title: Adenosine and cytokine levels following treatment of rheumatoid arthritis with dipyridamole.
abstract: Adenosine can suppress the release of tumour necrosis factor-alpha (TNF-alpha) from activated monocytes and macrophages, and may contribute to the anti-inflammatory activities of methotrexate and sulphasalazine. Dipyridamole inhibits the cellular uptake and metabolism of adenosine and we have, therefore, examined the effects of dipyridamole in patients with rheumatoid arthritis in an attempt to alleviate their symptoms. Forty patients aged 18-75 years were randomised to receive dipyridamole 400 mg/day or placebo. Blood samples were taken at baseline and at monthly intervals for 6 months. Purines were determined by HPLC and cytokines by ELISA. After 3 months of treatment there were significant reductions in neopterin levels and in the modified Health Assessment Questionnaire score, but these were not maintained. Dipyridamole had no effect on disease severity or the levels of purine metabolites, interleukin-1beta (IL-1beta), IL-6, TNF-alpha, lipid peroxidation products, erythrocyte sedimentation rate or C-reactive protein. In conclusion, rheumatoid arthritis patients showed no clinical improvement following treatment with dipyridamole for 6 months.
authors.affiliation: Institute of Biomedical and Life Sciences, University of Glasgow, Glasgow, G12 8QQ, UK. C.M.Forrest@bio.gla.ac.uk
authors.forename: Caroline M
authors.initials: CM
authors.lastname: Forrest
authors.forename: Nicholas
authors.initials: N
authors.lastname: Stoy
authors.forename: Trevor W
authors.initials: TW
authors.lastname: Stone
authors.forename: Gillian
authors.initials: G
authors.lastname: Harman
authors.forename: Gillian M
authors.initials: GM
authors.lastname: Mackay
authors.forename: Lynn
authors.initials: L
authors.lastname: Oxford
authors.forename: L Gail
authors.initials: LG
authors.lastname: Darlington
mesh_terms: D000241:Adenosine / Q000097:blood*; D000293:Adolescent; D000328:Adult; D000368:Aged; D001172:Arthritis, Rheumatoid / Q000097:blood* / Q000188:drug therapy*; D016207:Cytokines / Q000097:blood*; D004176:Dipyridamole / Q000494:pharmacology / Q000627:therapeutic use*; D004305:Dose-Response Relationship, Drug; D006801:Humans; D053583:Interleukin-1beta / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D015227:Lipid Peroxidation / Q000187:drug effects; D008875:Middle Aged; D019798:Neopterin / Q000097:blood; D010975:Platelet Aggregation Inhibitors / Q000494:pharmacology / Q000627:therapeutic use*; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000097:blood; D055815:Young Adult
chemical_list: D016207:Cytokines; D053583:Interleukin-1beta; D015850:Interleukin-6; D010975:Platelet Aggregation Inhibitors; D014409:Tumor Necrosis Factor-alpha; D004176:Dipyridamole; D019798:Neopterin; D000241:Adenosine