Regulation of monocyte to macrophage differentiation by antiglucocorticoids and antioxidants

OBJECTIVE: Our purpose was to examine RU 486 and related compounds on monocyte to macrophage differentiation through scavenger receptors and cellular adhesion. STUDY DESIGN: Human monocytes were isolated, cultured, and treated with dexamethasone, levonorgestrel, RU 486, and other structurally related compounds alone or in combination. Macrophage scavenger receptor activity, inhibited by glucocorticoids and associated in the current literature with macrophage cellular adhesion, was determined in this study by counting the number of adherent cells after treatment. In addition, fluorescent-labeled acetyl-low-density lipoprotein uptake was determined as a function of scavenger receptor biologic activity. RESULTS: Dexamethasone, levonorgestrel (antiglucocorticoid only) and RU 486 (antiglucocorticoid and antioxidant) all significantly decreased adherent macrophages (4%, 52%, and 74% of control). Levonorgestrel, however, demonstrated a marked uptake of fluorescent-labeled scavenger receptor ligand. RU 486 and dexamethasone were antagonistic when combined (P < .001); levonorgestrel was less antagonistic but, however, still significant (P < .05). Reduced RU 486 (antioxidant but loses antiglucocortioid activity) decreased cellular adhesion, yet scavenger receptor function was enhanced. Both probucol (extracellular mechanism of action) and probucol analog (intracellular action) markedly up-regulated scavenger function, but once again a separation of adhesion from scavenger activity was noted. Vitamin E (antioxidant) and onapristone (antioxidant and antiglucocorticoid) had virtually little to no effect on adhesion and scavenger receptor activity. Finally, pyrrolidine dithiocarbamate, a potent oxygen-free radical quencher, was toxic to all cells examined. CONCLUSIONS: RU 486 is a known antiglucocorticoid with novel antioxidant properties first demonstrated by our laboratories. Levonorgestrel has antiglucocorticoid but no antioxidant activity. RU 486 antagonized the inhibitory effect of dexamethasone on scavenger receptor development, whereas levonorgestrel was stimulatory. A separation of scavenger receptor-induced cellular adhesion and scavenger receptor internalized ligand was demonstrated by (1) reduced RU 486, which loses its antiglucocorticoid activity but retains its antioxidant activity, and (2) probucol analog, which is chemically altered to allow intracellular entry. Glucocorticoids decrease the development of scavenger receptors, whereas antioxidants regulate inflammatory cytokines by intracellular mechanisms. It is therapeutically important to up-regulate scavenger receptor activity by antiglucocorticoids in the peritoneal cavity of women with endometriosis. However, because these mechanisms also induce inflammatory cytokines, a balance of antioxidants and antiglucocorticoids such as those demonstrated in the above study may prove beneficial.