Effects of metronidazole and tinidazole ointments on models for inflammatory dermatitis in mice

Medermycin Inhibits TNFα-Promoted Inflammatory Reaction in Human Synovial Fibroblasts

Synovial inflammation plays a crucial role in the destruction of joints and the experience of pain in osteoarthritis (OA). Emerging evidence suggests that certain antibiotic agents and their derivatives possess anti-inflammatory properties. Medermycin (MED) has been identified as a potent antibiotic, specifically active against Gram-positive bacteria. In this study, we aimed to investigate the impact of MED on TNFα-induced inflammatory reactions in a synovial cell line, SW-982, as well as primary human synovial fibroblasts (HSF) using RNA sequencing, rtRT-PCR, ELISA, and western blotting. Through the analysis of differentially expressed genes (DEGs), we identified a total of 1478 significantly upregulated genes in SW-982 cells stimulated with TNFα compared to the vehicle control. Among these upregulated genes, MED treatment led to a reduction in 1167 genes, including those encoding proinflammatory cytokines such as IL1B, IL6, and IL8. Pathway analysis revealed the enrichment of DEGs in the TNF and NFκB signaling pathway, further supporting the involvement of MED in modulating inflammatory responses. Subsequent experiments demonstrated that MED inhibited the expression of IL6 and IL8 at both the mRNA and protein levels in both SW982 cells and HSF. Additionally, MED treatment resulted in a reduction in p65 phosphorylation in both cell types, indicating its inhibitory effect on NFκB activation. Interestingly, MED also inhibited Akt phosphorylation in SW982 cells, but not in HSF. Overall, our findings suggest that MED suppresses TNFα-mediated inflammatory cytokine production and p65 phosphorylation. These results highlight the potential therapeutic value of MED in managing inflammatory conditions in OA. Further investigations utilizing articular chondrocytes and animal models of OA may provide valuable insights into the therapeutic potential of MED for this disease.

Current treatment modalities in granulomatous cheilitis

BACKGROUND

Granulomatous cheilitis (GC) is a poorly understood disorder of the labial mucosa, which is a subtype under an umbrella term "orofacial granulomatosis." Several treatment modalities have been tried in the management of GC with suboptimal to optimal results.

OBJECTIVE

The objective of this article is to discuss various treatment modalities, whether medical or surgical, that have been tried for the management of GC with success.

METHODS

A comprehensive literature search was performed to screen articles related to the successful treatment of GC. Articles published in journals indexed in PubMed were searched along with those in Google Scholar. There was no availability of systematic review or meta-analysis on treatment of GC in the literature search. Recent data has been collected and consolidated from various case reports and case series to provide a concise overview of various treatments applied in GC.

RESULTS

Various treatment modalities have been used in GC including glucocorticoids, antibiotics, immunomodulatory, and biological agents, surgical debulking, and laser therapy. No treatment modality has provided a predictable success. Intralesional corticosteroid therapy has been used more frequently either alone or in combination with other modalities.

Metronidazole Topically Immobilized Electrospun Nanofibrous Scaffold: Novel Secondary Intention Wound Healing Accelerator

The process of secondary intention wound healing includes long repair and healing time. Electrospun nanofibrous scaffolds have shown potential for wound dressing. Biopolymers have gained much attention due to their remarkable characteristics such as biodegradability, biocompatibility, non-immunogenicity and nontoxicity. This study anticipated to develop a new composite metronidazole (MTZ) immobilized nanofibrous scaffold based on poly (3-hydroxy butyrate) (PHB) and Gelatin (Gel) to be utilized as a novel secondary intention wound healing accelerator. Herein, PHB and Gel were mixed together at different weight ratios to prepare polymer solutions with final concentration of (7%), loaded with two different concentrations 5% (Z₁) and 10% (Z₂) of MTZ. Nanofibrous scaffolds were obtained by manipulating electrospinning technique. The properties of MTZ immobilized PHB/Gel nanofibrous scaffold were evaluated (SEM, FTIR, TGA, water uptake, contact angle, porosity, mechanical properties and antibacterial activity). Additionally, in vitro cytocompatibility of the obtained nanofibrous scaffolds were assessed by using the cell counting kit-8 (CCK-8 assay). Moreover, in vivo wound healing experiments revealed that the prepared nanofibrous scaffold highly augmented the transforming growth factor (TGF-β) signaling pathway, moderately suppressed the pro-inflammatory cytokine (IL-6). These results indicate that MTZ immobilized PHB/Gel nanofibrous scaffold significantly boost accelerating secondary intention wound healing.

