Estimation of Anti-inflammatory and Analgesic Effects of Topical NANOCEN (Nanoliposomal Arthrocen) on Mice

Naringenin loaded nanomicelles effect on second-degree burn in Balb/c mice: A promising formulation for wound healing

Burns can cause long-term complications and require immediate and effective treatment in patients. The therapeutic potential of naringenin (NG) is hampered by its hydrophobic nature. To improve the bioavailability and efficacy of NG in experimental burn wounds in mice, NG-loaded nanomicelles (NGMs) were prepared using the thin-film hydration method. The characterization of the formulation in different concentrations (0.3 %, 0.6 %, and 1.25 %) was carried out using HPLC, DLS, and TEM techniques. A second-degree burn was inflicted on the back of the mice for evaluation of NGM efficacy. The NGM formulation was evaluated topically on the treated mice for wound recovery, improvement of histological and immunohistochemical parameters, and in vitro antibacterial activity. The effect of NGMs on wound healing was evaluated by hematoxylin and eosin (H&E) and Masson's trichrome staining (MT), and expression of transforming growth factor-β (TGF-β) and nuclear factor-κB (NFκ-B) using immunohistochemistry (IHC). The characterization tests revealed nanosized micelles with dimensions around 7 nm and a high entrapment efficiency percentage of NG which had sustained release behavior. Wound healing was significantly faster in mice treated with NGMs (0.3 %) compared to other concentrations, silver sulfadiazine (SSD), and an untreated group. IHC analysis of mice receiving NGMs (0.3 %) showed a significant reduction in NFκ-B, while TGF-β1 was increased. In addition, NGMs exhibited significant bactericidal activity against Staphylococcus aureus and Pseudomonas aeruginosa in vitro. These findings show that NGMs accelerate the wound-healing process and lead to regeneration of the epidermis without the need for additional medication.

Soybean and avocado unsaponifiables: a review of their potential use in the treatment of osteoarthritis

Recent research has shown that Avocado-Soybean Unsaponifiables (ASU) greatly reduce the symptoms of osteoarthritis (OA). It's yet unknown exactly how ASU works, however, it has been demonstrated to have analgesic and anti-inflammatory effects. These qualities can potentially lessen the need for non-steroidal anti-inflammatory medicines (NSAIDs) and their secondary effects. This review aims to examine the current literature on ASU, focusing on their efficacy, mechanism of action, and potential utility in treating OA for managing chronic pain associated with this condition. The literature review was conducted manually through Pubmed, Scopus and Web of Science (WOS) databases, covering studies from 2000 to 2022 with terms like "osteoarthritis," "OA," "animal models," "ASU," and "soy/avocado." Two reviewers independently screened each article using inclusion and exclusion criteria and categorized the studies into in vitro, preclinical, and clinical groups. According to in vitro research, ASU affect the regulation of molecules related to OA, increasing structural elements like collagen and aggrecan and decreasing pro-inflammatory mediators. Although results vary, pre-clinical research in different animal models has demonstrated positive effects, such as ameliorating histopathological changes and reduced inflammation. Despite some discrepancies regarding structural changes in the joints, clinical trials typically demonstrate symptom relief and slow down the disease progression. While ASU demonstrates significant promise in alleviating OA symptoms and reducing reliance on NSAIDs, further research is essential to fully understand its mechanisms of action. More studies are needed to determine the precise pathways through which ASU exerts its effects and to establish the most effective dosages for its administration, either alone or in combination with other treatments.

Formulation, optimization and evaluation of ibuprofen loaded menthosomes for transdermal delivery

