Rheumatoid Arthritis (RA) is an autoimmune disease characterized by chronic inflammation, pain and joint remodeling. Existing RA therapies such analgesics and anti-inflammatories can treat symptoms. More recent strides in disease modifying anti-rheumatic drugs (DMARDs) can slow progression of disease. However, there is still no therapeutic that can reverse disease damage and there is no cure for RA. Resolvin E1 (RvE1) is an endogenous lipid initially identified as a key pro-resolving mediator. By tamping down expression of pro-inflammatory cytokines, tumor necrosis factor-α (TNF-α) and interleukin-1β (IL-1β), RvE1 is able to down-modulate inflammation and return an inflamed tissue to a homeostatic state. More recently, RvE1 has been shown to act directly to inhibit inflammatory pain through central and peripheral nervous system mechanisms. RvE1 has also been shown to restore bone homeostasis by balancing osteoclast and osteoblast activity. In contrast to current therapeutics that treat symptoms and slow disease progression, a RvE1 pathway agonist has the potential to reverse RA by resolving inflammation, reversing bone remodeling and returning joints to normal homeostasis.

Periodontal disease is initiated by bacterial plaque that induces a chronic inflammatory condition with subsequent leukocyte infiltration, osteoclast activation and alveolar bone resorption. The ideal treatment for periodontal disease is the complete regeneration of the lost periodontium. Resolvin E1 (RvE1) is an endogenous anti-inflammatory lipid mediator derived from omega-3 fatty acids. Animal studies showed that topical treatment of periodontitis with RvE1 significantly decreased osteoclast counts, prevented alveolar bone loss, and restored lost periodontal tissues including bone. It is not known if RvE1 directly impacts osteoblast functions and bone formation. The objective of this study was to determine RvE1 mechanism of action on osteoblasts. Results showed that topical RvE1 treatment prevented the progression of ligature-induced periodontitis in mice compared to the vehicle. RvE1 receptor, chemR23, was expressed in murine calvaria osteoblasts and the expression was not changed in the inflammatory environment with or without RvE1 treatment. RvE1 treatment resulted in a significant increase in the ALP activity after 2 and 7 days of treatment compared to the control as well as in the inflammatory milieu. Similarly, RvE1 treatment enhanced murine calvaria osteoblasts mineralization in vitro compared to the inflammatory environment. The proliferation of mouse calvaria osteoblasts was significantly increased with RvE1 treatment after 2 and 10 days of treatment compared to the control. Results for evaluating the impact of RvE1 on OPG/RANKL axis showed that RvE1 treatment markedly elevated OPG production compared to the IL-6/IL-6R treatment and decreased RANKL. Overall, RvE1 increased the OPG/RANKL ratio to favor bone formation. RvE1 treatment resulted in a significant increase in the phosphorylation of AKT, ERK1/2 and ribosomal S6 (rS6) kinase. Those pathways were further confirmed via using specific pharmacological inhibitors which showed a significant reduction in OPG production and in the osteoblast proliferation as well. In conclusion, RvE1 has a positive anabolic impact in ligature-induced periodontitis model via direct actions on osteoblasts. RvE1 increases the OPG/RANKL production ratio favoring the bone formation through a pathway that includes phosphorylation of AKT, ERK1/2 and rS6 kinase. The data suggest that RvE1 stimulates bone formation in inflammatory conditions by directly modulating both the osteoclast and osteoblast functions.

AIM & HYPOTHESIS: Resolvins, derived from omega-3 fatty acids, may actively resolve inflammation. Resolvin E1 (RvE1) binds to Chem-R23 as an endogenous anti-inflammatory and pro-resolving lipid mediator. We hypothesized that RvE1 may also activate osteoblasts to restore critical size bone defects in a calvarial model. MATERIALS & METHODS: An in-vitro calvarial culture system was used to evaluate the stimulative effects of RvE1 compared to Amniotic Growth Factor (AGF) (a known stimulant in this system) on critical size defects under static conditions. Calvaria harvested from 10 mice and separated into 20 calvaria halves were cultured under conditions favoring bone formation. The test groups were defect only, defect plus a collagen membrane, defect plus a collagen membrane plus RvE1, and defect plus a collagen membrane plus AGF. The effect of RvE1 and AGF on healing of a critical size bone defect was assessed with both histological evaluation and alkaline phosphatase assays. RESULTS: RvE1 binds in a receptor-ligand interaction with Chem-R23 in the periosteum to stimulate cellular proliferation and migration into a critical size bone defect of neonatal mouse calvaria. CONCLUSION: These results suggest that RvE1 has a direct effect on osteoblast activity at and around the edge of a critical size 2 mm defect without an inflammatory reaction.

