A Single Oral Dose of Diclofenac Causes Transition of Experimental Subclinical Acute Kidney Injury to Chronic Kidney Disease

Introducing a passively targeted formulation of diclofenac potassium for application in endodontics to minimize renal and gastrointestinal side effects

This research aims to formulate, evaluate, and conduct a clinical investigation of mucoadhesive buccal discs of diclofenac potassium (DP) for application in endodontics to minimize side effects, mainly renal and gastrointestinal. The discs were compressed directly utilizing bioadhesive polymers like hydroxypropyl methylcellulose K4M (HPMC K4M), sodium carboxymethyl cellulose (NaCMC), Carbopol 934 (Cp934), methylcellulose (MC) and combinations of these polymers. In-vitro, release studies and ex-vivo and in-vivo determination of bioadhesion time were conducted. The selected formula was sealed on one surface with ethyl cellulose to allow unidirectional drug release. It was evaluated for permeation through the chicken pouch membrane in the absence and presence of permeation enhancers. The formula of choice (F3) containing methyl cellulose was further assessed for the swelling index, bioadhesion strength, hardness, friability, surface pH, in-vivo bioadhesion performance, and storage effect under ambient and accelerated conditions. It showed drug release of 99 % ± 1 in 2 h, permeation flux (Jss) of 3.5 ± 1.6 mg cm-2 h-1, and bioadhesion time of 4 ± 0.5 h without bitterness, irritation, or fragmentation. The introduced 25 mg DP bioadhesive disc formulation F3 was then clinically compared with the marketed 50 mg oral Cataflam® tablets regarding the effect of single-dose pretreatment in endodontic procedures of subjects with symptomatic irreversible pulpitis (SIP) through a randomized clinical trial. No significant difference was detected in all evaluated clinical criteria. This proves clinical efficiency with the advantage of half-dose administration and targeted localized effect leading to minimized renal and gastrointestinal side effects.

The protective effect of Chlorella vulgaris against diclofenac toxicity in Clarias gariepinus: haemato-immunological parameters and spleen histological features as outcome markers

Introduction

Diclofenac (DCF) is a commonly utilized medication in the non-steroidal anti-inflammatory drug category that is released into aquatic systems in significant amounts. Chlorella vulgaris (C. vulgaris) is rich in active phytochemicals known for their haemato-immunological boosting properties.

Methods

Our objective was to investigate the haemato-immunological protective properties of Chlorella in mitigating the toxic effects of DCF. Five groups of Clarias gariepinus, each comprising 36 fish, were assigned over a two-week period. The groups were assigned as follows: control group, which received a basal diet only; DCF1 group, which received a basal diet and was exposed to 20 μg/L of DCF; DCF2 group, which received a basal diet and was exposed to 10 mg/L of DCF; and Chlorella +DCF1 and Chlorella+DCF2 groups, which were exposed to the same DCF doses as Groups 2 and 3, respectively, while also being fed a diet containing 25% Chlorella.

Results

Exposure to both doses of DCF significantly decreased erythrocyte count, hemoglobin content, white blood cell count, phagocytic index, and lysozyme activity, while increased eosinophil and neutrophil % in an equipotent manner. The low dose caused a more pronounced reduction in packed cell volume (PCV)% and large lymphocyte% compared to the high dose. A significant decline in platelet count was observed only with the low DCF dose, while the high dose led to a decrease in monocyte%. DCF intoxication led to a dose-related decrease in small lymphocyte% and an increase in erythrocyte morphological alterations and interleukin (IL)-6 levels. The DCF2 group exhibited a higher increase in apoptotic RBCs than the DCF1 group. Intervention with Chlorella alongside the two DCF doses significantly normalized RBC count and eosinophil %, increased PCV% and small lymphocyte%, and decreased erythrocyte abnormalities to an equal extent. Large lymphocyte% in the Chlorella+DCF1 group was successfully restored to normal levels. Phagocytic index and lysozyme activity in the supplemented groups were lower, while IL-6 levels were higher than in the DCF groups. The percentage of apoptotic cells decreased with Chlorella administration, with the Chlorella+DCF1 group showing fewer apoptotic cells than the Chlorella+DCF2 group. Histopathological deterioration and excessive collagen deposition were observed in the spleen of DCF groups, while notable improvements were seen following C. vulgaris supplementation.