The study aimed to improve the transdermal permeation of IBU utilizing menthosomes as a vesicular carrier. IBU-loaded menthosomes were formulated by thin film hydration & optimized using 23 factorial designs (Design Expert® version 13 software). In vitro & ex vivo skin permeation analysis of IBU-encapsulated menthosomes was studied across the rat skin sample. In vivo pharmacodynamic activity was studied in an arthritis rat model. The optimized IBU-loaded menthosomes exhibited an optimum vesicle size of 214.2 ± 2.96 nm, Zeta potential of -21.1 ± 2.72 mV, (PDI) Polydispersity Index of 0.267 ± 0.018 with Entrapment efficiency (EE%) of 78.7 ± 2.73 %. The in vitro & ex vivo skin penetration study displayed enhanced release of drug of 77.02 ± 1.0 % and 40.91 ± 0.81 % respectively, compared to conventional liposomes. In vivo pharmacodynamic study on carrageenan-induced paw edema in Wistar albino rats demonstrated superior anti-inflammatory activity of the optimized IBU-encapsulated menthosomes (**p < 0.01) and effective inhibition of paw edema (34.04 ± 0.155 %). The formalin test indicated a significant analgesic effect of optimized formulation during the chronic phase of analgesia (*p < 0.05) compared to the control group. Thus, the developed and optimized drug-loaded menthosomes could serve as a suitable vesicular delivery carrier in enhancing the transdermal delivery of other NSAID drugs.

Anti-psoriatic characteristics of ROCEN (topical Arthrocen) in comparison with Cyclosporine A in a murine model

Topical ROCEN (Roc), liposomal arthrocen hydrogel, is a robust anti-inflammatory formulation which has been developed for skin diseases such as eczema. Therefore, we aimed to evaluate the efficacy of Roc 2% on the healing of imiquimod (Imiq)-induced psoriasis in a mouse model. Psoriasis was induced by applying Imiq topically to the mice's back skin once daily for five consecutive days. Moreover, a group of animal experiments was treated with Cyclosporine A (CsA), as a standard drug, for comparison with Roc treated group. The efficacy of Roc on skin lesions was evaluated by employing Psoriasis Area and Severity Index (PASI) scores. Subsequently, the skin samples were assessed using Baker's scoring system and Masson's trichrome staining, immunohistochemistry, and real-time PCR analysis. The observational and histopathological results indicated that topical application of Roc significantly reduced the PASI and Baker's scores in the plaque-type psoriasis model. Moreover, biochemical assessments showed that Roc suppressed significantly the increase of IL-17, IL-23, and TNF-α cytokines gene expression in the lesion site of psoriatic animals. In conclusion topical Roc 2% could significantly alleviate major pathological aspects of Imiq-induced psoriasis through inflammation inhibition which was comparable to the CsA drug. The beneficial outcomes of Roc application in the psoriasis model suggest its potential usage in complementary medicine.

In vitro study of nanoliposomes containing curcumin and doxycycline for enhanced antimicrobial photodynamic therapy against Aggregatibacter actinomycetemcomitans

The excessive inappropriate use of systemic antibiotics has contributed to the emergence of antibiotic-resistant pathogens, which pose a significant risk to the success of treatment. This study has approached this problem by developing doxycycline-loaded liposome doped with curcumin (NL-Cur^+Dox) for combination antibacterial therapy against Aggregatibacter actinomycetemcomitans. The characterization of formulation revealed encapsulation of both drugs in NL-Cur^+Dox with an average size of 239 nm and sustained release behavior. Transmission electron microscopy analysis confirmed the vesicular-shaped nanocarriers without any aggregation or crystallization. The cytotoxic and hemolytic activities of NL-Cur^+Dox were evaluated. The anti-biofilm and anti-metabolic effects of NL-Cur^+Dox -mediated antimicrobial photodynamic therapy (aPDT) were examined. The data indicated that NL-Cur^+Dox -mediated aPDT led to a significant reduction of biofilm (82.7%, p = 0.003) and metabolic activity (75%, p < 0.001) of A. actinomycetemcomitans compared to the control. NL-Cur^+Dox had no significant cytotoxicity to human gingival fibroblast cells under selected conditions (p = 0.074). In addition, the hemolytic activity of NL-Cur^+Dox were negligible (< 5%). These findings demonstrate the potential application of such potent formulations in reducing one of the main bacteria causing periodontitis where the NL-Cur^+Dox could be exploited to achieve an improved phototherapeutic efficiency.

