G S Panayi

King College, Guymon, Oklahoma, United States

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Publications (366)1775.63 Total impact

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    ABSTRACT: OBJECTIVE: Collagen type II (CII), post-translationally modified by reactive oxygen species (ROS-CII), present in an inflamed joint, is an auto-antigen in rheumatoid arthritis (RA). In this study we investigated the potential use of anti-ROS-CII auto-antibodies as a biomarker. METHODS: CII was exposed to oxidants that are present in the rheumatoid joint. Auto-reactivity to ROS-CII was tested by ELISA in synovial fluid (SF) and serum samples taken from various phases of RA including: a)disease modifying anti-rheumatic drug (DMARD) naïve patients with early RA (n=85 serum);b) patients with established RA (n=80 serum and 50 SF), both DMARD responders (DMARD-R) and non-responders (DMARD-NR). As controls we used c) anti-citrullinated peptide antibodies (ACPA) positive individuals with arthralgia (n=58 serum); d) samples from patients with osteoarthritis (OA, n=49 serum and 52 SF)and e)healthy individuals (n=51 serum). RESULTS: Reactivity in DMARD naïve early RA to ROS-CII was significantly higher than in ACPA positive arthralgia, OA and healthy controls (p<0.0001), with 92.9% binders. There was no significant difference in anti-ROS-CII reactivity between ACPA positive and ACPA negative RA patients, with 93.8% and 91.6% binders, respectively. The sensitivity and specificity of binding to ROS-CII in early RA compared with HC was 92% and 98%, respectively. In established RA DMARD-NR serum reactivity was significantly higher than in DMARD-R (p<0.0001) with 58.3% and 70% binders compared to 7.6% and 60% in serum and SF, respectively. In longstanding RA,auto-reactivity to ROS-CII changed longitudinally. CONCLUSION: Auto-antibodies to ROS-CII have the potential to become diagnostic biomarkers for RA.
    Arthritis & Rheumatology 04/2013; · 7.48 Impact Factor
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    Arthritis Research & Therapy 04/2012; 1:1-1. · 4.30 Impact Factor
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    Rheumatology (Oxford, England) 01/2012; 51(4):759-61. · 4.24 Impact Factor
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    ABSTRACT: Heat shock proteins (HSPs) and other members of the much broader stress protein family have been shown to play important roles in coordinating multiple phases of immunological reactions; from facilitating immunological recognition, to promoting and regulating immunological responses and finally augmenting the resolution of inflammation and return to immunological homeostasis. In this review, we consider the challenges facing the stress protein field as we enter 2012; in particular we consider the role that HSPs and stress proteins may play in the initiation and termination of immunological responses. Special attention is afforded to the resolution-associated molecular pattern, binding immunoglobulin protein (BiP, also known as glucose regulated protein-78). We review the evidence that resolution-promoting proteins such as BiP may herald a new generation of biologics for inflammatory disease and reflect on the challenges of achieving clinical remission in rheumatoid arthritis with novel therapeutics and correlating clinical remission with immunological parameters of resolution of inflammation.
    Frontiers in Immunology 01/2012; 3:17.
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    ABSTRACT: Appropriate regulation and subsequent resolution of acute inflammatory events is critical to the prevention of autoinflammatory diseases. Indeed, the chronic inflammation observed in diseases such as RA is at least partially consequent on the failure of endogenous immunoregulation. Current RA therapies (e.g. anti-TNF-α inhibitors and MTX) inhibit components of the inflammatory disease process without directly promoting the resolution of inflammation. We propose that the next generation of RA therapeutics will complement and augment endogenous immunoregulatory and pro-resolution immunological networks, thus promoting the definitive resolution of inflammation rather than temporary immunological control. Of particular interest with respect to this therapeutic approach is binding immunoglobulin protein [BiP; also known as glucose-regulated protein-78 (GRP78)], a member of the recently defined resolution-associated molecular pattern (RAMP) family of molecules. In this review, we consider the preclinical evidence from experiments in mouse and man that suggests BiP and other members of the RAMP family have the potential to herald a new generation of immunotherapeutics.
