BibTex format

author = {Thornton, CC and Al-Rashed, F and Calay, D and Birdsey, GM and Bauer, A and Mylroie, H and Morley, BJ and Randi, AM and Haskard, DO and Boyle, JJ and Mason, JC},
doi = {10.1136/annrheumdis-2014-206305},
journal = {Annals of the Rheumatic Diseases},
pages = {439--448},
title = {Methotrexate-mediated activation of an AMPK-CREB-dependent pathway: a novel mechanism for vascular protection in chronic systemic inflammation},
url = {},
volume = {75},
year = {2016}

RIS format (EndNote, RefMan)

AB - Aims Premature cardiovascular events complicate chronic inflammatory conditions. Low-dose weekly methotrexate (MTX), the most widely used disease-modifying drug for rheumatoid arthritis (RA), reduces disease-associated cardiovascular mortality. MTX increases intracellular accumulation of adenosine monophosphate (AMP) and 5-aminoimidazole-4-carboxamide ribonucleotide which activates AMP-activated protein kinase (AMPK). We hypothesised that MTX specifically protects the vascular endothelium against inflammatory injury via induction of AMPK-regulated protective genes.Methods/results In the (NZW×BXSB)F1 murine model of inflammatory vasculopathy, MTX 1mg/kg/week significantly reduced intramyocardial vasculopathy and attenuated end-organ damage. Studies of human umbilical vein endothelial cells (HUVEC) and arterial endothelial cells (HAEC) showed that therapeutically relevant concentrations of MTX phosphorylate AMPKαThr172, and induce cytoprotective genes including manganese superoxide dismutase (MnSOD) and haem oxygenase-1 (HO-1). These responses were preserved when HUVECs were pretreated with tumour necrosis factor-α to mimic dysfunctional endothelium. Furthermore, MTX protected against glucose deprivation-induced endothelial apoptosis. Mechanistically, MTX treatment led to cyclic AMP response element-binding protein (CREB)Ser133 phosphorylation, while AMPK depletion attenuated this response and the induction of MnSOD and HO-1. CREB siRNA inhibited upregulation of both cytoprotective genes by MTX, while chromatin immunoprecipitation demonstrated CREB binding to the MnSOD promoter in MTX-treated EC. Likewise, treatment of (NZW×BXSB)F1 mice with MTX enhanced AMPKαThr172 phosphorylation and MnSOD, and reduced aortic intercellular adhesion molecule-1 expression.Conclusions These data suggest that MTX therapeutically conditions vascular endothelium via activation of AMPK-CREB. We propose that this mechanism contributes to the protection against
AU - Thornton,CC
AU - Al-Rashed,F
AU - Calay,D
AU - Birdsey,GM
AU - Bauer,A
AU - Mylroie,H
AU - Morley,BJ
AU - Randi,AM
AU - Haskard,DO
AU - Boyle,JJ
AU - Mason,JC
DO - 10.1136/annrheumdis-2014-206305
EP - 448
PY - 2016///
SN - 0003-4967
SP - 439
TI - Methotrexate-mediated activation of an AMPK-CREB-dependent pathway: a novel mechanism for vascular protection in chronic systemic inflammation
T2 - Annals of the Rheumatic Diseases
UR -
UR -
UR -
UR -
VL - 75
ER -