Nanomedicine and regenerative medicine approaches in osteoarthritis therapy

Osteoarthritis (OA), the most common chronic joint disease, is a degenerative disease that affects 7% of the worldwide population, more than 500 million people all over the world. OA is the main factor of disability in elderly people which decreases the quality of life of patients. It is characterized by joint pain, low bone density, and deterioration of the joint structure. Despite ongoing novel advances in drug discovery and drug delivery, OA therapy is still a big challenge since there is no available effective treatment and the existing therapies mainly focus on pain and symptomatic management rather than improving and/or suppressing its progression. This review aims to summarize the currently available and novel emerging therapies for OA including regenerative medicine and nanotechnology-based materials and formulations at the clinical and experimental levels. Applications of regenerative medicine and novel technologies such as nanotechnology in OA treatments have opened a new window to support OA patients by offering treatments that could halt or delay OA progression satisfactorily or provide an effective cure in near future. Nanomedicine and regenerative medicine suggest novel alternatives in the regeneration of cartilage, repair of bone damage, and control of chronic pain in OA therapy.

Joint Dysfunctionality Alleviation along with Systemic Inflammation Reduction following Arthrocen Treatment in Patients with Knee Osteoarthritis: A Randomized Double-Blind Placebo-Controlled Clinical Trial

Background and objectives: Many mediators and cytokines are involved in the pathogenesis of osteoarthritis (OA). Some of these cytokines are spontaneously expressed by cultured fibroblast-like synoviocytes. Therefore, using serum samples, the efficacy and the effects of avocado/soy unsaponifiables, ASU, (Arthrocen) on cytokine changes were assessed in patients with knee OA (KOA). Materials and Methods: Experimental procedure: A randomized, double-blind, placebo-controlled clinical trial was conducted on patients with a diagnosis of mild to moderate OA who received either Arthrocen 300 mg/day (n = 61) or placebo (n = 58) for 3 months. Data collection was performed using questionnaires including the Western Ontario and McMaster Universities osteoarthritis index (WOMAC), 20-item short form survey (SF-20), Lequesne index of severity for osteoarthritis of the knee (LISOK), and three visual analog scales (VASs) as pain quality indices. The serum levels of interleukins 2 (IL-2), IL-4, IL-10, IL-17α, and TNF-α were measured using an ELISA reader. Results: Both quality of life indices, pain sensation and scored by specialists (as VASs), respectively, including WOMAC and SF-20, as well as joint dysfunctionality symptoms assessed by physicians were significantly improved (p < 0.05) in OA patients receiving Arthrocen. The serum levels of anti-inflammatory interleukins 4 and 10 were also augmented, while levels of inflammatory IL-17 and TNF-ɑ cytokines were decreased significantly (p < 0.05) compared with the control groups during the 3- and 6-month treatment. Conclusions: Arthrocen consumption may increase the quality of life in OA patients through amelioration of inflammation and improvement of functional activities without any adverse effects in the long term.

Beneficial effects of ROCEN (Topical Nano-arthrocen) on atopic dermatitis in mice

Objective

Atopic dermatitis (AD) is a chronic inflammatory skin disease mainly caused by immune stimuli. The current study was conducted to investigate the effects of ROCEN and to compare it with betamethasone (Beta) on mice subjected to AD.

Methods

First, the safety of topical ROCEN was tested to determine possible sensitization induction in vivo. Then, the mice were subjected to oxazolone (Oxa) to induce chronic AD. Consequently, they underwent treatment with ROCEN and Beta. Scratching and wiping behaviors related to dermatitis were evaluated in treated animals for 35 days. The histopathology and immunohistochemistry (IHC) analysis of interleukin-8 (IL-8) and tumor necrosis factor-α (TNF-α) cytokines were performed on the dorsal skin of the treated mice.

Results

Topical administration of ROCEN and Beta to the dorsum of sensitized mice for 5 weeks significantly alleviated scratching and wiping symptoms and reduced erythema, scaling, and edema in the skin of the mice with AD. Moreover, histological indices showed that ROCEN effectively reduced leucocyte infiltration and improved skin healing parameters in treated AD mice. Application of ROCEN or Beta reduced IHC markers including IL-8 and TNF-α significantly.

Conclusion

ROCEN alleviated the AD symptoms similar to betamethasone in an experimental animal model.