    Rheumatology (Oxford, England) 12/2011; 51(5):780-8. · 4.24 Impact Factor
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    ABSTRACT: Binding immunoglobulin protein (BiP) has previously shown powerful anti-inflammatory properties in the collagen-induced arthritis (CIA) model, where a single dose of BiP has proved to be both a long-term prophylactic and therapeutic. In both CIA and human in vitro studies, BiP induced regulatory T cells. The present investigation looked at the anti-inflammatory effect of BiP on inflamed human synovial tissue transplanted into severe combined immunodeficient mice (SCID), a chimaeric in vivo model previously used to test the efficacy of biologic therapies. Rheumatoid arthritis synovial membrane (RASM) was engrafted into SCID mice. Following successful engraftment, mice were intravenously injected with BiP or human serum albumin in the presence or absence of anti-IL-10 mAb. Twelve days later the grafts were removed for analysis and human cytokines in the sera were quantified by ELISA. The extent of residual inflammatory cellular infiltrate in the synovial explants was determined by weight of the explants. The RASM transplants from mice treated with BiP showed visual reduction in cellular infiltrate and downregulation of all quantifiable features of inflammation as assessed by the Koizumi or Rooney histological criteria. Also downregulated were HLA-DR, CD86, IL-6 and TNFα expression as assessed by immunohistology. ELISA detected significantly less human IL-6 circulating in the BiP-treated mouse serum. After removal of transplanted tissue 12 days post administration of BiP, the RASM explants from the BiP-treated SCID mice weighed significantly less, indicating a suppression of tissue inflammation. Mice given concomitant neutralising anti-IL-10 antibody and BiP showed no such suppression. BiP has anti-inflammatory properties partially dependent on the downregulation of HLA-DR and co-stimulatory molecules and the predominant production of IL-10.
    Arthritis research & therapy 09/2011; 13(5):R149. · 4.27 Impact Factor
  • Gabriel S. Panayi, Valerie M. Corrigall
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    ABSTRACT: In this chapter we shall review the possible role of heat shock proteins (HSP) and chaperones in the pathogenesis of rheumatoid arthritis (RA). Although HSP/chapcrones are found in all cells, their expression is increased at times of cellular or tissue stress. It is under these conditions that new roles or functions for these proteins will become apparent. Hence, the first section of the review deals with the expression of HSP in the RA synovial membrane (SM). There then follow two sections dealing with the immune response to HSP by patients with RA. The first part considers the antibody responses and the second part the response at the T-cell level. In the third section, we consider the proposal by Roudier and his colleagues that bacterial HSP are involved in the pathogenesis of RA because of molecular mimicry with the shared epitope. This is an innovative concept worthy of separate discussion not least because it is being tested in the clinic. Finally, we review our work on BiP, the endoplasmic reticulum chaperone, which focuses on the concept that HSP/chapcrones may have immunomodulatory or anti-inflammatory effects when found extra-cellularly rather than solely being involved in pro-inflammatory events, which has been the prevailing view to date.
    06/2011: pages 109-137;
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    A M Shields, G S Panayi, V M Corrigall
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    ABSTRACT: The resolution of inflammation is central to the maintenance of good health and immune homeostasis. Recently, several intracellular stress proteins have been described as having extracellular properties that are anti-inflammatory or favour the resolution of inflammation. We propose that these molecules should be defined as resolution-associated molecular patterns (RAMPs). RAMPs are released at times of cellular stress and help to counterbalance the inflammatory effects of pathogen-associated (PAMPs) and damage-associated (DAMPs) molecular patterns. We propose that heat shock protein 10 (HSP10), αB-crystallin (αBC), HSP27 and binding immunoglobulin protein (BiP) should be considered founding members of the RAMP family. A greater understanding of RAMP biology may herald the development of novel immunotherapies.
    Clinical & Experimental Immunology 06/2011; 165(3):292-300. · 3.41 Impact Factor
  • Annals of The Rheumatic Diseases - ANN RHEUM DIS. 01/2010; 69(2).
