Methotrexate accumulation in target intestinal mucosa and white blood cells differs from non-target red blood cells of patients with Crohn's disease

IF 2.7 4区 医学 Q2 PHARMACOLOGY & PHARMACY
Maartje M. van de Meeberg, Janani Sundaresan, Marry Lin, Gerrit Jansen, Eduard A. Struys, Herma H. Fidder, Bas Oldenburg, Wout G. N. Mares, Nofel Mahmmod, Dirk P. van Asseldonk, Svend T. Rietdijk, Loes H. C. Nissen, Nanne K. H. de Boer, Gerd Bouma, Maja Bulatović Ćalasan, Robert de Jonge, On behalf on the Dutch Initiative on Crohn and Colitis (ICC)
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Abstract

Background

Intracellular methotrexate polyglutamates (MTX-PGs) concentrations are measurable in red blood cells (RBCs) during MTX treatment. MTX-PG3 concentrations correlate with efficacy in patients with Crohn's disease (CD). Since RBCs are not involved in pathogenesis of CD and lack extended MTX metabolism, we determined MTX-PGs accumulation in peripheral blood mononuclear cells (PBMCs: effector cells) and intestinal mucosa (target cells) and compared those with RBCs as a potential more precise biomarker.

Methods

In a multicentre prospective cohort study, blood samples of patients with CD were collected during the first year of MTX therapy. Mucosal biopsies were obtained from non-inflamed rectum and/or inflamed intestine. MTX-PGs concentrations in mucosa, PBMCs and RBCs were measured by liquid chromatography–tandem mass spectrometry.

Results

From 80 patients with CD, a total of 27 mucosal biopsies, 9 PBMC and 212 RBC samples were collected. From 12 weeks of MTX therapy onwards, MTX-PG3 was the most predominant species (33%) in RBCs. In PBMCs, the distribution was skewed towards MTX-PG1 (48%), which accounted for an 18 times higher concentration than in RBCs. Long-chain MTX-PGs were highly present in mucosa: 21% of MTX-PGtotal was MTX-PG5. MTX-PG6 was measurable in all biopsies.

Conclusions

MTX-PG patterns differ between mucosa, PBMCs and RBCs of patients with CD.

Abstract Image

克罗恩病患者的目标肠粘膜和白细胞中的甲氨蝶呤蓄积与非目标红细胞中的甲氨蝶呤蓄积不同。
背景:细胞内甲氨蝶呤多聚谷氨酸盐(MTX-PGs)浓度可在 MTX 治疗期间在红细胞(RBC)中测量到。MTX-PG3 浓度与克罗恩病(CD)患者的疗效相关。由于红细胞不参与克罗恩病的发病机制,也缺乏MTX的扩展代谢,因此我们测定了MTX-PGs在外周血单核细胞(PBMCs:效应细胞)和肠粘膜(靶细胞)中的积累情况,并将其与红细胞进行比较,以此作为一种潜在的更精确的生物标志物:在一项多中心前瞻性队列研究中,收集了 CD 患者在接受 MTX 治疗第一年期间的血液样本。从未发炎的直肠和/或发炎的肠道中获取粘膜活检组织。采用液相色谱-串联质谱法测定了粘膜、白细胞和红细胞中的 MTX-PGs 浓度:结果:共收集了 80 名 CD 患者的 27 份粘膜活检样本、9 份 PBMC 样本和 212 份 RBC 样本。从接受 MTX 治疗 12 周起,MTX-PG3 是红细胞中最主要的物种(33%)。在白细胞介质中,MTX-PG1(48%)的分布偏向于白细胞介质,其浓度是红细胞介质的 18 倍。长链 MTX-PGs 在粘膜中的含量很高:MTX-PG 总量的 21% 是 MTX-PG5。在所有活检组织中均可测量到 MTX-PG6:结论:MTX-PG模式在CD患者的粘膜、PBMC和RBC中存在差异。
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来源期刊
CiteScore
5.60
自引率
6.50%
发文量
126
审稿时长
1 months
期刊介绍: Basic & Clinical Pharmacology and Toxicology is an independent journal, publishing original scientific research in all fields of toxicology, basic and clinical pharmacology. This includes experimental animal pharmacology and toxicology and molecular (-genetic), biochemical and cellular pharmacology and toxicology. It also includes all aspects of clinical pharmacology: pharmacokinetics, pharmacodynamics, therapeutic drug monitoring, drug/drug interactions, pharmacogenetics/-genomics, pharmacoepidemiology, pharmacovigilance, pharmacoeconomics, randomized controlled clinical trials and rational pharmacotherapy. For all compounds used in the studies, the chemical constitution and composition should be known, also for natural compounds.
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