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      Drug Repositioning of Metformin Encapsulated in PLGA Combined with Photothermal Therapy Ameliorates Rheumatoid Arthritis

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          Abstract

          Purpose

          Rheumatoid arthritis (RA) is a highly prevalent form of autoimmune disease that affects nearly 1% of the global population by causing severe cartilage damage and inflammation. Despite its prevalence, previous efforts to prevent the perpetuation of RA have been hampered by therapeutics’ cytotoxicity and poor delivery to target cells. The present study exploited drug repositioning and nanotechnology to convert metformin, a widely used antidiabetic agent, into an anti-rheumatoid arthritis drug by designing poly(lactic-co-glycolic acid) (PLGA)-based spheres. Moreover, this study also explored the thermal responsiveness of the IL-22 receptor, a key regulator of Th-17, to incorporate photothermal therapy (PTT) into the nanodrug treatment.

          Materials and Methods

          PLGA nanoparticles were synthesized using the solvent evaporation method, and metformin and indocyanine green (ICG) were encapsulated in PLGA in a dropwise manner. The nanodrug’s in vitro anti-inflammatory properties were examined in J744 and FLS via real-time PCR. PTT was induced by an 808 nm near-infrared (NIR) laser, and the anti-RA effects of the nanodrug with PTT were evaluated in DBA/1 collagen-induced arthritis (CIA) mice models. Further evaluation of anti-RA properties was carried out using flow cytometry, immunofluorescence analysis, and immunohistochemical analysis.

          Results

          The encapsulation of metformin into PLGA allowed the nanodrug to enter the target cells via macropinocytosis and clathrin-mediated endocytosis. Metformin-encapsulated PLGA (PLGA-MET) demonstrated promising anti-inflammatory effects by decreasing the expression of pro-inflammatory cytokines (IL-1β, IL-6, and TNF-α), increasing the expression of anti-inflammatory cytokines (IL-10 and IL-4), and promoting the polarization of M1 to M2 macrophages in J774 cells. The treatment of the nanodrug with PTT exhibited more potent anti-inflammatory effects than free metformin or PLGA-MET in CIA mice models.

          Conclusion

          These results demonstrated that PLGA-encapsulated metformin treatment with PTT can effectively ameliorate inflammation in a spatiotemporal manner.

          Graphical Abstract

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          Most cited references65

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          Fibroblast-like synoviocytes: key effector cells in rheumatoid arthritis.

          Rheumatoid arthritis (RA) remains a significant unmet medical need despite significant therapeutic advances. The pathogenesis of RA is complex and includes many cell types, including T cells, B cells, and macrophages. Fibroblast-like synoviocytes (FLS) in the synovial intimal lining also play a key role by producing cytokines that perpetuate inflammation and proteases that contribute to cartilage destruction. Rheumatoid FLS develop a unique aggressive phenotype that increases invasiveness into the extracellular matrix and further exacerbates joint damage. Recent advances in understanding the biology of FLS, including their regulation regulate innate immune responses and activation of intracellular signaling mechanisms that control their behavior, provide novel insights into disease mechanisms. New agents that target FLS could potentially complement the current therapies without major deleterious effect on adaptive immune responses.
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            Diagnosis and Management of Rheumatoid Arthritis

            Rheumatoid arthritis (RA) occurs in about 5 per 1000 people and can lead to severe joint damage and disability. Significant progress has been made over the past 2 decades regarding understanding of disease pathophysiology, optimal outcome measures, and effective treatment strategies, including the recognition of the importance of diagnosing and treating RA early.
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              Poly Lactic-co-Glycolic Acid (PLGA) as Biodegradable Controlled Drug Delivery Carrier.

              In past two decades poly lactic-co-glycolic acid (PLGA) has been among the most attractive polymeric candidates used to fabricate devices for drug delivery and tissue engineering applications. PLGA is biocompatible and biodegradable, exhibits a wide range of erosion times, has tunable mechanical properties and most importantly, is a FDA approved polymer. In particular, PLGA has been extensively studied for the development of devices for controlled delivery of small molecule drugs, proteins and other macromolecules in commercial use and in research. This manuscript describes the various fabrication techniques for these devices and the factors affecting their degradation and drug release.
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                Author and article information

                Journal
                Int J Nanomedicine
                Int J Nanomedicine
                ijn
                International Journal of Nanomedicine
                Dove
                1176-9114
                1178-2013
                06 December 2023
                2023
                : 18
                : 7267-7285
                Affiliations
                [1 ]Deparment of Biochemistry, Bowdoin College , Brunswick, ME, 04011, USA
                [2 ]Lee Gil Ya Cancer and Diabetes Institute, Gachon University , Incheon, 21999, South Korea
                [3 ]Department of Health Sciences and Technology, GAIHST, Gachon University , Incheon, 21999, South Korea
                [4 ]Department of Rehabilitation Medicine, Nowon Eulji Medical Center, Eulji University School of Medicine , Seoul, 01830, South Korea
                [5 ]Department of Physiology, School of Medicine, Gachon University , Incheon, 21999, South Korea
                Author notes
                Correspondence: Dongwoo Khang, Department of Physiology, School of Medicine, Gachon University , Incheon, 21999, South Korea, Tel +82 32 899 6515, Fax +82 32 899 6471, Email dkhang@gachon.ac.kr
                Youn Joo Kang, Department of Rehabilitation Medicine, Nowon Eulji Medical Center, Eulji University School of Medicine , Seoul, 01830, South Korea, Tel/Fax + 82-2-970-8315, Email md52516@eulji.ac.kr
                [*]

                These authors contributed equally to this work

                Author information
                http://orcid.org/0009-0008-1275-7680
                http://orcid.org/0000-0002-9938-5435
                http://orcid.org/0000-0003-2353-8017
                Article
                438388
                10.2147/IJN.S438388
                10711299
                38090362
                86096e1d-710b-48fb-86bf-e82e0eb3dae4
                © 2023 Kim et al.

                This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms ( https://www.dovepress.com/terms.php).

                History
                : 27 September 2023
                : 30 November 2023
                Page count
                Figures: 8, References: 65, Pages: 19
                Categories
                Original Research

                Molecular medicine
                rheumatoid arthritis,drug repositioning,nanoparticles,photothermal therapy
                Molecular medicine
                rheumatoid arthritis, drug repositioning, nanoparticles, photothermal therapy

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