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Apaydin AS, Sahin C, Cayli S, Bal E, Bal C, Gökcem Yildiz F, Ayberk G. Levetiracetam treatment in an experimental model of sciatic nerve injury: A randomized controlled trial. Neurol Res 2023; 45:86-96. [PMID: 36373802 DOI: 10.1080/01616412.2022.2143617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 10/29/2022] [Indexed: 11/16/2022]
Abstract
AIM This study examined whether levetiracetam contributes to improvements in the axon-nerve damage in an experimental rat model. MATERIALS AND METHODS Forty-eight Wistar albino adult male rats weighing 250-300 gr were randomized into six groups having or not having sciatic nerve damages and receiving different (none, 300 and 600 mg/kg) levetiracetam doses, and control (non-levetiracetam). Functional gait analysis and tissue sample analysis with the aid of light microscopy and hematoxylin-eosin dye were evaluated between the groups. Additionally, scanning electron microscopy (SEM) was used for the detailed examination of sciatic nerves. S-100 (Schwann cell marker) immunoreactivities in sciatic nerve was detected by immunohistochemistry. RESULTS Sciatic functional index of the injured rats receiving 300 mg/kg levetiracetam was -65.59 ± 29.48 and -47.13 ± 21.36 in the 2nd and 6th weeks, respectively (p < 0.001). Also, IMA and TOS levels were significantly higher in the control group compared to those receiving levetiracetam (p = 0.001 and p < 0.001, respectively). The most significant nerve regeneration was in the group injured and treated with LEV 600 mg/kg (p < 0.05). CONCLUSION There was a significant improvement in the sciatic functional index, histopathological findings, and parameters showing tissue oxidant status in rats with sciatic nerve injury receiving levetiracetam treatment. Further investigations should be performed to evaluate the contribution of levetiracetam as a treatment modality in sciatic nerve injuries.
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Affiliation(s)
- Aydin Sinan Apaydin
- Faculty of Medicine Ankara City Hospital Department of Neurosurgery, Yıldırım Beyazıt University, Ankara, Turkey
| | - Cansu Sahin
- CÚRAM-SFI Research Centre for Medical Devices, Department of Physiology, University of Galway, Galway, Ireland
| | - Sevil Cayli
- Faculty of Medicine Ankara City Hospital Department of Histology and Embryology, Yıldırım Beyazıt University, Ankara, Turkey
| | - Ercan Bal
- Faculty of Medicine Ankara City Hospital Department of Neurosurgery, Yıldırım Beyazıt University, Ankara, Turkey
| | - Ceylan Bal
- Faculty of Medicine Ankara City Hospital Department of Biochemistry, Yıldırım Beyazıt University, Ankara, Turkey
| | - Fatma Gökcem Yildiz
- Hacettepe University Faculty of Medicine, Department of Neurology, Ankara, Turkey
| | - Giyas Ayberk
- Faculty of Medicine Ankara City Hospital Department of Neurosurgery, Yıldırım Beyazıt University, Ankara, Turkey
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Antinociceptive and Antiallodynic Activity of Some 3-(3-Methylthiophen-2-yl)pyrrolidine-2,5-dione Derivatives in Mouse Models of Tonic and Neuropathic Pain. Int J Mol Sci 2022; 23:ijms23074057. [PMID: 35409413 PMCID: PMC8999233 DOI: 10.3390/ijms23074057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 04/01/2022] [Accepted: 04/04/2022] [Indexed: 11/16/2022] Open
Abstract
Antiseizure drugs (ASDs) are commonly used to treat a wide range of nonepileptic conditions, including pain. In this context, the analgesic effect of four pyrrolidine-2,5-dione derivatives (compounds 3, 4, 6, and 9), with previously confirmed anticonvulsant and preliminary antinociceptive activity, was assessed in established pain models. Consequently, antinociceptive activity was examined in a mouse model of tonic pain (the formalin test). In turn, antiallodynic and antihyperalgesic activity were examined in the oxaliplatin-induced model of peripheral neuropathy as well as in the streptozotocin-induced model of painful diabetic neuropathy in mice. In order to assess potential sedative properties (drug safety evaluation), the influence on locomotor activity was also investigated. As a result, three compounds, namely 3, 6, and 9, demonstrated a significant antinociceptive effect in the formalin-induced model of tonic pain. Furthermore, these substances also revealed antiallodynic properties in the model of oxaliplatin-induced peripheral neuropathy, while compound 3 attenuated tactile allodynia in the model of diabetic streptozotocin-induced peripheral neuropathy. Apart from favorable analgesic properties, the most active compound 3 did not induce any sedative effects at the active dose of 30 mg/kg after intraperitoneal (i.p.) injection.
