Moreover, high levels of MMP-1 and MMP-13 have been found in arthritic tissues . 2.2. degradation of Type II collagen and aggrecan constitute major Chlorhexidine cellular events in the progression of RA and OA to joint failure. Several findings have also implicated MMP-13 as a suitable target for the development of selective MMP-13 inhibitors [73, 74]. Thus, medicinal chemistry produced an MMP-13 inhibitor, PF152 (N-(4-fluoro-3-methoxybenzyl)-6-(2-(((2S,5R)-5-(hydroxymethyl)-1,4-dioxan-2-yl)methyl)-2H-tetrazol-5-yl)-2-methylpyrimidine-4-carboxamide), which was shown to decrease human cartilage degradation as well as possessing the capacity to reduce the severity of articular cartilage lesions in dogs with OA induced by partial medial meniscectomy . However, additional preclinical testing of PF152 indicated significant nephrotoxicity which was believed to have been mediated by human organic anion transporter 3. Thus, a follow-up analysis produced a compound lacking this nephrotoxic property . As of this writing, a search of the PubMed data base using the search term, MMP-13 inhibitors/Osteoarthritis Clinical Trials failed to reveal any human OA trials as yet in which PF152 or its successor was evaluated for clinical efficacy. 2.3. ADAMTS ADAMTS and ADAMTS-like proteins are members of a superfamily of 26 secreted Chlorhexidine enzyme molecules comprising 2 related, but distinct families. ADAMTS are zinc-metalloproteinases with a thrombospondin motif, whereas ADAMTS-like molecules lack the thrombospondin motif . ADAMTS-5 is the principle aggrecanase found in animal  and human OA articular cartilage . In that regard, the degradation and diffusion of Type II collagen and aggrecan fragments from OA articular cartilage without the compensatory synthesis of these macromolecules to replace those lost through degradation significantly compromises the biomechanical properties of articular cartilage . 2.4. ADAMTS Inhibitors ADAMTS-5 was validated as a drug target for OA and experimental ADAMTS-5 inhibitors were shown to reduce synovial joint damage in OA animal models. Thus, an active ADAMTS-5 drug development program has been established with the lead compound, GLPG1972, being assessed in a Phase I OA clinical trial (“type”:”clinical-trial”,”attrs”:”text”:”NCT03311009″,”term_id”:”NCT03311009″NCT03311009). Chlorhexidine In addition to GLPG1972, a Chlorhexidine humanized anti-ADAMTS-5 monoclonal antibody, GSK2394002  which was shown to inhibit ADAMTS-5 catalytic activity with a Ki 0.08nM, has been earmarked as a potential OA therapeutic agent. However, as of April, 2018, GSK2394002 did not appear to have progressed beyond preclinical evaluation. ADAMTS-4 and ?5 also abolish cartilage integrity in RA by degrading aggrecan . Additional novel ADAMTS-5 inhibitors Chlorhexidine are in the process of development. In one such study a bias-selection of antibodies analysis targeting ADAMTS-5 was shown to block the catalytic site of ADAMTS-5  resulting in selective aggrecanase inhibition. 2.5. ADAMs and ADAM Inhibitors We previously proposed a biological role for soluble IL-6 receptor (IL-6R) in OA . In that regard, sIL-6R was shown to stimulate MMP synthesis by activating the JAK-STAT and ERK-MAPK signaling pathways in human chondrocyte cultures . The sIL-6R is MUK generated by ectodomain shedding [84C86] mediated by the ADAM class of metzincin proteases . In the present view, dysregulation of ectodomain shedding mediated by ADAM proteases has been associated with autoimmune and cardiovascular diseases, neurodegeneration, cancer, infection, and inflammation . Regarding the removal of the membrane form of the IL-6 receptor (mIL-6), this is carried out either by ADAM10 or ADAM17 , where ADAM17 is mostly associated with sIL-6R arising from neutrophils during acute and chronic inflammation . In the course of recognizing the role played by ADAM17, an inhibitor, GW280264X was developed wherein this agent was shown to block the constitutive release of mIL-6R in addition to blocking the release of chemokines CX3CL1/fractalkine, and chemokine C-X-C ligand 16 . This finding was consistent with a previous report showing that ADAM17, and not ADAM10 was responsible for removing TNF- and L-selectin from leukocyte membranes . 3.?Signal Transduction Pathways: Pro-inflammatory Cytokines, NF-B, MMPs and Apoptosis Early on the JAK-STAT pathway was identified as a critical inducer of inflammation in RA and PsA because several of the pro-inflammatory cytokines (e.g. IL-6) and other soluble mediators (e.g. interferon-) activate STAT proteins via their interaction with specific receptors [91C93]. However, more.