title: Erosive arthritis and hepatic granuloma formation induced by peptidoglycan polysaccharide in rats is aggravated by prasugrel treatment.
abstract: Administration of the thienopyridine P2Y12 receptor antagonist, clopidogrel, increased the erosive arthritis induced by peptidoglycan polysaccharide (PG-PS) in rats or by injection of the arthritogenic K/BxN serum in mice. To determine if the detrimental effects are caused exclusively by clopidogrel, we evaluated prasugrel, a third-generation thienopyridine pro-drug, that contrary to clopidogrel is mostly metabolized into its active metabolite in the intestine. Prasugrel effects were examined on the PG-PS-induced arthritis rat model. Erosive arthritis was induced in Lewis rats followed by treatment with prasugrel for 21 days. Prasugrel treated arthritic animals showed a significant increase in the inflammatory response, compared with untreated arthritic rats, in terms of augmented macroscopic joint diameter associated with significant signs of inflammation, histomorphometric measurements of the hind joints and elevated platelet number. Moreover, fibrosis at the pannus, assessed by immunofluorescence of connective tissue growth factor, was increased in arthritic rats treated with prasugrel. In addition to the arthritic manifestations, hepatomegaly, liver granulomas and giant cell formation were observed after PG-PS induction and even more after prasugrel exposure. Cytokine plasma levels of IL-1 beta, IL-6, MIP1 alpha, MCP1, IL-17 and RANTES were increased in arthritis-induced animals. IL-10 plasma levels were significantly decreased in animals treated with prasugrel. Overall, prasugrel enhances inflammation in joints and liver of this animal model. Since prasugrel metabolites inhibit neutrophil function ex-vivo and the effects of both clopidogrel and prasugrel metabolites on platelets are identical, we conclude that the thienopyridines metabolites might exert non-platelet effects on other immune cells to aggravate inflammation.
authors.affiliation: Sol Sherry Thrombosis Research Center, Temple University School of Medicine, Temple University Hospital, Philadelphia, Pennsylvania, United States of America. agarcia@temple.edu
authors.forename: Analia E
authors.initials: AE
authors.lastname: Garcia
authors.forename: Mario C
authors.initials: MC
authors.lastname: Rico
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Liverani
authors.forename: Raul A
authors.initials: RA
authors.lastname: DeLa Cadena
authors.forename: Paul F
authors.initials: PF
authors.lastname: Bray
authors.forename: Satya P
authors.initials: SP
authors.lastname: Kunapuli
mesh_terms: D000818:Animals; D001169:Arthritis, Experimental / Q000139:chemically induced / Q000276:immunology / Q000473:pathology*; D000077144:Clopidogrel; D016207:Cytokines / Q000096:biosynthesis / Q000276:immunology; D005260:Female; D006099:Granuloma / Q000139:chemically induced / Q000276:immunology / Q000473:pathology*; D007249:Inflammation / Q000139:chemically induced / Q000276:immunology / Q000473:pathology; D007596:Joints / Q000276:immunology / Q000473:pathology*; D008099:Liver / Q000276:immunology / Q000473:pathology*; D010457:Peptidoglycan; D010879:Piperazines / Q000009:adverse effects*; D010975:Platelet Aggregation Inhibitors / Q000009:adverse effects*; D000068799:Prasugrel Hydrochloride; D011355:Prodrugs / Q000009:adverse effects*; D051381:Rats; D011917:Rats, Inbred Lew; D013876:Thiophenes / Q000009:adverse effects*; D013988:Ticlopidine / Q000009:adverse effects / Q000031:analogs & derivatives
chemical_list: D016207:Cytokines; D010457:Peptidoglycan; D010879:Piperazines; D010975:Platelet Aggregation Inhibitors; D011355:Prodrugs; D013876:Thiophenes; D000077144:Clopidogrel; D000068799:Prasugrel Hydrochloride; D013988:Ticlopidine