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3
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Modulation of nociception and pain-evoked neurobehavioral responses by levetiracetam in a craniotomy pain model. Behav Brain Res 2021; 420:113728. [PMID: 34952028 DOI: 10.1016/j.bbr.2021.113728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 12/06/2021] [Accepted: 12/18/2021] [Indexed: 11/23/2022]
Abstract
Traditional and novel analgesic modalities have been extensively tested for post-craniotomy pain management, yet the role of newer antiepileptic drugs in this area remains obscure. This study investigates the impact of levetiracetam (LEV) on pain modulation and neurobehavioral performance in a craniotomy model. Fifty-six Wistar rats were randomly assigned into seven groups: no intervention (CTRL), administration of placebo or LEV with no further intervention (PBO and LEV, respectively), and sham-operation or craniotomy in placebo (PBO-SHAM and PBO-CR, respectively) or LEV-treated rats (LEV-SHAM and LEV-CR, respectively). Pain was assessed by the rat grimace scale before, and at 8 and 24 h after craniotomy, following intraperitoneal injections of LEV (100 mg/kg twice daily) or normal saline two consecutive days before and on the craniotomy day. Elevated plus-maze and olfactory social memory tests were performed at 24- and 48 h post-craniotomy, respectively. Upon testing conclusion blood samples were collected for cytokines estimation. Levetiracetam administration enhanced antinociception in sham and craniotomy groups. In the elevated plus-maze test, LEV-CR rats spent more time in investigating open arms and performed more open arm entries than PBO-SHAM and PBO-CR animals. The olfactory test revealed no between-groups difference in acquisition time during first contact with a juvenile rat, while LEV-CR rats spent less time to recognize the same juvenile rat compared to PBO-SHAM and PBO-CR groups. Furthermore, LEV-treatment attenuated cortisol, interleukin-6 and TNF-a release, in sham and craniotomy animals. In conclusion, preemptive use of LEV decreases nociception, improves pain-evoked behavior and attenuates stress response in rats subjected to craniotomy.
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Tsymbalyuk S, Smith M, Gore C, Tsymbalyuk O, Ivanova S, Sansur C, Gerzanich V, Simard JM. Brivaracetam attenuates pain behaviors in a murine model of neuropathic pain. Mol Pain 2020; 15:1744806919886503. [PMID: 31615323 PMCID: PMC6880061 DOI: 10.1177/1744806919886503] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Background The antiseizure racetams may provide novel molecular insights into
neuropathic pain due to their unique mechanism involving synaptic vesicle
glycoprotein 2A. Anti-allodynic effects of levetiracetam have been shown in
animal models of neuropathic pain. Here, we studied the effect of
brivaracetam, which binds to synaptic vesicle glycoprotein 2A with 20-fold
greater affinity, and has fewer off-target effects. Methods Mice underwent unilateral sciatic nerve cuffing and were evaluated for
mechanical sensitivity using von Frey filaments. Pain behaviors were
assessed with prophylactic treatment using levetiracetam (100 or 10 mg/kg)
or brivaracetam (10 or 1 mg/kg) beginning after surgery and continuing for
21 days, or with therapeutic treatment using brivaracetam (10 or 1 mg/kg)
beginning on day 14, after allodynia was established, and continuing for 28
or 63 days. Spinal cord tissues from the prophylaxis experiment with10 mg/kg
brivaracetam were examined for neuroinflammation (Iba1 and tumor necrosis
factor), T-lymphocyte (CD3) infiltration, and synaptic vesicle glycoprotein
2A expression. Results When used prophylactically, levetiracetam, 100 mg/kg, and brivaracetam,
10 mg/kg, prevented the development of allodynia, with lower doses of each
being less effective. When used therapeutically, brivaracetam extinguished
allodynia, requiring 10 days with 10 mg/kg, and six weeks with 1 mg/kg.
Brivaracetam was associated with reduced neuroinflammation and reduced
T-lymphocyte infiltration in the dorsal horn. After sciatic nerve cuffing,
synaptic vesicle glycoprotein 2A expression was identified in neurons,
activated astrocytes, microglia/macrophages, and T lymphocytes in the dorsal
horn. Conclusion Synaptic vesicle glycoprotein 2A may represent a novel target for neuropathic
pain. Brivaracetam may warrant study in humans with neuropathic pain due to
peripheral nerve injury.
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Affiliation(s)
- Solomiya Tsymbalyuk
- Department of Neurosurgery, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Madeleine Smith
- Department of Neurosurgery, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Charles Gore
- Department of Neurosurgery, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Orest Tsymbalyuk
- Department of Neurosurgery, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Svetlana Ivanova
- Department of Neurosurgery, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Charles Sansur
- Department of Neurosurgery, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Volodymyr Gerzanich
- Department of Neurosurgery, University of Maryland School of Medicine, Baltimore, MD, USA
| | - J Marc Simard
- Department of Neurosurgery, University of Maryland School of Medicine, Baltimore, MD, USA.,Department of Pathology, University of Maryland School of Medicine, Baltimore, MD, USA.,Department of Physiology, University of Maryland School of Medicine, Baltimore, MD, USA
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Cortes-Altamirano JL, Reyes-Long S, Olmos-Hernández A, Bonilla-Jaime H, Carrillo-Mora P, Bandala C, Alfaro-Rodriguez A. Antinociceptive and pronociceptive effect of levetiracetam in tonic pain model. Pharmacol Rep 2018; 70:385-389. [PMID: 29477948 DOI: 10.1016/j.pharep.2017.09.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Revised: 08/28/2017] [Accepted: 09/25/2017] [Indexed: 01/08/2023]
Abstract
BACKGROUND Levetiracetam (LEV) is a novel anticonvulsant with proven antinociceptive properties. However, the antinociceptive and pronociceptive effect of this drug has not yet been fully elucidated in a tonic pain model. METHODS Thirty-six male rats (Wistar) were randomized into six groups and underwent the formalin test as follows: rats in the control group were administered 50μL of 1% formalin in the paw; sham-group rats were administered 50μL of saline in the paw to mimick the application of formalin; the four experimental groups were administered LEV intragastrically (ig) (50, 100, 200 and 300mg/kg), and 40min later 50μL of 1% formalin was injected in the paw. RESULTS LEV exhibited antinociceptive effect in the 300mg/kg LEV group (p<0.05) and a pronociceptive effect in the 100mg/kg LEV group (p<0.05) and in the 50mg/kg LEV group (p<0.001). CONCLUSIONS The antinociceptive and pronociceptive effect of LEV in a tonic pain model is dose-dependent.
