Remdesivir alleviates joint damage in collagen-induced arthritis and inhibits inflammatory cell death of RA synovial fibroblasts

Immunol Lett. 2025 Oct:275:107009. doi: 10.1016/j.imlet.2025.107009. Epub 2025 Apr 5.

Abstract

Background: The antiviral agent, remdesivir, is adenosine analogue which is currently also used as anti-coronavirus disease 2019. Remdesivir also had anti-inflammatory effect which reduced pro-inflammatory cytokine production, and inhibition of the cyclic GMP-AMP synthase-STING pathway.

Methods: We evaluated the antiarthritic effects of remdesivir in a mouse model of High-fat diet (HFD) collagen-induced arthritis (CIA) and in fibroblast-like synoviocytes from patients with RA. Type II collagen was administered to DBA/1J mice to induce CIA. Vehicle or remdesivir was injected subcutaneously three times a week. During 7 weeks of treatment, the arthritis score and incidence were evaluated twice a week. Flow cytometry and confocal imaging were used to evaluate CD4 + T cells in the spleen. FLSs from patients with RA were stimulated in vitro with remdesivir and tumor necrosis factor (TNF)-α, and western blotting was used to measure the expression of STING and necroptosis-related markers.

Results: Remdesivir administration suppressed the incidence and progression of arthritis in mice with CIA. Histological analysis revealed lower inflammation and cartilage damage scores in remdesivir-treated than in vehicle groups. Interleukin (IL)-17 + CD4 + T-cell differentiation was inhibited in the remdesivir-treated group. Furthermore, IL-17/-6/-1β, monocyte chemoattractant protein -1, and TNF-α expression was reduced in the remdesivir group. In vitro, remdesivir suppressed the expression of STING, nuclear factor-κB, RIPK3, and phosphorylated MLKL in RA-FLSs under TNF-α stimulation.

Conclusions: The antiviral agent remdesivir suppressed arthritis by regulating Th cell differentiation, pro-inflammatory cytokine expression, the STING pathway, and necroptosis.

Keywords: Fibroblast-like synoviocyte; Necroptosis; Remdesivir; Rheumatoid arthritis; STING.

MeSH terms

  • Adenosine Monophosphate* / analogs & derivatives
  • Adenosine Monophosphate* / pharmacology
  • Adenosine Monophosphate* / therapeutic use
  • Alanine* / analogs & derivatives
  • Alanine* / pharmacology
  • Alanine* / therapeutic use
  • Animals
  • Anti-Inflammatory Agents* / pharmacology
  • Arthritis, Experimental* / drug therapy
  • Arthritis, Experimental* / immunology
  • Arthritis, Experimental* / metabolism
  • Arthritis, Experimental* / pathology
  • Arthritis, Rheumatoid* / drug therapy
  • Arthritis, Rheumatoid* / immunology
  • Arthritis, Rheumatoid* / metabolism
  • Arthritis, Rheumatoid* / pathology
  • Cell Death / drug effects
  • Cells, Cultured
  • Cytokines / metabolism
  • Disease Models, Animal
  • Fibroblasts* / drug effects
  • Fibroblasts* / immunology
  • Fibroblasts* / metabolism
  • Fibroblasts* / pathology
  • Humans
  • Male
  • Mice
  • Mice, Inbred DBA
  • Synovial Membrane* / drug effects
  • Synovial Membrane* / pathology
  • Synoviocytes / drug effects
  • Synoviocytes / metabolism

Substances

  • Adenosine Monophosphate
  • Alanine
  • remdesivir
  • Cytokines
  • Anti-Inflammatory Agents