Review Article

Protective Effects of Methotrexate against Proatherosclerotic Cytokines: A Review of the Evidence

Table 2

Effects of methotrexate, adenosine, AICAR, and AMPK activation on endothelial function and vascular homeostasis.

MediatorReported effects

MethotrexateRelease of soluble TNF-α receptor p75 ↑
TNF-α expression/concentrations ↓
IL-6 expression/concentrations ↓
ICAM-1 expression ↓
VCAM-1 expression ↓
eNOS activity ↑
Endothelium-dependent vasodilatation ↑
Mitochondrial mass, membrane potential, and intracellular ATP concentrations ↑

AdenosineTNF-α expression/concentrations ↓
IL-6 expression/concentrations ↓
ICAM-1 expression ↓
VCAM-1 expression ↓
E-selectin expression ↓
eNOS activity ↑
Blood pressure ↓
Mitochondrial mass, membrane potential, and intracellular ATP concentrations ↑
Formation of atherosclerotic lesions ↓
Cholesterol concentrations ↓
Triglyceride concentrations ↓

AICAR/AMPKIL-1 expression/concentrations ↓
IL-6 expression/concentrations ↓
ICAM-1 expression ↓
VCAM-1 expression ↓
NO synthesis ↑
Endothelium-dependent vasodilation ↑
Endothelium-independent vasodilation ↑
Blood pressure ↓
Oxidative stress ↓
Endoplasmic reticulum stress ↓
Manganese superoxide dismutase induction ↑
NF-κB ↓
Monocyte adhesion to endothelial cells ↓
Restenosis ↓
Cholesterol efflux capacity ↑
Cellular glucose uptake ↑
Glycolysis ↑

AICAR: aminoimidazole carboxamide ribonucleotide; AMPK: 5 adenosine monophosphate-activated protein kinase; TNF-α: tumour necrosis factor-alpha; IL-1: interleukin-1; IL-6: interleukin-6; ICAM-1: intercellular adhesion molecule-1; VCAM-1: vascular cell adhesion molecule-1; ATP: adenosine triphosphate; eNOS: endothelial nitric oxide synthase; NF-κB: nuclear factor kappa-light-chain-enhancer of the activated B-cell; NO: nitric oxide; ↑: increase; ↓: decrease.