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Affiliation(s)
- José Luis Cortes-Altamirano
- PhD Program in Biological and Health Sciences, Universidad Autónoma Metropolitana (UAM) Iztapalapa-Xochimilco-Cuajimalpa, Mexico City, Mexico
| | - Samuel Reyes-Long
- Facultad de Estudios Superiores Iztacala, Universidad Nacional Autónoma de México (UNAM), Tlalnepantla, Estado de México, Mexico
| | - Adriana Olmos-Hernández
- Department of Neurosciences, National Rehabilitation Institute "Luis Guillermo Ibarra Ibarra" (INR) Secretaría de Salud (SSA), Mexico City, Mexico
| | - Herlinda Bonilla-Jaime
- Departament of Reproductive Biology, Universidad Autónoma Metropolitana (UAM) Campus Iztapalapa, Mexico City, Mexico
| | - Paul Carrillo-Mora
- Department of Neurosciences, National Rehabilitation Institute "Luis Guillermo Ibarra Ibarra" (INR) Secretaría de Salud (SSA), Mexico City, Mexico
| | - Cindy Bandala
- Department of Neurosciences, National Rehabilitation Institute "Luis Guillermo Ibarra Ibarra" (INR) Secretaría de Salud (SSA), Mexico City, Mexico
| | - Alfonso Alfaro-Rodriguez
- Department of Neurosciences, National Rehabilitation Institute "Luis Guillermo Ibarra Ibarra" (INR) Secretaría de Salud (SSA), Mexico City, Mexico.
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Di Cesare Mannelli L, Maresca M, Micheli L, Farina C, Scherz MW, Ghelardini C. A rat model of FOLFOX-induced neuropathy: effects of oral dimiracetam in comparison with duloxetine and pregabalin. Cancer Chemother Pharmacol 2017; 80:1091-1103. [PMID: 29026967 DOI: 10.1007/s00280-017-3449-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2017] [Accepted: 10/06/2017] [Indexed: 12/13/2022]
Abstract
BACKGROUND AND AIM The FOLFOX family of chemotherapy regimens are hampered by the development of a painful neuropathy. Current clinical treatments are inadequate, and furthermore, the research of innovative drugs is strongly disadvantaged by the absence of a preclinical model based on the complete mixture of FOLFOX components. The aim of this study was to set up a rat model of FOLFOX-induced neuropathy in rats, validate its predictability by reference drugs, and evaluate the effectiveness of the new anti-neuropathic compound dimiracetam. METHODS Male Sprague-Dawley rats were treated intraperitoneally with the FOLFOX components (6 mg kg-1 oxaliplatin, 50 mg kg-1 5-FU, 90 mg kg-1 leucovorin calcium salt) or oxaliplatin alone (6 mg kg-1) on days 0, 7, 14, and 21, whereas a separate group received one more injection of FOLFOX on day 28. Pain behavioural measurements (paw pressure, cold plate, and electronic Von Frey tests) and motor coordination (Rota-rod test) were assessed before and after treatments. Behavioural, motor, neurological, and autonomic parameters (open field and Irwin tests) were evaluated. RESULTS FOLFOX reduced the pain threshold in response to mechanical noxious and thermal (cold) non-noxious stimuli beginning from day 14 up to day 42 comparably to oxaliplatin alone. A fifth FOLFOX injection enhanced the severity but not the duration of painful alterations. Spontaneous activity, behavioural, autonomic, and neurological functions were also affected, whereas the motor coordination was not altered. On day 22, duloxetine (15 mg kg-1, per os), morphine (10 mg kg-1, subcutaneously), or pregabalin (20 mg kg-1, per os), acutely administered, reduced the FOLFOX-dependent hypersensitivity. Repeated treatments with dimiracetam (150 mg kg-1, per os, twice daily, from day 22) significantly protected rats from FOLFOX-induced alterations of pain threshold as well as from autonomic and neurological impairments taking effect after 7 days treatment. Pregabalin repeatedly administered (20 mg kg-1, per os, twice daily, from day 22) was less effective in reducing mechanical hypersensitivity. CONCLUSION A clinically consistent model of FOLFOX-induced neurotoxicity has been developed in rats. Dimiracetam fully reduced hypersensitivity and neurological alterations showing a relevant profile as anti-neuropathic resource.