Multitarget Approaches against Multiresistant Superbugs

Despite efforts to develop new antibiotics, antibacterial resistance still develops too fast for drug discovery to keep pace. Often, resistance against a new drug develops even before it reaches the market. This continued resistance crisis has demonstrated that resistance to antibiotics with single protein targets develops too rapidly to be sustainable. Most successful long-established antibiotics target more than one molecule or possess targets, which are encoded by multiple genes. This realization has motivated a change in antibiotic development toward drug candidates with multiple targets. Some mechanisms of action presuppose multiple targets or at least multiple effects, such as targeting the cytoplasmic membrane or the carrier molecule bactoprenol phosphate and are therefore particularly promising. Moreover, combination therapy approaches are being developed to break antibiotic resistance or to sensitize bacteria to antibiotic action. In this Review, we provide an overview of antibacterial multitarget approaches and the mechanisms behind them.

THE INFLUENCE OF VAGINAL SUPPOSITORIES “MELANIZOL” ON THE SYSTEM OF LPO-AOS IN CONDITION OF MODEL OF A NONSPECIFIC VAGINITIS IN RATS

It is known that almost any pathology is accompanied by an imbalance of the lipid peroxidation (LPO) and the antioxidant system (AOS), and diseases of the female reproductive system are no exception. Thus, modern therapies of nonspecific vaginitis (NV) should include drugs with an antioxidant effect in the complex treatment, because the role of the LPO-AOS system in the mechanism for the development of NV is great. This problem can be solved by new complex drug with plant material with a wide spectrum of action. Aim. The aim of our research was to study the effect of new vaginal suppositories “Melanizol”, containing metronidazole and tea tree oil on the system of LPO-AOS on a model of nonspecific vaginitis in rats. Materials and methods. The study object was the new vaginal suppositories “Melanizol”. As reference drugs there were taken suppositories “Gravagin” and “Hippophaes oleum suppositories”. The study has been carried out on the model of experimental nonspecific (irritative) vaginitis caused in rats by the mixture of turpentine oil and dimethyl sulfoxide. Blood serum and vaginal tissue were used as the material for the study. Thiobarbituric acid-active products (TBA-AP) were determined as the component of a lipid peroxidation. The catalase (CAT), the superoxide dismutase (SOD) and the reduced glutathione (G-SH) were determined as the component of an antioxidant system. Results and discussion. On the background of experimental vaginitis in serum and in vaginal tissue homogenate in rats, significant changes in indicators of the LPO-AOS were noted. Change of these indicators show a systemic response of the body to pathological changes in the vagina, which is manifested in the depletion of AOS and activation of the LPO. The vaginal suppositories “Melanizol” in the study on the model of nonspecific (irritative) vaginitis in rats showed an antioxidant effect. Suppositories “Melanizol” significantly reduce the level of TBA-AP, interfering with lipid peroxidation processes, and restore the level of G-SH, as well as the activity of SOD and catalase in the blood and in the vaginal homogenate, helping to protect the cell membranes. Suppositories “Melanizol” significantly exceed the reference suppositories “Gravagin” and are not inferior to the reference drug “Hippophaes oleum suppositories” in activity to reduce the level of TBA-AP, and to restore the level of G-SH, as well as restoration the activity of SOD and CAT. Antioxidant activity of vaginal suppositories “Melanizol” can be explained by the presence of tea tree oil and metronidazole in their composition, which is confirmed by literature data. Conclusions. The conducted researches have shown that the new vaginal suppositories “Melanizol” demonstrated antioxidation activity. Results of this experiment allow us to recommend them for the further studies as medication for the treatment of nonspecific vaginitis.

Effect of metronidazole ophthalmic solution on corneal neovascularization in a rat model

PURPOSE

To evaluate the effect of metronidazole ophthalmic solutions on corneal neovascularization (CNV) in a rat model.

METHODS

A chemical burn was created in the right central cornea of 40 rats. Animals were randomized and distributed into four study groups (n = 10 rats per group) designated Met_0.1%, Met_0.5%, sham, and untreated groups. Chemical-burned corneas in the Met_0.1% and Met_0.5% groups received ophthalmic solutions of 0.1 and 0.5% metronidazole, respectively. Corneas in the sham group received phosphate-buffered saline (metronidazole diluent). All treated eyes received ophthalmic solution at intervals of 6 h, for up to 30 days. Untreated corneas received no treatment. CNV was evaluated postinjury using corneal photographs at different evaluation time points. The main CNV outcome measures were: burn intensity, index of CNV, and percentage of vascularized corneal area. Five rats from each group were euthanized, on days 15 and 30; the samples were collected for histological analyses. Differences with P < 0.05 were considered significant.

