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Khrieba MO, Hegazy SK, Mohammed WF, El-Haggar SM. Clinical study to investigate the adjuvant role of Pentoxifylline in patients with Parkinson's disease: A randomized controlled study. Int Immunopharmacol 2025; 156:114689. [PMID: 40253769 DOI: 10.1016/j.intimp.2025.114689] [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: 01/26/2025] [Revised: 04/14/2025] [Accepted: 04/15/2025] [Indexed: 04/22/2025]
Abstract
BACKGROUND Parkinson's disease (PD) is a common neurodegenerative disease characterized by the loss of dopaminergic neurons in the par's compacta of the substantia nigra. A lot of studies have since been carried out on the neuroinflammation linked to the pathophysiology of PD, including elevated levels of proinflammatory cytokines. Preclinical studies proved the efficacy of pentoxifylline (PTX) in PD. AIM To assess the neuroprotective and anti-inflammatory effects of PTX in patients with PD. METHODS Sixtytwo Patients were randomly assigned to two groups (n1 = 30, and n2 = 32); the PTX group received conventional treatment for Parkinson's disease, levodopa/carbidopa, plus PTX 400 mg twice daily, whereas the control group received conventional treatment only. Every patient was assessed by a neurologist both at the start of treatment and six months thereafter. Every patient is evaluated using the Unified Parkinson's disease rating scale (UPDRS). Adenosine monophosphate activated protein kinase (AMPK), reduced glutathione (GSH), high mobility group box protein (HMGB1), and mammalian target of rapamycin (mTOR) were measured both before and after therapy. The statistical analysis within and between groups was evaluated using direct and indirect t-tests, respectively. RESULTS The PTX group revealed a statistically significant decrease in the level of assessed variables as followed: mTOR (p = 0.037), HMGB-1 (p = 0.029), and a significant increase in GSH (p = 0.016) and AMPK (p = 0.027), when compared to the control group. Additionally, the PTX group had a significantly reduced UPDRS. (p < 0.05). CONCLUSION PTX may be suggested as a promising adjuvant anti-inflammatory medication for Parkinson's disease treatment. CLINICAL TRIAL IDENTIFIER NCT05962957.
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Affiliation(s)
- Mohannad O Khrieba
- Pharmacy Practice Department, Faculty of Pharmacy, Horus University, New Damietta, Egypt.
| | - Sahar K Hegazy
- Pharmacy Practice Department, Faculty of Pharmacy, Horus University, New Damietta, Egypt; Clinical Pharmacy Department, Faculty of Pharmacy, Tanta University, El-Guiesh Street, El-Gharbia Government, Tanta 31527, Egypt
| | | | - Sahar M El-Haggar
- Clinical Pharmacy Department, Faculty of Pharmacy, Tanta University, El-Guiesh Street, El-Gharbia Government, Tanta 31527, Egypt
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Iciek M, Bilska-Wilkosz A, Górny M, Bednarski M, Zygmunt M, Miller A, Nicosia N, Lombardo GP, Zammit P, Kotańska M. The Effect of Disulfiram and N-Acetylcysteine, Potential Compensators for Sulfur Disorders, on Lipopolysaccharide-Induced Neuroinflammation Leading to Memory Impairment and the Metabolism of L-Cysteine Disturbance. Molecules 2025; 30:578. [PMID: 39942681 PMCID: PMC11820383 DOI: 10.3390/molecules30030578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2024] [Revised: 01/20/2025] [Accepted: 01/24/2025] [Indexed: 02/16/2025] Open
Abstract
BACKGROUND The role of sulfur-containing drugs, disulfiram (DSF) and N-acetylcysteine (NAC), in alleviating neuroinflammation is poorly understood. The objective of this study was to examine the effect of DSF and NAC on memory and on the metabolism of L-cysteine and inflammation-related parameters in the cerebral cortex of rats in a model of neuroinflammation induced by the administration of lipopolysaccharide (LPS). METHODS All the treatments were administered intraperitoneally for 10 days (LPS at a dose of 0.5 mg/kg b.w., DSF at a dose of 100 mg/kg b.w, and NAC at a dose of 100 mg/kg b.w.). Behavior was evaluated by the novel object recognition (NOR) test and object location (OL) test, and the level of brain-derived neurotrophic factor (BDNF) was assayed to evaluate neuronal functioning. Cerebral cortex homogenates were tested for hydrogen sulfide (H2S), sulfane sulfur, sulfates, non-protein sulfhydryl groups (NPSH), nitric oxide (NO), and reactive oxygen species (ROS) by biochemical analysis. RESULTS Neither DSF nor NAC alleviated LPS-induced memory disorders estimated by the NOR test and OL test. The studied compounds also did not affect significantly the levels of BDNF, ROS, NO, H2S, and sulfane sulfur in the cerebral cortex. However, we observed an increase in sulfate concentration in brain tissues after LPS treatment, while DSF and NAC caused an additional increase in sulfate concentration. On the other hand, our study showed that the administration of DSF or NAC together with LPS significantly enhanced the cortical level of NPSH, of which glutathione is the main component. CONCLUSIONS Our study did not confirm the suggested potential of DSF and NAC to correct memory disorders; however, it corroborated the notion that they reduced oxidative stress induced by LPS by increasing the NPSH level. Additionally, our study showed an increase in sulfate concentration in the brain tissues after LPS treatment, which means the upregulation of sulfite and sulfate production in inflammatory conditions.