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Affiliation(s)
- Lorenzo Di Cesare Mannelli
- Department of Neuroscience, Psychology, Drug Research and Child Health, Neurofarba-Pharmacology and Toxicology Section, University of Florence, Viale G. Pieraccini, 6, 50139, Firenze, Italy.
| | - Mario Maresca
- Department of Neuroscience, Psychology, Drug Research and Child Health, Neurofarba-Pharmacology and Toxicology Section, University of Florence, Viale G. Pieraccini, 6, 50139, Firenze, Italy
| | - Laura Micheli
- Department of Neuroscience, Psychology, Drug Research and Child Health, Neurofarba-Pharmacology and Toxicology Section, University of Florence, Viale G. Pieraccini, 6, 50139, Firenze, Italy
| | - Carlo Farina
- Metys Pharmaceuticals AG, Leimenstrasse 57, 4055, Basel, Switzerland
| | - Michael W Scherz
- Metys Pharmaceuticals AG, Leimenstrasse 57, 4055, Basel, Switzerland
| | - Carla Ghelardini
- Department of Neuroscience, Psychology, Drug Research and Child Health, Neurofarba-Pharmacology and Toxicology Section, University of Florence, Viale G. Pieraccini, 6, 50139, Firenze, Italy
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Stepanović-Petrović R, Micov A, Tomić M, Pecikoza U. Levetiracetam synergizes with gabapentin, pregabalin, duloxetine and selected antioxidants in a mouse diabetic painful neuropathy model. Psychopharmacology (Berl) 2017; 234:1781-1794. [PMID: 28332005 DOI: 10.1007/s00213-017-4583-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2016] [Accepted: 02/25/2017] [Indexed: 12/29/2022]
Abstract
RATIONALE We have reported that levetiracetam, a novel anticonvulsant with analgesic properties, synergizes with ibuprofen/aspirin/paracetamol in a model of diabetic painful neuropathy (DPN). Most guidelines recommend gabapentin, pregabalin, and duloxetine as first- or second-line agents for DPN. OBJECTIVE We examined the effects of combination treatment of first-/second-line analgesics with levetiracetam in a model of DPN. Additionally, the levetiracetam's combinations with antioxidants, low dose of aspirin, coenzyme Q10, or α-lipoic acid were evaluated. METHODS Diabetes was induced in C57BL/6 mice with a single high dose of streptozotocin. The antinociceptive effects of orally administered levetiracetam, gabapentin, pregabalin, duloxetine (acute treatment) and aspirin, coenzyme Q10, and α-lipoic acid (preventive 7-day treatment), as well as combinations of levetiracetam with individual drugs were examined in the tail-flick test. In combination experiments, the drugs were coadministered in fixed-dose fractions of single-drug ED50; the type of interaction was determined by isobolographic analysis. RESULTS About 60-, 32-, 30-, 26-, 18-, and 6-fold reductions of doses of both drugs in levetiracetam combinations with pregabalin, gabapentin, coenzyme Q10, aspirin, duloxetine, and α-lipoic acid, respectively, were detected. CONCLUSIONS Combinations of levetiracetam with gabapentin/pregabalin/duloxetine that target different mechanisms/sites of action involved in DPN, as well as combinations of levetiracetam and low-dose aspirin/coenzyme Q10/α-lipoic acid that target underlying causes of DPN, produce marked synergistic interactions in reducing nociception in diabetic mice. This suggests that these combination treatments might be of great benefit for diabetic patients and should be explored further in clinical trials.
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Affiliation(s)
- Radica Stepanović-Petrović
- Department of Pharmacology, Faculty of Pharmacy, University of Belgrade, Vojvode Stepe, 450, POB 146, Belgrade, 11221, Serbia.
