. 2006;14:404–10.

    Article  PubMed  Google Scholar 

  24. Katz LM, Marr CM, Elliott J. Characterisation of the response of equine digital arteries and veins to substance P. J Vet Pharmacol Ther. 2003;26:361–8.

    Article  PubMed  CAS  Google Scholar 

  25. Pascual DW, Bost KL. Substance P production by P388D1 macrophages: a possible autocrine function for this neuropeptide. Immunology. 1990;71:52–6.

    PubMed  CAS  Google Scholar 

  26. Sato J, Segami N, Yoshitake Y, Kaneyama K, Yoshimura H, Fujimura K, et al. Specific expression of substance P in synovial tissues of patients with symptomatic, non-reducing internal derangement of the temporomandibular joint: comparison with clinical findings. Br J Oral Maxillofac Surg. 2007;45:372–7.

    Article  PubMed  Google Scholar 

  27. Larsson J, Ekblom A, Henriksson K, Lundeberg T, Theodorsson E. Concentration of substance P, neurokinin A, calcitonin gene-related peptide, neuropeptide Y and vasoactive intestinal polypeptide in synovial fluid from knee joints in patients suffering from rheumatoid arthritis. Scand J Rheumatol. 1991;20:326–35.

    Article  PubMed  CAS  Google Scholar 

  28. Sakuta H, Inaba K, Muramatsu S. Calcitonin gene-related peptide enhances cytokine-induced IL-6 production by fibroblasts. Cell Immunol. 1995;165:20–5.

    Article  PubMed  CAS  Google Scholar 

  29. Wang F, Millet I, Bottomly K, Vignery A. Calcitonin gene-related peptide inhibits interleukin 2 production by murine T lymphocytes. J Biol Chem. 1992;267:21052–7.

    PubMed  CAS  Google Scholar 

  30. Nong Y, Titus R, Ribeiro J, Remold HG. Peptides encoded by the calcitonin gene inhibit macrophage function. J Immunol. 1989;143:45–9.

    PubMed  CAS  Google Scholar 

  31. Grimsholm O, Guo Y, Ny T, Rantapaa-Dahlqvist S, Forsgren S. Are neuropeptides important in arthritis? Studies on the importance of bombesin/GRP and substance P in a murine arthritis model. Ann N Y Acad Sci. 2007;1110:525–38.

    Article  PubMed  CAS  Google Scholar 

  32. Iannone F, Lapadula G. Neuropeptides and human osteoarthritis. J Rheumatol. 1998;25:386–8.

    PubMed  CAS  Google Scholar 

  33. Lotz M, Vaughan JH, Carson DA. Effect of neuropeptides on production of inflammatory cytokines by human monocytes. Science. 1988;241:1218–21.

    Article  PubMed  CAS  Google Scholar 

  34. Cuesta MC, Quintero L, Pons H, Suarez-Roca H. Substance P and calcitonin gene-related peptide increase IL-1 beta, IL-6 and TNF alpha secretion from human peripheral blood mononuclear cells. Neurochem Int. 2002;40:301–6.

    Article  PubMed  CAS  Google Scholar 

  35. Kane D, Lockhart JC, Balint PV, Mann C, Ferrell WR, McInnes IB. Protective effect of sensory denervation in inflammatory arthritis (evidence of regulatory neuroimmune pathways in the arthritic joint). Ann Rheum Dis. 2005;64:325–7.

    Article  PubMed  CAS  Google Scholar 

  36. Green PG. Gastrin-releasing peptide, substance P and cytokines in rheumatoid arthritis. Arthritis Res Ther. 2005;7:111–3.

    Article  PubMed  CAS  Google Scholar 

  37. Hernanz A, Medina S, de Miguel E, Martin-Mola E. Effect of calcitonin gene-related peptide, neuropeptide Y, substance P, and vasoactive intestinal peptide on interleukin-1beta, interleukin-6 and tumor necrosis factor-alpha production by peripheral whole blood cells from rheumatoid arthritis and osteoarthritis patients. Regul Pept. 2003;115:19–24.

    Article  PubMed  CAS  Google Scholar 

  38. Hernanz A, Tato E, De la Fuente M, de Miguel E, Arnalich F. Differential effects of gastrin-releasing peptide, neuropeptide Y, somatostatin and vasoactive intestinal peptide on interleukin-1 beta, interleukin-6 and tumor necrosis factor-alpha production by whole blood cells from healthy young and old subjects. J Neuroimmunol. 1996;71:25–30.

    Article  PubMed  CAS  Google Scholar 

Download references

Conflict of interest

None.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Tomoki Origuchi.

About this article

Cite this article

Origuchi, T., Iwamoto, N., Kawashiri, Sy. et al. Reduction in serum levels of substance P in patients with rheumatoid arthritis by etanercept, a tumor necrosis factor inhibitor. Mod Rheumatol 21, 244–250 (2011). https://doi.org/10.1007/s10165-010-0384-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10165-010-0384-5

Keywords

Navigation