  • Annals of The Rheumatic Diseases - ANN RHEUM DIS. 01/2010; 69(2).
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    ABSTRACT: Work disability is a serious consequence of rheumatoid arthritis (RA). We conducted a 6-month, prospective randomized controlled trial comparing assessments of function, work, coping, and disease activity in employed patients with RA receiving occupational therapy intervention versus usual care. Employed patients with RA with increased perceived work disability risk were identified by the RA Work Instability Scale (WIS; score >or=10). Patients were stratified into medium- (score >or=10 and <17) and high-risk (>or=17) groups, then randomized into occupational therapy or usual care groups. Assessments were conducted at baseline and 6 months. The primary outcome was the Canadian Occupational Performance Measure (COPM), a standardized patient self-report of function. Other outcomes included the disability index (DI) of the Health Assessment Questionnaire (HAQ); Disease Activity Score in 28 joints (DAS28); RA WIS; EuroQol Index; visual analog scales (VAS) for pain, work satisfaction, and work performance; and days missed/month. Independent sample t-tests and Mann-Whitney U tests were used. We recruited 32 employed patients with RA. At baseline the groups were well matched. At 6 months the improvement in the occupational therapy group was significantly greater than that in the usual care group for all functional outcomes (COPM performance P < 0.001, COPM satisfaction P < 0.001, HAQ DI P = 0.02) and most work outcomes (RA WIS [P = 0.04], VAS work satisfaction [P < 0.001], VAS work performance [P = 0.01]). Additionally, Arthritis Helplessness Index (P = 0.02), Arthritis Impact Measurement Scales II pain subscale (P = 0.03), VAS pain (P = 0.007), EuroQol Index (P = 0.02), EuroQol global (P = 0.02), and DAS28 (P = 0.03) scores significantly improved. Targeted, comprehensive occupational therapy intervention improves functional and work-related outcomes in employed RA patients at risk of work disability.
    Arthritis & Rheumatology 11/2009; 61(11):1522-30. · 7.48 Impact Factor
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    Gabriel S Panayi
    Arthritis & Rheumatology 11/2009; 60(12):3857; author reply 3857-8. · 7.48 Impact Factor
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    ABSTRACT: Binding immunoglobulin protein (BiP) has been shown previously to have immunomodulatory functions. Herein we investigated whether BiP could affect the differentiation of monocytes into dendritic cells (DCs) and thence the development of regulatory T cells. Peripheral blood monocyte-derived DCs were matured with lipopolysaccharide in the presence or absence of BiP. DC development and T-cell changes were monitored by flow cytometry and regulatory T-cell function was measured by uptake of tritiated thymidine. More BiP-treated DCs (DC((BiP))s) expressed amounts of intracellular indoleamine 2,3-dioxygenase (IDO) and cell surface leucocyte immunoglobulin-like receptor subfamily B member 1 (LILRB1), retained CD14 expression but down-regulated expression of human leucocyte antigen (HLA)-DR and CD86, and produced copious amounts of interleukin (IL)-10, when compared with control DCs. T cells co-cultured with DC((BiP))s developed regulatory function with increased surface expression of CD4(+) CD25(hi) CD27(hi) but with no concomitant increase in forkhead box P3 (Foxp3). These T cells also showed significantly higher levels of intracellular cytotoxic T-lymphocyte antigen (CTLA)-4. The latter could be inhibited by the presence of the IDO inhibitor 1 methyl tryptophan. The addition of neutralizing anti-IL-10 antibody or the specific mitogen-activated protein kinase (MAPK) p38 inhibitor SB203580 reversed the inhibition of DC differentiation by BiP. In conclusion, BiP is an immunomodulator able to arrest inflammation through induction of tolerogenic DCs and subsequent generation of T regulatory cells.