| | - Ana Micov
- Department of Pharmacology, Faculty of Pharmacy, University of Belgrade, Vojvode Stepe, 450, POB 146, Belgrade, 11221, Serbia
| | - Maja Tomić
- Department of Pharmacology, Faculty of Pharmacy, University of Belgrade, Vojvode Stepe, 450, POB 146, Belgrade, 11221, Serbia
| | - Uroš Pecikoza
- Department of Pharmacology, Faculty of Pharmacy, University of Belgrade, Vojvode Stepe, 450, POB 146, Belgrade, 11221, Serbia
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Sidhu HS, Sadhotra A. Current Status of the New Antiepileptic Drugs in Chronic Pain. Front Pharmacol 2016; 7:276. [PMID: 27610084 PMCID: PMC4996999 DOI: 10.3389/fphar.2016.00276] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2016] [Accepted: 08/12/2016] [Indexed: 12/17/2022] Open
Abstract
Antiepileptic drugs (AEDs) are extensively used worldwide to treat a wide range of disorders other than epilepsy, such as neuropathic pain, migraine, and bipolar disorder. Due to this situation more than 20 new third-generation AEDs have been introduced in the market recently. The future design of new AEDs must also have potential to help in the non-epileptic disorders. The wide acceptance of second generation AEDs for the management of various non-epileptic disorders has caused the emergence of generics in the market. The wide use of approved AEDs outside epilepsy is based on both economic and scientific reasons. Bipolar disorders, migraine prophylaxis, fibromyalgia, and neuropathic pain represent the most attractive indication expansion opportunities for anticonvulsant developers, providing blockbuster revenues. Strong growth in non-epilepsy conditions will see Pfizer's Lyrica become the market leading brand by 2018. In this review, we mainly focus on the current status of new AEDs in the treatment of chronic pain and migraine prophylaxis. AEDs have a strong analgesic potential and this is demonstrated by the wide use of carbamazepine in trigeminal neuralgia and sodium valproate in migraine prophylaxis. At present, data on the new AEDs for non-epileptic conditions are inconclusive. Not all AEDs are effective in the management of neuropathic pain and migraine. Only those AEDs whose mechanisms of action are match with pathophysiology of the disease, have potential to show efficacy in non-epileptic disorder. For this better understanding of the pathophysiology of the disease and mechanisms of action of new AEDs are essential requirement before initiating pre-clinical and clinical trials. Many new AEDs show good results in the animal model and open-label studies but fail to provide strong evidence at randomized, placebo-controlled trials. The final decision regarding the clinical efficacy of the particular AEDs in a specific non-epileptic disorder should be withdrawal from randomized placebo trials rather than open-label studies; otherwise this may lead to off-label uses of drug. The purpose of the present review is to relate the various mechanisms of action of new AEDs to pathophysiological mechanisms and clinical efficacy in neuropathic pain and migraine.
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Czopek A, Sałat K, Byrtus H, Rychtyk J, Pawłowski M, Siwek A, Soluch J, Mureddu V, Filipek B. Antinociceptive activity of novel amide derivatives of imidazolidine-2,4-dione in a mouse model of acute pain. Pharmacol Rep 2016; 68:529-35. [DOI: 10.1016/j.pharep.2015.12.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2015] [Revised: 12/11/2015] [Accepted: 12/29/2015] [Indexed: 12/20/2022]
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Erbaş O, Oltulu F, Yılmaz M, Yavaşoğlu A, Taşkıran D. Neuroprotective effects of chronic administration of levetiracetam in a rat model of diabetic neuropathy. Diabetes Res Clin Pract 2016; 114:106-16. [PMID: 26795972 DOI: 10.1016/j.diabres.2015.12.016] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2015] [Revised: 12/04/2015] [Accepted: 12/28/2015] [Indexed: 01/01/2023]
Abstract
OBJECTIVE Diabetic neuropathy (DNP) is a frequent and serious complication of diabetes mellitus (DM) that leads to progressive and length-dependent loss of peripheral nerve axons. The purpose of the present study is to assess the neuroprotective effects of levetiracetam (LEV) on DNP in a streptozotocin (STZ)-induced DM model in rats. METHODS Adult Sprague-Dawley rats were administered with STZ (60mg/kg) to induce diabetes. DNP was confirmed by electromyography (EMG) and motor function test on 21st day following STZ injection. Study groups were assigned as follows; Group 1: Naïve control (n=8), Group 2: DM+1mL/kg saline (n=12), Group 3: DM+300mg/kg LEV (n=10), Group 4: DM+600mg/kg LEV (n=10). LEV was administered i.p. for 30 consecutive days. Then, EMG, motor function test, biochemical analysis (plasma lipid peroxides and total anti-oxidant capacity), histological and immunohistochemical analysis of sciatic nerves (TUNEL assay, bax, caspase 3, caspase 8 and NGF) were performed to evaluate the efficacy of LEV. RESULTS Treatment of diabetic rats with LEV significantly attenuated the inflammation and fibrosis in sciatic nerves and prevented electrophysiological alterations. Immunohistochemistry of sciatic nerves showed a considerable increase in bax, caspase 3 and caspase 8 and a decrease in NGF expression in saline-treated rats whereas LEV significantly suppressed apoptosis markers and prevented the reduction in NGF expression. Besides, LEV considerably reduced plasma lipid peroxides and increased total anti-oxidant capacity in diabetic rats. CONCLUSIONS The results of the present study suggest that LEV may have therapeutic effects in DNP through modulation of anti-oxidant and anti-apoptotic pathways.
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Affiliation(s)
- Oytun Erbaş
- Istanbul Bilim University School of Medicine, Department of Physiology, Istanbul, Turkey
| | - Fatih Oltulu
- Ege University School of Medicine, Department of Histology and Embryology, Izmir, Turkey
| | - Mustafa Yılmaz
- Mugla University School of Medicine, Department of Neurology, Mugla, Turkey
| | - Altuğ Yavaşoğlu
- Ege University School of Medicine, Department of Histology and Embryology, Izmir, Turkey
| | - Dilek Taşkıran
- Ege University School of Medicine, Department of Physiology, Izmir, Turkey.