Yes / Aspirin and eicosapentaenoic acid (EPA) have colorectal polyp prevention activity, alone and in combination. This study measured levels of plasma and rectal mucosal oxylipins in participants of the seAFOod 2 × 2 factorial, randomised, placebo-controlled trial, who received aspirin 300 mg daily and EPA 2000 mg free fatty acid, alone and in combination, for 12 months. Resolvin (Rv) E1, 15-epi-lipoxin (LX) A4 and respective precursors 18-HEPE and 15-HETE (with chiral separation) were measured by ultra-high performance liquid chromatography-tandem mass spectrometry in plasma taken at baseline, 6 months and 12 months, as well as rectal mucosa obtained at trial exit colonoscopy at 12 months, in 401 trial participants. Despite detection of S- and R- enantiomers of 18-HEPE and 15-HETE in ng/ml concentrations, RvE1 or 15‑epi-LXA4 were not detected above a limit of detection of 20 pg/ml in plasma or rectal mucosa, even in individuals randomised to both aspirin and EPA. We have confirmed in a large clinical trial cohort that prolonged (12 months) treatment with EPA is associated with increased plasma 18-HEPE concentrations (median [inter-quartile range] total 18-HEPE 0.51 [0.21-1.95] ng/ml at baseline versus 0.95 [0.46-4.06] ng/ml at 6 months [P

The health benefits of fish oil supplementations have been proven to be effective by several studies which are discussed in this thesis. It was found that these compounds had potent anti-inflammatory properties and since then has prompted much research into the use of these compounds as potential treatments for chronic inflammation based diseases, where the overuse of current anti-inflammatory drugs cause many problems with undesired side-effects. The aim of this research is to study the bioactivity of resolvin E1 and various analogues, and to determine a novel route towards resolvin E1 natural product so that bioactivity tests may be conducted in comparison of synthetically produced resolvin E1 and naturally extracted resolvin E1. The initial aim of this research was to develop a range of analogues of a fragment of Resolvin E1. This was so that a series of compounds could be produced with various R groups to identify any structure-activity relationships for this part of the natural product. There is one stereocentre in this fragment of resolvin E1 and it was decided that a racemic version of these compounds would be tested for bioactivity, and if any of the compounds had significant anti-inflammatory properties then the R and S versions could be separated, allowing for the testing of both enantiomers to determine which gave the most potent anti-inflammatory response. This led to the creation of several novel fragments and their biological testing. The secondary aim of the project was to complete the total synthesis of the resolvin E1 natural product. We devised a novel route towards resolvin E1 which used MIDA boronate protecting group to introduce a fixed trans double bond which was useful in a compound with multiple alkene systems. Resolvin E1 also contains three stereocentres, the synthesis from the fragment work was recycled to begin the synthesis, and made use of 1,2:5,6-di-O-isopropylidene-D-mannitol and Noyori s catalyst to setup the stereocentres. The use of new MIDA-boronate moieties were also explored in order to develop a new, efficient synthesis toward resolvin E1.

