Suppression of streptococcal cell wall–induced arthritis by human chorionic gonadotropin

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Abstract
Objective To determine whether human chorionic gonadotropin (HCG) contributes to pregnancy‐associated immunosuppression, as observed clinically by an amelioration of symptoms in human autoimmune diseases, including rheumatoid arthritis, during pregnancy. Methods Administration of HCG was initiated 2 days prior to an arthritogenic dose of streptococcal cell wall (SCW) in nonpregnant female rats, and the development and severity of SCW‐induced arthritis was monitored. Inflammatory mediators, including plasma nitrite/nitrate and cytokine levels, were measured. Inducible nitric oxide synthase (iNOS) protein and cytokine messenger RNA expression in joint tissue were compared between treated and untreated arthritic animals. Results Systemic administration of HCG resulted in a dose‐dependent reduction in the clinical arthritis index. Consistent with the amelioration of clinical symptoms, HCG significantly reduced the inflammatory cell infiltration, pannus formation, and bone and cartilage degradation. Mechanistically, HCG therapy was associated with suppression of the overzealous production of tumor necrosis factor α, interleukin‐6 (IL‐6), and IL‐1β, which contribute to synovial pathology in animals with SCW‐induced arthritis. Circulating nitric oxide and the amount of iNOS protein were also reduced. Furthermore, circulating transforming growth factor β levels were elevated by the HCG, all of which suggest monocytes/macrophages as a potential target. Conclusion These findings indicate that HCG exerts a protective effect in this experimental arthritis model, through modulation of inflammatory mediators.

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