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Reda HM, Zaitone SA, Moustafa YM. Effect of levetiracetam versus gabapentin on peripheral neuropathy and sciatic degeneration in streptozotocin-diabetic mice: Influence on spinal microglia and astrocytes. Eur J Pharmacol 2016; 771:162-72. [DOI: 10.1016/j.ejphar.2015.12.035] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2015] [Revised: 12/16/2015] [Accepted: 12/18/2015] [Indexed: 01/20/2023]
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Canpolat S, Ozcan M, Saral S, Kalkan OF, Ayar A. Effects of apelin-13 in mice model of experimental pain and peripheral nociceptive signaling in rat sensory neurons. J Recept Signal Transduct Res 2015; 36:243-7. [DOI: 10.3109/10799893.2015.1080274] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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The Effects of Levetiracetam, Sumatriptan, and Caffeine in a Rat Model of Trigeminal Pain. Anesth Analg 2015; 120:1385-93. [DOI: 10.1213/ane.0000000000000640] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Micov A, Tomić M, Pecikoza U, Ugrešić N, Stepanović-Petrović R. Levetiracetam synergises with common analgesics in producing antinociception in a mouse model of painful diabetic neuropathy. Pharmacol Res 2015; 97:131-42. [PMID: 25958352 DOI: 10.1016/j.phrs.2015.04.014] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2015] [Revised: 04/21/2015] [Accepted: 04/26/2015] [Indexed: 01/05/2023]
Abstract
Painful diabetic neuropathy is difficult to treat. Single analgesics often have insufficient efficacy and poor tolerability. Combination therapy may therefore be of particular benefit, because it might provide optimal analgesia with fewer adverse effects. This study aimed to examine the type of interaction between levetiracetam, a novel anticonvulsant with analgesic properties, and commonly used analgesics (ibuprofen, aspirin and paracetamol) in a mouse model of painful diabetic neuropathy. Diabetes was induced in C57BL/6 mice with a single high dose of streptozotocin, applied intraperitoneally (150 mg/kg). Thermal (tail-flick test) and mechanical (electronic von Frey test) nociceptive thresholds were measured before and three weeks after diabetes induction. The antinociceptive effects of orally administered levetiracetam, analgesics, and their combinations were examined in diabetic mice that developed thermal/mechanical hypersensitivity. In combination experiments, the drugs were co-administered in fixed-dose fractions of single drug ED50 and the type of interaction was determined by isobolographic analysis. Levetiracetam (10-100 mg/kg), ibuprofen (2-50 mg/kg), aspirin (5-75 mg/kg), paracetamol (5-100 mg/kg), and levetiracetam-analgesic combinations produced significant, dose-dependent antinociceptive effects in diabetic mice in both tests. In the tail-flick test, isobolographic analysis revealed 15-, and 19-fold reduction of doses of both drugs in the combination of levetiracetam with aspirin/ibuprofen, and paracetamol, respectively. In the von Frey test, approximately 7- and 9-fold reduction of doses of both drugs was detected in levetiracetam-ibuprofen and levetiracetam-aspirin/levetiracetam-paracetamol combinations, respectively. These results show synergism between levetiracetam and ibuprofen/aspirin/paracetamol in a model of painful diabetic neuropathy and might provide a useful approach to the treatment of patients suffering from painful diabetic neuropathy.
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Affiliation(s)
- Ana Micov
- Department of Pharmacology, Faculty of Pharmacy, University of Belgrade, Vojvode Stepe 450, POB 146, 11221 Belgrade, Serbia.
| | - Maja Tomić
- Department of Pharmacology, Faculty of Pharmacy, University of Belgrade, Vojvode Stepe 450, POB 146, 11221 Belgrade, Serbia.
| | - Uroš Pecikoza
- Department of Pharmacology, Faculty of Pharmacy, University of Belgrade, Vojvode Stepe 450, POB 146, 11221 Belgrade, Serbia.
| | - Nenad Ugrešić
- Department of Pharmacology, Faculty of Pharmacy, University of Belgrade, Vojvode Stepe 450, POB 146, 11221 Belgrade, Serbia.
| | - Radica Stepanović-Petrović
- Department of Pharmacology, Faculty of Pharmacy, University of Belgrade, Vojvode Stepe 450, POB 146, 11221 Belgrade, Serbia.
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Fariello RG, Ghelardini C, Di Cesare Mannelli L, Bonanno G, Pittaluga A, Milanese M, Misiano P, Farina C. Broad spectrum and prolonged efficacy of dimiracetam in models of neuropathic pain. Neuropharmacology 2014; 81:85-94. [PMID: 24486381 DOI: 10.1016/j.neuropharm.2014.01.029] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2013] [Revised: 01/16/2014] [Accepted: 01/20/2014] [Indexed: 01/11/2023]
Abstract
Dimiracetam, a bicyclic 2-pyrrolidinone derivative originally developed as cognition enhancer, is a member of the nootropic family for which anecdotal efficacy in models of neuropathic pain has been reported. Its antineuropathic activity was evaluated in established models of neuropathic pain induced by nerve injury, chemotherapy or MIA-induced osteoarthritis. Acutely, dimiracetam was very effective in models of antiretroviral drug induced painful neuropathy, oxaliplatin-induced hyperalgesia and in the MIA-osteoarthritis. Chronic dimiracetam dosing in the MIA and ART- induced models completely reverted hyperalgesia back to the level of healthy controls. Once reached, the maximal effect was maintained despite dose diminution and increased inter-dose interval. The effect of the last dose outlasted dimiracetam half-life longer than 12 times. In synaptosomal preparations, dimiracetam counteracted the NMDA-induced release of glutamate with highest potency in the spinal cord, possibly via NMDA receptor isoforms containing pH-sensitive GluN1 and GluN2A subunits. Dimiracetam appears to be a promising and safe treatment for neuropathic pain conditions for which there are very limited therapeutic options.
