title: Treatment of collagen induced arthritis by proteolytic enzymes: immunomodulatory and disease modifying effects.
abstract: OBJECTIVE
  To investigate the efficacy of a novel therapy (proteases) in an animal model of rheumatoid arthritis, and to investigate the mechanisms of arthritogenesis.
  
  
  METHODS
  We induced progressive arthritis in male DBA/1 mice by immunization and boosting with Type II collagen; groups of mice were treated orally twice daily with either ibuprofen or proteases, or were left untreated. After 2 weeks, joints were scored for clinical, radiographic, and histologic changes. In addition, we measured serum levels of IgG anti-collagen II, the glycosylation of circulating total and anti-collagen II IgG, and cytokine production by lymphocytes isolated from lymph nodes.
  
  
  RESULTS
  Amelioration of joint inflammation, and accentuation of a prototypical Th2 cytokine (interleukin 5) were similar in the ibuprofen and protease treatment groups. However, protease treatment protects and preserves articular cartilage, normalizes the sialylation of IgG and anti-collagen antibody, and fully restores Th1 (interferon-gamma) synthesis, distinct from ibuprofen.
  
  
  CONCLUSIONS
  Protease therapy has antiinflammatory efficacy in the early (inflammatory) phase of collagen induced arthritis, similar to ibuprofen. The immunomodulatory effects of proteases, not seen with ibuprofen, may underlie a correction of aberrant IgG glycosylation and/or contribute to the increased capacity of protease to delay or forestall erosive and destructive arthritis or ankylosis. Similar effects may apply to spontaneous RA in humans.
authors.affiliation: Institute of Pathology, Department of Radiology, Case Western Reserve University, Cleveland, Ohio 44106, USA.
authors.forename: S R
authors.initials: SR
authors.lastname: Chintalacharuvu
authors.forename: N
authors.initials: N
authors.lastname: Urankar-Nagy
authors.forename: C A
authors.initials: CA
authors.lastname: Petersilge
authors.forename: F W
authors.initials: FW
authors.lastname: Abdul-Karim
authors.forename: S N
authors.initials: SN
authors.lastname: Emancipator
mesh_terms: D000818:Animals; D000888:Antibodies, Anti-Idiotypic / Q000032:analysis*; D001172:Arthritis, Rheumatoid / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000276:immunology / Q000473:pathology*; D003094:Collagen; D004195:Disease Models, Animal; D007052:Ibuprofen / Q000494:pharmacology*; D007074:Immunoglobulin G / Q000032:analysis*; D007150:Immunohistochemistry; D008297:Male; D051379:Mice; D008811:Mice, Inbred DBA; D010447:Peptide Hydrolases / Q000494:pharmacology*; D011859:Radiography; D012016:Reference Values; D012680:Sensitivity and Specificity; D016896:Treatment Outcome
chemical_list: D000888:Antibodies, Anti-Idiotypic; D007074:Immunoglobulin G; D003094:Collagen; D010447:Peptide Hydrolases; D007052:Ibuprofen