Avocado/soy unsaponifiables can redress the balance between serum antioxidant and oxidant levels in patients with osteoarthritis: a double-blind, randomized, placebo-controlled, cross-over study

OBJECTIVES

Osteoarthritis (OA) is an inflammatory disorder of the joint characterized by pain and stiffness. Oxidative stress plays an important role in pathogenesis of OA. We aimed to evaluate the effects of avocado/soy unsaponifiables (ASU) compound on serum antioxidant and oxidative stress in patients with Osteoarthritis.

METHODS

A double-blind, randomized, placebo-controlled, cross-over trial was performed. Fourty patients with osteoarthritis were randomized to two different sequences: 1) DP: received ASU for three months followed by three months placebo, 2) PD: received placebo for the first three months followed by three months ASU. The oxidant statue was evaluated by measurement of serum malonldialdehyde (MDA). The total antioxidant capacity (TAC), reduced glutathione (GSH) and antioxidant enzymes such as superoxide dismutase (SOD) and catalase (CAT) were also assessed.

RESULTS

Mean serum of MDA level as a marker of oxidative stress significantly decreased in all patients after three months treatment with ASU (4.46 ± 0.11 nmol/L) compare with baseline and placebo levels (5 ± 0.15 and 5.82 ± 0.12 nmol/L respectively) (p<0.05). On the other hand, ASU resulted in positive changes in serum antioxidant levels (p<0.05). Mixed-effects model of variance analyses showed that ASU effect is regardless of the order of receiving medication (p>0.05).

CONCLUSIONS

These data showed that Avocado/Soy Unsaponifiable can be an effective supplement in treatment of osteoarthritis through the control of the balance between antioxidant and oxidant molecular markers.

Meloxicam emulgels for topical management of rheumatism: Formulation development, in vitro and in vivo characterization

Purpose

The study designed, formulated and evaluated meloxicam emulgels as a potential alternative topical treatment option for rheumatism.

Methods

A 3² factorial design was employed to formulate nine preliminary meloxicam emulgels (Formulations F1 - F9). The influences of carbopol-934 and menthol as gelling agent and drug release enhancer, respectively, were correlated with four pharmaceutical properties of the formulated emulgels namely viscosity, spreadability, and cumulative drug release at one hour and at eight hours. Using the generated data and applying the Design Expert® modelling software, two optimized meloxicam emulgels (Formulations F10 and F11) were designed, formulated and evaluated. In vivo anti-inflammatory efficacy was conducted using carrageenan-induced rat paw oedema method. Drug release kinetics was modelled using DDSolver® dissolution software.

Results

All formulations were homogenous with no observable grittiness or phase separation. The optimized Formulations F10 and F11 had pH 6.5 and 6.4, viscosity of 23656 and 24524 mPa.s, spreadability of 9.9 and 9.5 cm, and drug content of 90.4% and 92.9%, respectively, all within optimal values. The cumulative percentage of drug released was 21.0% and 22.9% after one hour and 50.1% and 55.8% after eight hours for Formulations F10 and F11, respectively. Drug release kinetics exhibited Fickian diffusion best described by Korsmeyer-Peppas model. Paw volume inhibition by Formulation F11 at two and three hours after carrageenan injection was statistically significant (p < 0.05).

Conclusion

The optimized meloxicam emulgels had high pharmaceutical quality and were pharmacologically active. Further optimization could potentially provide a safe and efficacious alternative treatment option for rheumatism.

Antinociceptive and Anti-Inflammatory Properties of Cannabidiol Alone and in Combination with Standardized Bioflavonoid Composition

Symptom-alleviating therapies for osteoarthritis (OA) management are inadequate. Long-term application of first-line treatments, such as nonsteroidal anti-inflammatory drugs, is limited due to associated side effects. We believe that a combination of traditionally used botanical extracts, which have diverse active components that target multiple inflammatory pathways, may provide a safe and efficacious alternative to address the multifactorial nature of OA. Recently, cannabidiol (CBD), the major nonpsychoactive component of the hemp plant, has gained renewed global attention for its pharmacological actions. It has shown promise in reducing pain and inflammation in preclinical models of arthritis. In this study, widely employed inflammatory and noninflammatory animal pain models, such as the hot plate test, visceral pain model (writhing test), and carrageenan-induced rat paw edema model, were utilized to evaluate the antinociceptive and anti-inflammatory activity of CBD alone and in combination with standardized bioflavonoid compositions. CBD was tested at 5, 10, 20, and 40 mg/kg orally and at 5% topically. Administered alone, CBD produced dose-correlated, statistically significant pain inhibition in all the models. Enhanced performance in pain and inflammation reduction was observed when CBD was orally administered in complex with the bioflavonoid compositions. Data from this study show that for clinically meaningful efficacy against OA, CBD may have to be delivered in higher dosage or formulated with other medicinal plants with similar activities.