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Affiliation(s)
| | - Carla Ghelardini
- Department of Neurosciences, Psychology, Drug Research and Child Health, Section of Pharmacology and Toxicology, University of Florence, Viale Pieraccini 6, I-50139 Florence, Italy.
| | - Lorenzo Di Cesare Mannelli
- Department of Neurosciences, Psychology, Drug Research and Child Health, Section of Pharmacology and Toxicology, University of Florence, Viale Pieraccini 6, I-50139 Florence, Italy.
| | - Giambattista Bonanno
- Department of Pharmacy, Pharmacology and Toxicology Unit, University of Genoa, Viale Cembrano 4, I-16148 Genoa, Italy.
| | - Anna Pittaluga
- Department of Pharmacy, Pharmacology and Toxicology Unit, University of Genoa, Viale Cembrano 4, I-16148 Genoa, Italy.
| | - Marco Milanese
- Department of Pharmacy, Pharmacology and Toxicology Unit, University of Genoa, Viale Cembrano 4, I-16148 Genoa, Italy.
| | - Paola Misiano
- NiKem Research, Via Zambeletti 25, I-20021 Baranzate, Milan, Italy.
| | - Carlo Farina
- Neurotune AG, Wagistrasse 27a, CH-8952 Schlieren, Switzerland.
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Tomić MA, Micov AM, Stepanović-Petrović RM. Levetiracetam Interacts Synergistically With Nonsteroidal Analgesics and Caffeine to Produce Antihyperalgesia in Rats. THE JOURNAL OF PAIN 2013; 14:1371-82. [DOI: 10.1016/j.jpain.2013.06.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/26/2013] [Revised: 05/31/2013] [Accepted: 06/10/2013] [Indexed: 11/28/2022]
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Mitsikostas DD, Pantes GV, Avramidis TG, Karageorgiou KE, Gatzonis SD, Stathis PG, Fili VA, Siatouni AD, Vikelis M. An observational trial to investigate the efficacy and tolerability of levetiracetam in trigeminal neuralgia. Headache 2013; 50:1371-7. [PMID: 21044281 DOI: 10.1111/j.1526-4610.2010.01743.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To explore the efficacy and tolerability of levetiracetam in medical treatment of trigeminal neuralgia. BACKGROUND Antiepileptic drugs (AEDs) are considered as first-line treatment for trigeminal neuralgia, although their use is often limited due to incomplete efficacy and tolerability. Newer AEDs with improved safety profile may be useful in this disorder. METHODS Patients suffering from trigeminal neuralgia (either primary or secondary) refractory to previous treatments were recruited to be treated with levetiracetam (3-4 g/day) for 16 weeks as add-on therapy, after a 2-week baseline period. Rescue medication was allowed in both the baseline and treatment phases. The primary efficacy measure was the number of attacks per day. The patients' efficacy evaluation, the patients' global evaluation for both safety and efficacy, changes in the Hamilton Depression Scale, the Hamilton Anxiety Scale, and the Quality of Life Measure Short Form-36 were secondary parameters. RESULTS Twenty-three patients were included in the analysis. After treatment and compared to the baseline phase, the number of daily attacks decreased by 62.4%. All secondary parameters changed significantly with the exception of the Quality of Life Measure Short Form-36 score. Seven patients withdrew from the study. Five patients (21.7%) reported side effects and 2 withdrew. CONCLUSIONS Levetiracetam may be effective and safe in trigeminal neuralgia treatment. Confirmation in a randomized controlled study is needed.
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Gunduz A, Eraydin I, Turkmen S, Kalkan OF, Turedi S, Eryigit U, Ayar A. Analgesic effects of mad honey (grayanotoxin) in mice models of acute pain and painful diabetic neuropathy. Hum Exp Toxicol 2013; 33:130-5. [DOI: 10.1177/0960327113482693] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Objectives: The aim of this experimental study was to investigate the effects of mad honey (grayanotoxin, GTX), used in complementary medicine for a variety of purposes besides being food, on pain thresholds in normal mice as model for acute pain and diabetic mouse as model for neuropathic pain. Methods: Hind paw withdrawal pain threshold to thermal stimulus was measured with a plantar analgesia meter in a mice model using healthy intact animals for acute pain and streptozotocin-induced diabetic animals for chronic neuropathic pain. Time and dose-dependent effects of intraperitoneally (i.p.) administered GTX were investigated in both acute and neuropathic pain. Results: In the acute pain model, administration of GTX caused a dose- and time-dependent marked increase in the pain latency values. In diabetic mice, which had markedly increased threshold to pain, GTX (0.1 mg/kg, i.p.) restored the mean pain latencies by decreasing from the pre-GTX treatment values of 3.2 ± 0.6 to 3.0 ± 0.9s at 10 min, 3.2 ± 0.6s at 20 min, 3.4 ± 0.6s at 30 min, 2.6 ± 0.5s at 60 min and 2.4 ± 0.6s ( p < 0.05) at 100 min. Conclusion: The results from this experimental study indicate that GTX exhibits significant analgesic activity and has potential benefits against painful diabetic neuropathy. This is compatible with the widespread use of GTX containing mad honey for alleviating pain. Further studies involving long-term applications are needed for a more decisive conclusion regarding the usefulness of GTX as an analgesic, especially in the treatment of painful neuropathy.