RESULTS

CNV was observed in the eyes from day 7 postinjury. However, the indices of CNV for the Met_0.1% and Met_0.5% groups were smaller than those for the sham and untreated groups (P < 0.05). Furthermore, corneas treated with 0.1 or 0.5% metronidazole had smaller vascularized areas compared to control corneas. On histological study, the presence of blood vessels confirmed clinical outcomes.

CONCLUSIONS

Regular instillation of 0.1 or 0.5% metronidazole had a significant inhibitory effect for CNV on chemical burns induced in a rat model.

Anti-inflammatory and Immunomodulatory Effects of Antibiotics and Their Use in Dermatology

Antibiotics (antibacterial, antiviral, and antiparasitic) are class of drugs which result in either killing or inhibiting growth and multiplication of infectious organisms. Antibiotics are commonly prescribed by all specialties for treatment of infections. However, antibiotics have hitherto immunomodulatory and anti-inflammatory properties and can be exploited for various noninfectious dermatoses. Dermatologists routinely prescribe antibiotics in treatment of various noninfectious disorders. This study will review anti-inflammatory and immunomodulatory effects of antibiotics and their use in dermatology.

Clinical experience of using metronidazole as an external therapy of acne

Metrogyl gel for external use (metronidazole 1%) has an antioxidant activity and substantially reduces the production of active oxygen compounds by neutrophilic leukocytes in the skin. A combination therapy of light to moderate acne with the use of external retinoids and metronidazole can be more efficient than a monotherapy with the use of these drugs alone. Goal. To assess the clinical efficacy, safety and tolerability of Metrogyl gel for external use in a combination with Klenzit gel (adapalene 0.1%) for treatment of patients with acne vulgaris. Materials and methods. The authors conducted an open-label controlled study of the efficacy, safety and tolerability of Metrogyl gel for external use in a combination with Klenzit gel for external use. As many as 50 patients suffering from acne vulgaris took part in the study, which lasted for eight weeks. The subjects were subdivided into two groups: combination therapy (Group 1, n = 15) and monotherapy with the use of external retinoids (Group 2, n = 15). Results. Adverse effects such as dry skin and peeling were observed among the patients from Group 1 less often (by 3.3 times - 5/35 (14.3%) of cases) than in Group 2 (7/15 (46.7%) of cases) (p = 0.036). The total share of acne patients with clinical recovery and substantial improvement in Group 1 was 33/35 (94.3%), which is 41.4% as much as in Group 2 (10/15 (66.7%)) (p = 0.033). Conclusions. A combination of Metrogyl gel and external retinoids is more efficient than a monotherapy with the use of topical retinoid alone, and such a therapy demonstrates higher tolerability.

Detrimental effects of metronidazole on selected innate immunological indicators in common carp (Cyprinus carpio L.)

The widely used antibiotic metronidazole (MTZ) was investigated for its toxic effects on the innate immunity in common carp (Cyprinus carpio L.). The fish were exposed to MTZ at nominal concentrations of 0.1, 0.5, and 2.5 mg L(-1) in water for 30 days, followed by a 5-days of cleanout period, after which certain innate immunity parameters were measured. The results showed that under the tested concentrations, MTZ-exposed fish exhibited decline in several humoral and cellular parameters, including complement activity, lysozyme activity, bactericidal activity, total serum protein levels, total WBC count, and the respiratory burst activity of kidney leukocytes. Except for total serum proteins, all of these parameters showed a significant difference in the 2.5 mg L(-1) MTZ group compared to control group (p < 0.05). The results clearly support the contention that MTZ suppresses the innate immunity of common carp.

Detrimental effects of metronidazole on the liver of freshwater common carp (Cyprinus carpio L.)

The widely used antibiotic metronidazole (MTZ) was investigated for its toxic effects on the liver of the common carp (Cyprinus carpio L.). The fish were exposed to 0.1, 0.5, and 2.5 mg/L MTZ in water for 30 days, and parameters that are indicative of liver damage and oxidative stress were measured. MTZ increased liver ethoxyresorufin-O-deethylase, malondialdehyde, and glutathione levels, and elevated the activities of superoxide dismutase, catalase, aspartate aminotransferase, and alanine aminotransferase. These parameters usually showed significant differences in the 0.5 and 2.5 mg/L MTZ groups compared to the control group (p < 0.05). These findings indicated that MTZ induced oxidative stress and caused liver damage in common carp, suggesting that measures should be taken to avoid contamination of surface waters with MTZ.

