Leflunomide protects mice from multiple low dose streptozotocin (MLD-SZ)-induced insulitis and diabetes.
In certain animal models of autoimmunity the isoxasol derivative leflunomide has been reported to exert a protective effect against autodestruction. In the present study, the immunomodulatory potential of the main metabolite of leflunomide, A77 1726, in experimentally induced autoimmune diabetes was investigated. The disease was induced in genetically susceptible CBA/H mice by multiple low doses of streptozotocin (MLD-SZ, 40 mg/kg per day, given intraperitoneally for 5 consecutive days). Effects of leflunomide were evaluated by two treatment protocols: mice treated with MLD-SZ were injected intraperitoneally with A77 1726 for 10 consecutive days, either during the first 10 days of the disease (early treatment), or starting from day 10 after disease induction (late treatment). Disease manifestations defined by hyperglycaemia, mononuclear infiltration into pancreas, expression of interferon-gamma (IFN-gamma) and inducible nitric oxide synthase (iNOS) and destruction of the islets of Langerhans were reduced in a dose-dependent fashion after early treatment with A77 1726 (dose range of 5-35 mg/kg per day). Moreover, late treatment with the high dose of the drug (25 mg/kg per day), started when the autoimmune disease was already apparent, arrested progression of ongoing inflammatory response. Analysis of the effects of A77 1726 on the adhesive interactions of spleen-derived or peripheral blood-derived mononuclear cells from MLD-SZ-treated and normal mice demonstrated that the drug inhibits both ex vivo and in vitro spontaneous mononuclear cell aggregation, thus suggesting that an important component of leflunomide's immunomodulatory action is suppression of adhesive interactions. These results demonstrate both preventive and therapeutic effects of leflunomide in a model of MLD-SZ-induced diabetes and suggest that the drug may be considered a potent therapeutic tool for autoimmune inflammatory disorders, including diabetes.
Stosic-Grujicic
S
S
Institute for Biological Research 'Sinisa Stankovic', Department of Microbiology and Immunology, University School of Pharmacy, Belgrade, Yugoslavia.
Dimitrijevic
M
M
Bartlett
R
R
D000818:Animals; D001327:Autoimmune Diseases / Q000473:pathology / Q000517:prevention & control*; D001786:Blood Glucose / Q000032:analysis; D003922:Diabetes Mellitus, Type 1 / Q000473:pathology / Q000517:prevention & control*; D004305:Dose-Response Relationship, Drug; D004353:Drug Evaluation, Preclinical; D007166:Immunosuppressive Agents / Q000494:pharmacology / Q000627:therapeutic use*; D007371:Interferon-gamma / Q000032:analysis; D007515:Islets of Langerhans / Q000276:immunology / Q000473:pathology; D007555:Isoxazoles / Q000494:pharmacology / Q000627:therapeutic use*; D000077339:Leflunomide; D008297:Male; D051379:Mice; D008808:Mice, Inbred CBA; D019001:Nitric Oxide Synthase / Q000032:analysis; D052247:Nitric Oxide Synthase Type II; D010195:Pancreatitis / Q000473:pathology / Q000517:prevention & control*; D013311:Streptozocin / Q000037:antagonists & inhibitors*; D013602:T-Lymphocytes, Cytotoxic / Q000276:immunology
D001786:Blood Glucose; D007166:Immunosuppressive Agents; D007555:Isoxazoles; D013311:Streptozocin; D007371:Interferon-gamma; D019001:Nitric Oxide Synthase; D052247:Nitric Oxide Synthase Type II; C496317:Nos2 protein, mouse; D000077339:Leflunomide