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Affiliation(s)
- A Gunduz
- Department of Emergency Medicine, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey
| | - I Eraydin
- Department of Emergency Medicine, Trabzon Teaching and Research Hospital, Trabzon, Turkey
| | - S Turkmen
- Department of Emergency Medicine, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey
| | - O F Kalkan
- Department of Physiology, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey
| | - S Turedi
- Department of Emergency Medicine, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey
| | - U Eryigit
- Department of Emergency Medicine, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey
| | - A Ayar
- Department of Physiology, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey
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Jungehulsing GJ, Israel H, Safar N, Taskin B, Nolte CH, Brunecker P, Wernecke KD, Villringer A. Levetiracetam in patients with central neuropathic post-stroke pain - a randomized, double-blind, placebo-controlled trial. Eur J Neurol 2012; 20:331-7. [DOI: 10.1111/j.1468-1331.2012.03857.x] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2012] [Accepted: 07/12/2012] [Indexed: 12/28/2022]
Affiliation(s)
| | - H. Israel
- Department of Neurology; Charité University Medicine ; Berlin; Germany
| | - N. Safar
- Department of Neurology; Charité University Medicine ; Berlin; Germany
| | - B. Taskin
- Department of Neurology; Charité University Medicine ; Berlin; Germany
| | | | - P. Brunecker
- Center for Stroke Research Berlin (CSB); Charité University Medicine ; Berlin; Germany
| | - K.-D. Wernecke
- Institute of Medical Biometry; Charité University Medicine Berlin; Berlin; Germany
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Ozcan M, Ayar A. Modulation of action potential and calcium signaling by levetiracetam in rat sensory neurons. J Recept Signal Transduct Res 2012; 32:156-62. [DOI: 10.3109/10799893.2012.672993] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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21
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Martini E, Di Cesare Mannelli L, Bartolucci G, Bertucci C, Dei S, Ghelardini C, Guandalini L, Manetti D, Scapecchi S, Teodori E, Romanelli MN. Synthesis and Biological Evaluation of 3,7-Diazabicyclo[4.3.0]nonan-8-ones as Potential Nootropic and Analgesic Drugs. J Med Chem 2011; 54:2512-6. [DOI: 10.1021/jm101376k] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Elisabetta Martini
- Department of Pharmaceutical Sciences, University of Florence, Via Ugo Schiff 6, 50019 Sesto Fiorentino, Italy
| | - Lorenzo Di Cesare Mannelli
- Department of Preclinical and Clinical Pharmacology, University of Florence, Viale Pieraccini 6, 50139 Firenze, Italy
| | - Gianluca Bartolucci
- Department of Pharmaceutical Sciences, University of Florence, Via Ugo Schiff 6, 50019 Sesto Fiorentino, Italy
| | - Carlo Bertucci
- Department of Pharmaceutical Sciences, University of Bologna, Via Belmeloro 6, 40126 Bologna, Italy
| | - Silvia Dei
- Department of Pharmaceutical Sciences, University of Florence, Via Ugo Schiff 6, 50019 Sesto Fiorentino, Italy
| | - Carla Ghelardini
- Department of Preclinical and Clinical Pharmacology, University of Florence, Viale Pieraccini 6, 50139 Firenze, Italy
| | - Luca Guandalini
- Department of Pharmaceutical Sciences, University of Florence, Via Ugo Schiff 6, 50019 Sesto Fiorentino, Italy
| | - Dina Manetti
- Department of Pharmaceutical Sciences, University of Florence, Via Ugo Schiff 6, 50019 Sesto Fiorentino, Italy
| | - Serena Scapecchi
- Department of Pharmaceutical Sciences, University of Florence, Via Ugo Schiff 6, 50019 Sesto Fiorentino, Italy
| | - Elisabetta Teodori
- Department of Pharmaceutical Sciences, University of Florence, Via Ugo Schiff 6, 50019 Sesto Fiorentino, Italy
| | - Maria Novella Romanelli
- Department of Pharmaceutical Sciences, University of Florence, Via Ugo Schiff 6, 50019 Sesto Fiorentino, Italy
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Ozcan M, Ayar A, Alcin E, Ozcan S, Kutlu S. Effects of levobupivacaine and bupivacaine on intracellular calcium signaling in cultured rat dorsal root ganglion neurons. J Recept Signal Transduct Res 2010; 30:115-20. [DOI: 10.3109/10799891003630614] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Current world literature. Curr Opin Neurol 2009; 22:554-61. [PMID: 19755870 DOI: 10.1097/wco.0b013e3283313b14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Current World Literature. Curr Opin Support Palliat Care 2009; 3:144-51. [DOI: 10.1097/spc.0b013e32832c6adb] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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