Article ; Online: Methotrexate and its mechanisms of action in inflammatory arthritis.
2020 Volume 16, Issue 3, Page(s) 145–154
Abstract: Despite the introduction of numerous biologic agents for the treatment of rheumatoid arthritis (RA) and other forms of inflammatory arthritis, low-dose methotrexate therapy remains the gold standard in RA therapy. Methotrexate is generally the first-line ...
Abstract | Despite the introduction of numerous biologic agents for the treatment of rheumatoid arthritis (RA) and other forms of inflammatory arthritis, low-dose methotrexate therapy remains the gold standard in RA therapy. Methotrexate is generally the first-line drug for the treatment of RA, psoriatic arthritis and other forms of inflammatory arthritis, and it enhances the effect of most biologic agents in RA. Understanding the mechanism of action of methotrexate could be instructive in the appropriate use of the drug and in the design of new regimens for the treatment of RA. Although methotrexate is one of the first examples of intelligent drug design, multiple mechanisms potentially contribute to the anti-inflammatory actions of methotrexate, including the inhibition of purine and pyrimidine synthesis, transmethylation reactions, translocation of nuclear factor-κB (NF-κB) to the nucleus, signalling via the Janus kinase (JAK)-signal transducer and activator of transcription (STAT) pathway and nitric oxide production, as well as the promotion of adenosine release and expression of certain long non-coding RNAs. |
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MeSH term(s) | Aminoimidazole Carboxamide/analogs & derivatives ; Aminoimidazole Carboxamide/antagonists & inhibitors ; Antirheumatic Agents/therapeutic use ; Arthritis/drug therapy ; Arthritis/immunology ; Arthritis/metabolism ; Humans ; Immunity, Cellular/drug effects ; Methotrexate/therapeutic use ; Ribonucleotides/antagonists & inhibitors ; T-Lymphocytes/drug effects ; T-Lymphocytes/immunology ; Tetrahydrofolate Dehydrogenase/drug effects ; Tetrahydrofolate Dehydrogenase/metabolism |
Chemical Substances | Antirheumatic Agents ; Ribonucleotides ; Aminoimidazole Carboxamide (360-97-4) ; Tetrahydrofolate Dehydrogenase (EC 1.5.1.3) ; AICA ribonucleotide (F0X88YW0YK) ; Methotrexate (YL5FZ2Y5U1) |
Language | English |
Publishing date | 2020-02-17 |
Publishing country | United States |
Document type | Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't ; Review |
ZDB-ID | 2491532-4 |
ISSN | 1759-4804 ; 1759-4790 |
ISSN (online) | 1759-4804 |
ISSN | 1759-4790 |
DOI | 10.1038/s41584-020-0373-9 |
Database | MEDical Literature Analysis and Retrieval System OnLINE |
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