pH-responsive and hyaluronic acid-functionalized metal-organic frameworks for therapy of osteoarthritis

Drug therapy of osteoarthritis (OA) is limited by the short retention and lacking of stimulus-responsiveness after intra-articular (IA) injection. The weak acid microenvironment in joint provides a potential trigger for controlled drug release systems in the treatment of OA. Herein, we developed an pH-responsive metal − organic frameworks (MOFs) system modified by hyaluronic acid (HA) and loaded with an anti-inflammatory protocatechuic acid (PCA), designated as MOF@HA@PCA, for the therapy of OA. Results demonstrated that MOF@HA@PCA could smartly respond to acidic conditions in OA microenvironment and gradually release PCA, which could remarkably reduce synovial inflammation in both IL-1β induced chondrocytes and the OA joints. MOF@HA@PCA also down-regulated the expression of inflammatory markers of OA and promoted the expression of cartilage-specific makers. This work may provide a new insight for the design of efficient nanoprobes for precision theranostics of OA.

Metformin loaded phosphatidylserine nanoliposomes improve memory deficit and reduce neuroinflammation in streptozotocin-induced Alzheimer's disease model

Alzheimer's disease (AD) is closely associated with neuroinflammation development in the brain. Co-delivery of metformin (MET) with phosphatidylserine liposomes neuroprotectant may be beneficial in ameliorating AD-related symptoms like memory impairment and inflammation. Therefore, we aimed to prepare metformin containing phosphatidylserine nanoliposomes formulation (MET-PSL) and to evaluate its effect on rats subjected to AD. Alzheimer's disease model was induced by bilateral intracerebroventricular injection of streptozotocin (3 mg/kg) into rat brains using the stereotactic technique. MET-PSL, MET, and PSL alone were administered intraperitoneally to AD-induced animals and factors including learning and memory storage in addition to cytokine and tissue inflammatory changes were evaluated after a 22-day experiment period. The learning and memory parameters significantly (P < 0.05) improved in AD-rats treated with MET-PSL. Moreover, MET-PSL administration significantly (P < 0.05) decreased cytokine levels of IL1-β, TNF-α, and TGF-β in hippocampal tissues of rats with AD. Histological results indicated a considerable reduction in inflammatory and necrotic neural cells along with significantly (P < 0.05) increased neurogenesis in MET-PSL treated rats. Furthermore, our results showed that MET-PSL formulation could potentially act better than the free form of MET and PSL alone in the recovery process of rats with AD. In general, our data suggest that combination therapy of metformin loaded phosphatidylserine liposomes may enhance the therapeutic performance in AD patients of a clinical study.

Evaluation of ROCEN on Burn Wound Healing and Thermal Pain: Transforming Growth Factor-β1 Activation

The present study aimed to evaluate the effect of liposomal arthrocen 2% (ROCEN) on the healing of burn wound and pain alleviation of thermal stimuli in a rat model of the second-degree burn. The results showed that ROCEN formulation significantly improved the main parameters of burn wound healing in a short period of time (7 days). The percentage of wound surface was also reduced significantly compared with the control group following once daily application of ROCEN for 14 days. The level of TGF (transforming growth factor)-β1 cytokine was also elevated significantly in the burn tissue treated with ROCEN almost the same as zinc oxide cream. Also, ROCEN showed a significant analgesic effect evaluated by 2 models of acute thermal pain, tail-flick and hotplate tests, which suggested that the formulation may act as a pain reliever in burn injuries. In conclusion, the application of the topical formulation of ROCEN may have benefits in the acceleration of the wound healing process and alleviation of the pain due to burn injuries.