    Immunology 11/2009; 128(2):218-26. · 3.71 Impact Factor
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    ABSTRACT: Patients with rheumatoid arthritis (RA) have increased cardiovascular mortality. Tumour necrosis factor alpha (TNFalpha)-blocking therapy has been shown to reduce RA disease activity measures and joint damage progression. Some observational studies suggest that TNFalpha blockade reduces mortality and incidence of first cardiovascular events. The mechanisms contributing to these outcomes are unclear. This study assessed the effects of infliximab treatment on vascular stiffness and structure in patients with RA. A post hoc analysis of longitudinal data from a randomised placebo controlled study evaluated the effect of infliximab on vascular assessments. 26 patients received intravenous infliximab (3 mg/kg) at weeks 0, 2, 6 and every 8 weeks thereafter to week 54. Patients were followed up to 56 weeks of infliximab therapy with assessments of RA disease activity, cardiovascular risk factors, vascular stiffness (pulse wave velocity (PWV)), carotid intima media thickness (CIMT) and carotid artery plaque (CAP). Univariate analyses of changes over time by repeated measures analysis of variance (ANOVA) were followed by multivariate time-series regression analysis (TSRA) if changes were seen. PWV was significantly lower (better) after 56 weeks of treatment with infliximab (ANOVA p<0.01, TSRA p<0.01). However, CIMT (ANOVA p = 0.50) and CAP (chi(2) = 4.13, p = 0.88) did not change over the study period. Multiple cardiovascular risk measures did not change with treatment and did not correlate with changes in measures of vascular structure. Arterial stiffness improves with infliximab treatment in RA. This change may help explain the improved cardiovascular disease survival in patients with RA receiving TNFalpha-blocking therapy.
    Annals of the rheumatic diseases 10/2008; 68(8):1277-84. · 8.11 Impact Factor
  • Gabriel S Panayi, Valerie M Corrigall
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    ABSTRACT: The endoplasmic reticulum chaperone and stress protein BiP has hitherto been considered as having only crucial intracellular cell protective functions. However, we have shown that BiP can be present in the extracellular environment and that it binds to a putative but as yet uncloned cell surface receptor. It will stimulate human monocytes via this receptor to express a gene profile that is anti-inflammatory. It will generate T cells with a regulatory function from human peripheral blood most likely by altering dendritic cell development. Intravenous BiP will both prevent and treat ongoing collagen induced arthritis in the DBA/1 mouse. Part of the suppression of arthritis is linked to interleukin (IL)4 as BiP-specific lymph node and spleen cells from these mice secrete IL4, and BiP has no suppressive effect on collagen induced arthritis in IL4 knockout mice. Lymph node and spleen cells isolated from mice administered intravenous BiP will suppress arthritis when transferred intravenously into recipient arthritic mice without any further BiP having to be given. Thus, both in vitro work with human peripheral blood mononuclear cells and in vivo work in the collagen arthritis model lead to the conclusion that BiP induces regulatory cells. Finally, intravenous BiP will ablate the inflammatory cell infiltrate and inflammatory cytokine expression in rheumatoid synovial membrane tissue transplanted subcutaneously into SCID mice. The conclusion from all this experimental work is that BiP may be a novel therapy for the treatment of patients with rheumatoid arthritis.
    Novartis Foundation symposium 02/2008; 291:212-6; discussion 216-24.
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    ABSTRACT: Felty's syndrome (FS), the association of rheumatoid arthritis (RA) and idiopathic neutropenia, remains an unexplained phenomenon. HLA-DR4 is found in over 90% of cases. Patients with FS may have a T cell lymphocytosis of CD3+CD8+CD57+ large granular lymphocytes (LGL syndrome). In this study of 47 patients with FS, 19% had clear evidence for LGL expansions, while in total 42% had variable evidence for the LGL syndrome using currently available techniques. Of these T cell expansions, 76% were clonal, as demonstrated by Southern blotting and analysis with T cell receptor (TCR) β chain constant region probes. This technique may fail to detect clonal populations in some patients. Cytofluorographic analysis using antibodies specific for TCR β chains identified patients with clonal LGL expansions with results comparable to those obtained with Southern blotting. No evidence for shared Vβ usage among expansions from different patients was seen. The role of LGL in RA and FS is currently unclear, but this technique offers a practical and accessible means of identifying patients with LGL expansions, as a starting point for further investigation.