Le cerveau est très riche en acide docosahexaénoique (DHA, acide gras polyinsaturé (AGPI) n-3) et en acide arachidonique (AGPI n-6) qui sont de puissants immunomodulateurs. Ils pourraient être impliqués dans le contrôle de la neuroinflammation via leur conversion en dérivés lipidiques bioactifs. Dans ce contexte, notre objectif était de définir le rôle des médiateurs lipidiques dérivés des AGPI n-3 possédant des propriétés anti-inflammatoires et pro-résolutives dans la régulation de l’inflammation au niveau du cerveau. Nous avons d’abord caractérisé l’impact d’une modulation nutritionnelle en AGPI n-3 sur la composition lipidique cérébrale. Dans un modèle d’inflammation cérébrale, la consommation d’AGPI n-3 induit 1) une augmentation des métabolites lipidiques dérivés des AGPI n-3, 2) une diminution des métabolites lipidiques dérivés des AGPI n-6, et 3) une diminution de l’inflammation dans l’hippocampe. De plus, un apport en AGPI n-3 au cours de la période périnatale n’affecte pas la composition lipidique des cellules immunitaires du cerveau, les cellules microgliales. Ensuite, nous avons choisi une approche thérapeutique afin de démontrer in vitro dans un modèle de cellules microgliales que la RvD1, dérivée du DHA, en se fixant à son récepteur ALX/Fpr2, atténue l’inflammation via la régulation de la voie NFκB et de microARN. In vivo, l’injection i.c.v. de la RvD1 et du DHA atténue l’inflammation dans l’hippocampe par des processus différents. Les dérivés lipidiques bioactifs issus des AGPI n-3 pourraient être les médiateurs par lesquels les AGPI n-3 exercent leur effet bénéfique sur la régulation de l’inflammation au niveau du cerveau, la RvD1 étant fortement impliquée. / The brain is highly enriched in docosahexaenoic acid (DHA, n-3 polyunsaturated fatty acid, PUFA) and in arachidonic acid (n-6 PUFA) that are strong immunomodulators. They could be involved in the regulation of neuroinflammation through their conversion into bioactive lipid derivatives. Then, our objective was to define the role of n-3 PUFA derived lipid mediators that have anti-inflammatory and pro-resolutive properties in the regulation of brain inflammation. First, we characterized the impact of dietary n-3 PUFA modulation on brain lipid composition. In a central inflammatory model, n-3 PUFA intake induced 1) an increase in n-3 PUFA-derived lipid mediators, 2) a decrease in n-6 PUFA-derived lipid mediators, and 3) a decrease in inflammation in the hippocampus. Moreover, n-3 PUFA intake during the perinatal period did not affect lipid composition of brain immune microglial cells. Then, we chose a therapeutic approach to demonstrate in vitro in microglial cells that RvD1 derived from DHA, through the binding on its receptor ALX-Fpr2, attenuated inflammation via the regulation of NFκB pathway and microRNA expressions. In vivo, intracerebral injection of RvD1 and DHA reduced inflammation in the hippocampus by different pathways. Thus, the bioactive lipid derivatives from n-3 PUFA could be the mediators by which n-3 PUFA exert their beneficial effects on neuroinflammation, RvD1 playing a crucial role in this regulation.

京都大学 / 新制・課程博士 / 博士(医学) / 甲第23760号 / 医博第4806号 / 新制||医||1056(附属図書館) / 京都大学大学院医学研究科医学専攻 / (主査)教授 平井 豊博, 教授 湊谷 謙司, 教授 森信 暁雄 / 学位規則第4条第1項該当 / Doctor of Medical Science / Kyoto University / DFAM

