الفهرس 
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Abstract
Rheumatoid arthritis (RA) is a chronic, progressive, autoimmune disease caused by a malfunction of the immune system. Although there is no current cure for rheumatoid arthritis, treatments exist that aid with pain management, preventing diseases progression and further joint destruction. Some of the more common pharmacological treatments include nonsteroidal anti-inflammatory drugs (NSAIDs) that reduce inflammation by blocking prostaglandin production, but they do not stop joint deterioration.
The aim of this study was to evaluate the anti-arthritic effects and suggest the mechanisms of actions of MSCs EVs and azathioprine in male Wistar rats.
The aim also is to reach safe drug to avoid the side effects of DDAMERS drugs.
Complete Freund’s adjuvant (CFA) was used to establish RA in the animals .MSC microvesicles and exosomes were administered intravenously but azathioprine is administrated orally to CFA-induced arthritic rats for 3weeks
In the present work, the effect of MSC derived exosomes and micovisecles and also azathioprine in rheumatic arthritic rats were studied. Forty male rats were divided equally into five equal groups as following:
1- group 1 (Control group)
2- group 2 (RA group)
3- group 3 (Macrovesicles group): RA rats injected with MSC MVs.
4- group 4 (Exosomes groups): RA rats injected with MSC exosomes.
5- group 5 (Azathioprine group): RA rats treated with oral azathioprine.
from the analysis of our data, we found that:
*In group 3 which treated with micovesicles we evaluate decrease in all pro inflammatory markers (TNF- α and serum IL1B) but this decrease is less than of exosomes and azathioprine which means that MSCs derived exosomes is more effective than micovesicles and it is also safer than azathioprine.
*More over when we evaluate the effect of treatment on anti- inflammatory marker IL10 we found that there is highly increase in it in exosomes treated group than micovesicles treated group which means that MSCs derived exosomes is more effective than micovesicles and it is also safer than azathioprine.
*All anti- oxidant markers (GSH, GPX, GST and SOD) also highly increase in it in exosomes treated group than micovesicles treated group which means that MSCs derived exosomes is more effective than micovesicles and it is also safer than azathioprine.
*In western plot markers we asses NF-KB and NF-KB-P50 which are decreased in all treated groups but in microvisicles treated group decrease is less than of exosomes and azathioprine which means that MSCs derived exosomes is more effective than micovesicles and it is also safer than azathioprine.
*We asses also Nfr2 which increase in all groups but we found that there is highly increase in it in exosomes treated group than micovesicles treated group which means that MSCs derived exosomes is more effective than micovesicles and it is also safer than azathioprine.
*from all above we evaluate that MSCs derived exosomes is highly effective than microvesicles and also not cause the side effects of azathioprine.