Conclusion

These findings suggest that dietary inclusion of C. vulgaris may antagonize the haemato-cytological abnormalities induced by DCF intoxication.

Cultivable bacteria contribute to the removal of diclofenac and naproxen mix in a constructed wetland with Typha latifolia

Constructed wetlands are used to remove diclofenac and naproxen from wastewater. However, the role of plants and their root-associated bacteria in removing these pharmaceuticals is still unknown. In this work, bacteria were isolated from the roots of Typha latifolia cultivated in a constructed wetland to treat a diclofenac and naproxen mix. 16S rDNA sequencing indicated that bacterial isolates belong to the Pseudomonas, Serratia, and Rahnella genera. All bacterial isolates showed tolerance to high concentrations of diclofenac and naproxen and had differential laccase activity, phosphate-solubilizing activity, and indole acetic acid production.Bacteria were grouped into three consortia A (0-30 cm), B (50-80 cm), and C (100-130 cm), according to the site from which they were isolated in the wetland. Plant-bacteria interaction assays were conducted to determine the removal capacity of diclofenac and naproxen mix by the bacterial consortia or their interaction with T. latifolia. The results showed that all bacterial consortia removed over 50% of diclofenac and naproxen, while in their interaction with T. latifolia the removal capacity increased to over 70%. Consortium B was the most efficient in removing diclofenac and naproxen, with removal rates of 63.85 ± 0.45% and 74.93 ± 0.75%, respectively. Meanwhile, in the interaction of consortium B with T. latifolia, the removal of diclofenac and naproxen increased to 82.27 ± 0.30% and 88.12 ± 1.23%, respectively. Overall, the results indicated that T. latifolia and its root-associated bacteria removed the diclofenac and naproxen mix in the constructed wetland, contributing to understanding the role of the plant and bacteria in removing emerging contaminants. Therefore, the interaction of T. latifolia and its root-associated bacteria could potentially be used in strategies to remove emerging contaminants from wastewater.

Characterization of Diclofenac-induced Renal Damage in Normotensive and Hypertensive Rats: A Comparative Analysis

BACKGROUND

Diclofenac is the non-steroidal anti-inflammatory drug (NSAID) mostly prescribed worldwide, but it is highly associated with hypertension and acute kidney injury. Despite that, little information is available about the renal effects of diclofenac in hypertensive individuals, which led us to carry out this comparative study between the renal effects of this NSAID in normotensive (NTR) and spontaneously hypertensive rats (SHR).

METHODS

Male Wistar NTR and SHR were orally treated with vehicle (V: 10 mL/kg) or diclofenac sodium (D: 100 mg/kg) once a day for 3 days. Urine volume, electrolytes excretion (Na+, K+, Cl-, and Ca2+), urea, creatinine, pH, and osmolarity were evaluated. Furthermore, blood samples and renal tissue were collected to perform biochemical and histological analysis.

RESULTS

Diclofenac increased the renal corpuscle and bowman's space in the SHR, while no microscopic changes were observed in the renal tissue of NTR. Regarding the urinary parameters, diclofenac reduced urine volume, pH, osmolarity, and all electrolytes excretion, followed by decreased urea and creatinine levels in both lineages. Moreover, it also induced hyponatremia, hypokalemia, and hypocalcemia in SHR, while reduced glutathione-S-transferase activity, lipid hydroperoxides, and nitrite levels in renal tissue.

CONCLUSIONS

The data presented herein demonstrated that diclofenac induces renal damage and impaired renal function in both NTR and SHR, but those effects are exacerbated in SHR, as seen by the histological changes and electrolytes balance disturbance, therefore, reinforcing that diclofenac may increase the risks of cardiovascular events in hypertensive patients.