    Clinical & Experimental Immunology 01/2008; 101(1):18-24. · 3.41 Impact Factor
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    ABSTRACT: Following the demonstration that the stress protein, BiP, prevented induction of collagen-induced arthritis (CIA) in HLA-DRB*0101+/+ (HLA-DR1+/+) mice, we investigated the immunotherapeutic ability of BiP to suppress disease during the active phase of CIA in HLA-DR1+/+ and DBA/1 mice. BiP was administered either subcutaneously or intravenously to DBA/1, HLA-DR1+/+, or interleukin-4 (IL-4)-knockout mice at the onset of arthritis. Immune cells were used in adoptive transfer studies or were restimulated in culture with BiP or type II collagen (CII). Proliferation and cytokine release were measured. In addition, serum anti-CII antibodies were measured by enzyme-linked immunosorbent assay. Disease progression was scored using a visual analog scale. BiP was successful in suppressing established CIA in HLA-DR1+/+ and DBA/1 mice. Serum levels of anticollagen IgG antibodies were reduced in BiP-treated mice. T cells from BiP-immunized mice produced Th2 cytokines, in particular, IL-4. Treatment with BiP was also shown to increase the production of CII-specific IL-5, IL-10, and interferon-gamma at the termination of the study. Development of severe CIA was prevented by the intravenous transfer of BiP-specific cells at the time of CIA induction in HLA-DR1+/+ mice or by transferring BiP-specific cells to DBA/1 mice at the onset of disease. BiP failed to ameliorate the development of CIA in IL-4-/-, HLA-DR1+/+ mice. These novel results show that BiP can suppress active CIA by the induction of regulatory cells that act predominantly via IL-4. Thus, BiP is a potential immunotherapeutic agent for the treatment of patients with rheumatoid arthritis.
    Arthritis & Rheumatology 04/2006; 54(3):854-63. · 7.48 Impact Factor
  • G S Panayi, V M Corrigall
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    ABSTRACT: The endoplasmic reticulum chaperone BiP, in addition to its many important intracellular functions, has anti-inflammatory and immunomodulatory properties when present in the extracellular environment by the stimulation of an anti-inflammatory gene programme from human monocytes and by the development of T-cells that secrete regulatory cytokines such as interleukin-10 and interleukin-4. It can both prevent as well as treat ongoing collagen-induced arthritis. It is, therefore, a potential new biologic therapy for rheumatoid arthritis.
    Autoimmunity Reviews 03/2006; 5(2):140-2. · 7.98 Impact Factor
  • Gabriel S Panayi
    Nature Clinical Practice Rheumatology 03/2006; 2(2):58-9. · 5.85 Impact Factor

Publication Stats

10k Citations
1,775.63 Total Impact Points


  • 1999–2012
    • King College
      Guymon, Oklahoma, United States
  • 1998–2012
    • King's College London
      • • Centre for Molecular and Cellular Biology of Inflammation
      • • Department of Academic Rheumatology
      London, ENG, United Kingdom
  • 2011
    • Toin University of Yokohama
      Yokohama, Kanagawa, Japan
  • 2002
    • WWF United Kingdom
      Londinium, England, United Kingdom
  • 2000
    • Paul-Flechsig-Institut für Hirnforschung
      Leipzig, Saxony, Germany
    • Aristotle University of Thessaloniki
      Saloníki, Central Macedonia, Greece
  • 1995
    • University College London
      • Division of Medicine
      London, ENG, United Kingdom
  • 1994
    • Northwestern University
      Evanston, Illinois, United States
  • 1993
    • University of Leuven
      Louvain, Flanders, Belgium
  • 1989–1993
    • University of London
      Londinium, England, United Kingdom
  • 1992
    • University of Ioannina
      • Division of Internal Medicine II
      Ioánnina, Ipeiros, Greece
  • 1984
    • London School of Hygiene and Tropical Medicine
      Londinium, England, United Kingdom