Efficacy of 2% metronidazole gel in moderate acne vulgaris

BACKGROUND

Acne vulgaris is an inflammatory disease of the pilosebaceous units. Various systemic and topical options are available for its treatment.

AIMS

This study aimed to evaluate the efficacy of 2% metronidazole gel in acne vulgaris.

MATERIALS AND METHODS

Double-blind, randomized, placebo-controlled, split-face clinical trial. Seventy young adults with moderate acne vulgaris received 2% metronidazole gel on the right side of their face and placebo on the left side of their face twice daily for 8 weeks. The number of inflamed and noninflamed facial lesions and side effects of treatment were documented on weeks 1, 2, 4, and 8. The patients' overall satisfaction was recorded at the end of the study. For statistical analysis we used the repeated-measures analysis, the chi-square test, Fisher's exact test, and the independent-samples t-test as appropriate.

RESULTS

Counts of inflamed and noninflamed facial lesions were comparable between the two sides at baseline. The number of the lesions was significantly lower on the metronidazole-treated side at all follow-up visits. Erythema and oily face decreased by 85.7% and 87.1%, respectively, on the metronidazole-treated side. Mild burning sensation and dryness on the metronidazole-treated side was reported by 3.4% and 22.9% of the patients, respectively. Eighty-eight percent of the patients were satisfied with the results of treatment on the metronidazole-treated side.

CONCLUSIONS

Metronidazole gel (2%) is an effective, safe, and well-tolerated topical medication for moderate acne vulgaris.

Randomized clinical trial of metronidazole ointment versus placebo in perianal Crohn's disease

BACKGROUND

The potential for metronidazole 10 per cent ointment to exert therapeutic benefit in perianal Crohn's disease, while minimizing the adverse effects found with oral metronidazole, was evaluated in a randomized placebo-controlled study.

METHODS

Subjects with perianal Crohn's disease were randomized to metronidazole 10 per cent ointment, 0.7 g applied perianally three times daily, or placebo ointment. The Perianal Crohn's Disease Activity Index (PCDAI) was scored at baseline and after 4 weeks of treatment. Perianal pain was assessed on a visual analogue scale.

RESULTS

Seventy-four subjects (33 metronidazole, 41 placebo) were evaluated. The mean(s.e.m.) reduction in PCDAI score at 4 weeks was 2.4(0.5) in the metronidazole group and 2.2(0.4) in the placebo group (P = 0.660). More subjects in the metronidazole group than the placebo group showed a reduction in PCDAI score of at least 5 points (10 of 27 versus 4 of 34; P = 0.031). Perianal discharge was reduced significantly in metronidazole-treated subjects (P = 0.012). A greater reduction in perianal pain was seen in the metronidazole group, which approached statistical significance (P = 0.059). No serious adverse events were reported.

CONCLUSION

Metronidazole 10 per cent ointment was not effective in the reduction of PDCAI score, but some secondary outcomes showed improvement suggestive of a treatment effect. It is well tolerated, with minimal adverse effects, and has potential as treatment for pain and discharge associated with perianal Crohn's disease.

REGISTRATION NUMBER

NCT00509639 (http://www.clinicaltrials.gov).

Preliminary evaluation of interactions between selected alcoholamines and model skin sebum components

The aim was to evaluate the interaction between selected alcoholamines and components of artificial skin sebum. The rate and depth of penetration into the lipophilic bead imitating pilosebaceous unit lumen was applied for alcoholamine penetration activity assay. The activity differentiation of 0.5% aqueous alcoholamine solutions with a potential cleansing effect on the pilosebaceous unit was performed. The depth of aminomethylpropanol penetration increased from 0.080 mm after 15 min to 3.049 mm after 72 h. The depth of aminomethylpropendiol penetration increased with time from 0.148 to 4.064, respectively, of diisopropanolamine from 0.481 to 4.626, triethanolamine from 0.236 to 4.342, triisopropanolamine from 0.275 to 2.392 and trometamol from 0.338 to 4.580. The products of alcoholamines reaction with the model skin sebum are easily dispersed in water. The rate of alcoholamines reaction with the model skin sebum depends on the alcoholamine, being the highest in the case of diisopropanolamine, decreasing to minimum for triisopropanolamine. Selected alcoholamines would be applied in ex vivo and in vivo research.