Leflunomide protects mice from multiple low dose streptozotocin (MLD-SZ)-induced insulitis and diabetes

Abstract

In certain animal models of autoimmunity the isoxasol derivative leflunomide has been reported to exert a protective effect against autodestruction. In the present study, the immunomodulatory potential of the main metabolite of leflunomide, A77 1726, in experimentally induced autoimmune diabetes was investigated. The disease was induced in genetically susceptible CBA/H mice by multiple low doses of streptozotocin (MLD-SZ, 40 mg/kg per day, given intraperitoneally for 5 consecutive days). Effects of leflunomide were evaluated by two treatment protocols: mice treated with MLD-SZ were injected intraperitoneally with A77 1726 for 10 consecutive days, either during the first 10 days of the disease (early treatment), or starting from day 10 after disease induction (late treatment). Disease manifestations defined by hyperglycaemia, mononuclear infiltration into pancreas, expression of interferon-gamma (IFN-gamma) and inducible nitric oxide synthase (iNOS) and destruction of the islets of Langerhans were reduced in a dose-dependent fashion after early treatment with A77 1726 (dose range of 5-35 mg/kg per day). Moreover, late treatment with the high dose of the drug (25 mg/kg per day), started when the autoimmune disease was already apparent, arrested progression of ongoing inflammatory response. Analysis of the effects of A77 1726 on the adhesive interactions of spleen-derived or peripheral blood-derived mononuclear cells from MLD-SZ-treated and normal mice demonstrated that the drug inhibits both ex vivo and in vitro spontaneous mononuclear cell aggregation, thus suggesting that an important component of leflunomide's immunomodulatory action is suppression of adhesive interactions. These results demonstrate both preventive and therapeutic effects of leflunomide in a model of MLD-SZ-induced diabetes and suggest that the drug may be considered a potent therapeutic tool for autoimmune inflammatory disorders, including diabetes.

Synergistic Effects of Leflunomide and Benazepril in Streptozotocin-Induced Diabetic Nephropathy

“…The reason for this discrepancy is unclear, but it may be related to differences in the animal diabetes model and the timing of LEF administration. This concept is supported by studies indicating that early treatment of A77 1726, a main metabolite of LEF, protects mice from the onset of hyperglycemia as well as diabetes in a dose-dependent manner, but that late treatment with A77 1726 at a lower dose has no effect on hyperglycemic plasma glucose levels in mice with diabetes induced by multiple, low doses of STZ [17]. Thus, diverse functions of LEF may contribute to interfere with diabetes.…”

The Antidiabetic Effect of Mesenchymal Stem Cells vs. Nigella sativa Oil on Streptozotocin Induced Type 1 Diabetic Rats

“…These included: lymphocytic infiltration of the islets after MLD-STZ injection [23], immunocompromised mice did not develop diabetes after MLD-STZ treatment [24], induction of diabetes by the transfer of splenic cells from STZ-induced diabetic mice to normal mice [25] and the development of diabetes in young non-obese diabetic mice lacking T cell receptors after injection of MLD-STZ [5].…”

Sicherheit der Immunsuppressiva

“…1 zeigt die Häufigkeit der Nebenwirkungen auf den Metabolismus). Leflunomid zeigte in Tierversuchen sogar einen Diabetes-protektiven Effekt [5]. In einer prospektiven, multizentrischen Beobachtungsstudie mit 4905 Erwachsenen mit rheumatoider Arthritis (RA) ohne Diabetes mellitus [DM; 1808 hatten Hydroxychloroquin (HCQ) und 3097 hatten nie Hydroxychloroquin] über einen Zeitraum von 21,5 Jahren 1 Zur besseren Lesbarkeit wird die männliche Form verwendet.…”