Single high-dose treatment with glucosaminyl-muramyl dipeptide is ineffective in treating ankylosing spondylitis

Rheumatol Int. 2011 Aug;31(8):1101-3. doi: 10.1007/s00296-010-1663-3. Epub 2010 Nov 30.

Abstract

Earlier studies have shown that high doses of TNF-alpha increase apoptosis in human autoimmune T-cell clones. Based on these studies, a treatment approach was proposed to reduce or eliminate autoimmune T cells in patients with type 1 diabetes using drugs that temporarily elevate TNF levels. Here, we report the treatment of ankylosing spondylitis patient with a single high oral dose of Likopid (glucosaminyl-muramyl dipeptide), which aimed at increasing the levels of TNF-alpha in order to induce apoptosis of autoreactive T cells. The flow cytometric analysis of blood samples collected before and after treatment demonstrated massive elimination of CD8(+) T cells. However, the treatment did not result in any notable therapeutic effect, and real-time PCR analysis demonstrated that stably expanded T-cell clones that were earlier tracked in this patient were unaffected. This report suggests that the controversial approach to eliminate autoimmune T-cell clones through overstimulation is not effective in treating ankylosing spondylitis.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acetylmuramyl-Alanyl-Isoglutamine / analogs & derivatives*
  • Acetylmuramyl-Alanyl-Isoglutamine / therapeutic use
  • Adalimumab
  • Adjuvants, Immunologic / therapeutic use*
  • Antibodies, Monoclonal, Humanized / therapeutic use
  • Antirheumatic Agents / therapeutic use
  • CD8-Positive T-Lymphocytes / drug effects
  • CD8-Positive T-Lymphocytes / pathology
  • Cell Death / drug effects
  • Dose-Response Relationship, Drug
  • Flow Cytometry
  • Humans
  • Leukocyte Count
  • Male
  • Middle Aged
  • Spondylitis, Ankylosing / drug therapy*
  • T-Lymphocyte Subsets / drug effects
  • T-Lymphocyte Subsets / pathology
  • Treatment Failure

Substances

  • Adjuvants, Immunologic
  • Antibodies, Monoclonal, Humanized
  • Antirheumatic Agents
  • Acetylmuramyl-Alanyl-Isoglutamine
  • glucosaminylmuramyl-2-alanine-D-isoglutamine
  • Adalimumab