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La mise en évidence du caractère actif de la phase de la résolution de l'inflammation a ouvert la porte à de nouveaux paradigmes thérapeutiques pour les maladies inflammatoires. Des paradigmes qui reposent sur l’utilisation de médiateurs actifs ayant le potentiel de promouvoir la résolution de l’inflammation. En d’autres termes, ces médiateurs régulent la réaction inflammatoire, initient la réparation tissulaire et conduisent au retour de l’homéostasie. Parmi ces médiateurs, la résolvine D1 (RvD1) présente des propriétés anti-inflammatoires et prorésolutives remarquables et ce, dans divers fonctions et tissus de l’organisme. Bien que les effets de la RvD1 aient été bien caractérisés par de nombreuses recherches, son rôle potentiel au niveau ostéoarticulaire demeure peu documenté. Dans cette étude, nous approfondissons les connaissances sur l’effet de la RvD1 dans la protection et la préservation de l’intégrité ostéoarticulaire, en étudiant sa capacité à réguler les principaux facteurs impliqués dans la physiopathologie articulaire. Dans un premier temps, nous avons démontré que la RvD1 est bien présente dans l’environnement articulaire et que ses niveaux sont plus élevés dans le liquide synovial des genoux arthrosiques par rapport aux genoux sains. Ces genoux sont obtenus d’un modèle d’arthrose chez le chien réalisé lors d’une étude antérieure. Par la suite, nous avons étudié ses effets sur les composantes cellulaires de l’articulation. Sur les chondrocytes arthrosiques humains, nous avons démontré que la RvD1 inhibe l’expression des médiateurs inflammatoires et cataboliques induits par l'IL-1β, à savoir la COX-2, la PGE2, l’iNOS, le NO et la MMP-13. L’étude des voies de signalisation a ensuite révélé que la RvD1 s’oppose à l'activation de NF-κB / p65, p38 / MAPK et JNK1 / 2, induite par l’IL-1β. En plus de ces remarquables effets, la RvD1 confère une protection contre l’apoptose cellulaire et le stress oxydatif induits par le HNE, tel que démontré par l'inactivation des caspases, l'inhibition de la libération de la LDH, l’augmentation des taux de la Bcl-2 et de l’AKT, ainsi que la stimulation du GSH. À côté des chondrocytes, la RvD1 a montré des effets puissants sur les ostéoclastes. En effet, elle inhibe la différenciation et l'activation des ostéoclastes tel que démontré par l’inhibition de l’expression de TRAP et de la cathepsine K. Elle réduit l’expression de TNF-α, de l’IL-1β, de l’IFN-γ, de la PGE2 et de RANKL, induite par le LPS et augmente celle de l’IL- 10. De plus, elle protège contre la résorption de la matrice d’hydroxyapatite ainsi que l’érosion ii de la matrice osseuse ex vivo, induites par le RANKL et le M-CSF. Enfin, l’étude des propriétés de la RvD1 dans un modèle d’arthrite chez la souris a révélé qu’elle réduit le score clinique, l'inflammation de la patte et la destruction des os et des articulations. De surcroit, elle inhibe les médiateurs inflammatoires et diminue significativement les marqueurs sériques du remodelage osseux et cartilagineux. Nos résultats sont très prometteurs et confirment le potentiel de la RvD1 dans la résolution de l’inflammation et le maintien de l’intégrité articulaires. Ils mettent ainsi en évidence sa pertinence clinique en tant qu’agent actif dans la prise en charge thérapeutique des maladies ostéoarticulaires. / The recognition of the proactive character of the resolution phase of inflammation has revealed alternative therapeutic paradigms for inflammatory conditions, based on the use of active mediators capable of promoting the resolution of inflammation. In other words, these mediators regulate the inflammatory response, initiate tissue repair and promote the return to homeostasis. Among them, resolvin D1 (RvD1) has remarkable anti-inflammatory and proresolutive properties. Although the effects of RvD1 have been well studied, its potential role in the osteoarticular tissues remains poorly documented. In this study, we expand our understanding of the potential of RvD1 in protecting and preserving joint integrity by studying its ability to regulate the major factors involved in the articular pathophysiology. First, we demonstrated that RvD1 is produced in the articular environment and that its levels are higher in the synovial fluid of osteoarthritic knees compared to healthy knees. The knees were obtained from an osteoarthritic dog model performed in a previous study. Therefore, we studied RvD1 actions on the cellular components of the joint. In human osteoarthritic chondrocytes, we demonstrated that RvD1 inhibits IL-1β-induced inflammatory and catabolic mediators, namely COX-2, PGE2, iNOS, NO, and MMP-13. This led to the study of signaling pathways, which revealed that RvD1 counter-regulates IL-1β-induced activation of NF-κB / p65, p38 / MAPK and JNK1 / 2. In addition, RvD1 confers a protection against cellular apoptosis and oxidative stress induced by HNE, as revealed by caspases inactivation, LDH inhibition, as well as increased levels of Bcl-2, AKT, and GSH. In addition to chondrocytes, RvD1 showed remarkable effects on osteoclasts. Indeed, it inhibits osteoclast differentiation and activation, as demonstrated by the inhibition of TRAP and cathepsin K expression. Moreover, it reduces LPSinduced TNF-α, IL-1β, IFN-γ, PGE2 as well as RANKL and concurrently increases IL-10 expression. Furthermore, it inhibits RANKL and M-CSF-induced hydroxyapatite matrix degradation and bone matrix erosion, ex vivo. Finally, the study of the properties of RvD1 in a mouse model of arthritis, revealed that it alleviates the clinical score, paw inflammation, as well as bone and joint destruction. Furthermore, it reduces the inflammatory mediators and significantly decreases serum markers of bone and cartilage remodeling. Our results are very promising and confirm the high potential of RvD1 in resolving inflammation and preserving joint integrity. They highlight its clinical relevance as a therapeutic agent for the management of osteoarticular diseases.