Proteomic analysis of the hepatic response to a pollutant mixture in mice. The protective action of selenium

Metals and pharmaceuticals contaminate water and food worldwide, forming mixtures where they can interact to enhance their individual toxicity. Here we use a shotgun proteomic approach to evaluate the toxicity of a pollutant mixture (PM) of metals (As, Cd, Hg) and pharmaceuticals (diclofenac, flumequine) on mice liver proteostasis. These pollutants are abundant in the environment, accumulate in the food chain, and are toxic to humans primarily through oxidative damage. Thus, we also evaluated the putative antagonistic effect of low-dose dietary supplementation with the antioxidant trace element selenium. A total of 275 proteins were affected by PM treatment. Functional analyses revealed an increased abundance of proteins involved in the integrated stress response that promotes translation, the inflammatory response, carbohydrate and lipid metabolism, and the sustained expression of the antioxidative response mediated by NRF2. As a consequence, a reductive stress situation arises in the cell that inhibits the RICTOR pathway, thus activating the early stage of autophagy, impairing xenobiotic metabolism, and potentiating lipid biosynthesis and steatosis. PM exposure-induced hepato-proteostatic alterations were significantly reduced in Se supplemented mice, suggesting that the use of this trace element as a dietary supplement may at least partially ameliorate liver damage caused by exposure to environmental mixtures.

Hepatoprotective and nephroprotective effects of Tessaria integrifolia Ruiz and Pav. on diclofenac-induced toxicity in rats

Background and Aim

Tessaria integrifolia Ruiz and Pav. (also known as "Pájaro bobo") is known for its medicinal properties, including antiulcer, antiasthmatic, leishmanicidal, antipyretic, antispasmodic, diuretic, anti-inflammatory, analgesic, and hepatoprotective effects. Therefore, we aimed to evaluate its hepatoprotective and nephroprotective effects using a rat model of diclofenac-induced toxicity.

Materials and Methods

We administered three different doses of the methanolic extract of T. integrifolia (100, 200, and 400 mg/kg/day orally) and compared them with the commercial medicine silymarin (100 mg/kg orally). The rats received the T. integrifolia extracts for 5 days, and on days 3 and 4, 1 h after receiving the extracts, diclofenac was administered intraperitoneally at a dose of 50 mg/kg. The animals were euthanized 48 h after the last diclofenac injection, and blood samples were obtained to measure biochemical parameters related to liver and kidney function, such as alanine aminotransferase (ALT), aspartate aminotransferase (AST), bilirubin, cholesterol, triglycerides, creatinine, and urea. Kidney and liver tissues were preserved in 10% formaldehyde and sent for histopathological analysis.

Results

The results show that T. integrifolia has hepatoprotective and nephroprotective effects. These effects are verified by the lower blood levels of ALT, AST, urea, and creatinine compared to the diclofenac group, which exhibited elevated biochemical parameters. In addition, histopathological analysis showed that the groups that received T. integrifolia did not display necrosis or infiltration, which were observed in the diclofenac group.

Conclusion

The methanolic extract of T. integrifolia has hepatoprotective and nephroprotective effects, with the highest protective activity observed at a dose of 400 mg/kg/day.

Hepatorenal protective activity of Artemisia against diclofenac toxicity in male rats

Introduction

Artemisia is one of the important alternative treatments for many diseases, as well as the prevention of the effect of oxidizing substances that cause damage to the various organs of the body, including the liver and kidneys. The kidney and the liver are considered the body's most critical organs, and their functions in storage, metabolism, detoxification and elimination of medications, and their metabolic products make them target structures for "drug-induced" harm. The goal of this investigation was to see if Artemisia extract might protect hepatic and renal tissues from diclofenac-induced damage.

Methods

a total of 40 adult Wistar rats were separated equally into four groups randomly. The rats of the control group got only distilled water orally without medicine or therapy, while those in the second group administrated 100mg/kg/day of Artemisia orally for one month. The third group received 10mg/kg/day of Diclofenac (DF) orally. The fourth group received 10mg/kg/day of DF and 100mg/kg day of Artemisia orally. After one month, kidney parameters (albumin, creatinine, and urea) and liver parameters (aspartate aminotransferase (AST), alanine aminotransferase (ALT), and alkaline phosphatase (ALP)) were measured.

Results

the results revealed increasing in the kidney (albumin, creatinine, and urea) parameters and liver parameters (AST, ALT, and ALP) in the group treated with diclofenac compared to the control group while they decreased significantly (p≤0.05) in diclofenac + Artemisia group comparing to diclofenac group.

Conclusion

we conclude from these results that Artemisia may have a role in reducing the toxic effect of diclofenac on kidney and liver by decreasing the liver enzymes and kidney criteria in the blood. The aim of the present study is to evaluate the role of Artemisia to reduce the toxic effect of diclofenac on liver and kidney.