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Affiliation(s)
- Małgorzata Iciek
- Chair of Medical Biochemistry, Jagiellonian University Medical College, Kopernika 7, PL 31-034 Cracow, Poland; (M.I.); (A.B.-W.); (M.G.)
| | - Anna Bilska-Wilkosz
- Chair of Medical Biochemistry, Jagiellonian University Medical College, Kopernika 7, PL 31-034 Cracow, Poland; (M.I.); (A.B.-W.); (M.G.)
| | - Magdalena Górny
- Chair of Medical Biochemistry, Jagiellonian University Medical College, Kopernika 7, PL 31-034 Cracow, Poland; (M.I.); (A.B.-W.); (M.G.)
| | - Marek Bednarski
- Department of Pharmacological Screening, Jagiellonian University Medical College, Medyczna 9, PL 30-688 Cracow, Poland; (M.B.); (M.Z.); (A.M.); (P.Z.)
| | - Małgorzata Zygmunt
- Department of Pharmacological Screening, Jagiellonian University Medical College, Medyczna 9, PL 30-688 Cracow, Poland; (M.B.); (M.Z.); (A.M.); (P.Z.)
| | - Anthea Miller
- Department of Pharmacological Screening, Jagiellonian University Medical College, Medyczna 9, PL 30-688 Cracow, Poland; (M.B.); (M.Z.); (A.M.); (P.Z.)
- Department of Veterinary Sciences, University of Messina, 98168 Messina, Italy
| | - Noemi Nicosia
- PhD Program in Neuroscience, School of Medicine and Surgery, University of Milano-Bicocca, 20900 Monza, Italy;
- School of Medicine and Surgery, University of Milano-Bicocca, 20900 Monza, Italy
| | - Giorgia Pia Lombardo
- Department of Chemical, Biological, Pharmaceutical and Environmental Sciences, University of Messina, Viale Ferdinando Stagno d’Alcontres 31, 98166 Messina, Italy;
| | - Paula Zammit
- Department of Pharmacological Screening, Jagiellonian University Medical College, Medyczna 9, PL 30-688 Cracow, Poland; (M.B.); (M.Z.); (A.M.); (P.Z.)
- Department of Pharmacy, Faculty of Medicine and Surgery, University of Malta, MSD 2080 Msida, Malta
| | - Magdalena Kotańska
- Department of Pharmacological Screening, Jagiellonian University Medical College, Medyczna 9, PL 30-688 Cracow, Poland; (M.B.); (M.Z.); (A.M.); (P.Z.)
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Muhsen M, Alzoubi KH, Khabour OF, Mhaidat N, Rababa'h A, Ali S, Jarab A, Salim S. Pentoxifylline protects memory performance in streptozotocin-induced diabetic rats. Brain Res 2025; 1847:149319. [PMID: 39528094 DOI: 10.1016/j.brainres.2024.149319] [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: 09/09/2024] [Revised: 10/18/2024] [Accepted: 11/07/2024] [Indexed: 11/16/2024]
Abstract
Diabetes, characterized by elevated blood glucose levels and associated organ damage, is reportedly correlated with adecline in cognitive functions with a potential involvement of oxidative stress mechanisms. Mitochondria-induced oxidative stress reported to cause hyperglycemia is believed to impair hippocampal neural plasticity, affecting long-term potentiation, and isconsidered crucial for maintaining memory functions. In this study, the neuroprotective effect of Pentoxifylline (PTX) for four weeks, an agent known for antioxidant and anti-inflammatory properties, was examined in an animal model of diabetes. In a streptozotocin (STZ) diabetic model, rats received intraperitoneal PTX (100 mg/kg), and learning and memory functions were tested using the radial arm water maze. STZ-treated diabetic rats exhibited impaired learning and memory functions (short/long-term, P < 0.05), whereas PTX treatment prevented these deficits. PTX treatment normalized diabetes-induced reduction in the protein expression levels of two enzymes of antioxidant defense superoxide dismutase and glutathione peroxidase (P < 0.05) in the hippocampal brain tissues. PTX treatment also mitigated STZ-induced increase in lipid peroxidation (TBARS, P < 0.05). Furthermore, reduced/oxidized glutathione (GSH/GSSG) ratios were enhanced in PTX-treated diabetic rats (P < 0.05), emphasizing the importance of redox balance restoration. However, PTX treatment did not significantly affect theantioxidant defense enzyme catalase activity. In conclusion, STZ-induced diabetes resulted in learning and memory impairment in rats, while PTX treatment prevented these effects, most likely via enhancement of antioxidant defense in the brain. This study highlights PTX's potential neuroprotective benefits, providing translational insights into the issue of diabetes-related cognitive complications.
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Affiliation(s)
- Maram Muhsen
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - Karem H Alzoubi
- Department of Pharmacy Practice and Pharmacotherapeutics, University of Sharjah, Sharjah, United Arab Emirates; Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan.
| | - Omar F Khabour
- Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid, Jordan
| | - Nizar Mhaidat
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - Abeer Rababa'h
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - Shirin Ali
- Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - Anan Jarab
- Department of Pharmaceutical Sciences, College of Pharmacy, Al Ain University, Abu Dhabi, United Arab Emirates; AAU Health and Biomedical Research Center, Al Ain University, Abu Dhabi, United Arab Emirates; Department of Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - Samina Salim
- Department of Pharmacological & Pharmaceutical Sciences, College of Pharmacy, University of Houston, Houston, USA
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Elseweidy MM, Mahrous M, Ali SI, Shaheen MA, Younis NN. Pentoxifylline as Add-On Treatment to Donepezil in Copper Sulphate-Induced Alzheimer's Disease-Like Neurodegeneration in Rats. Neurotox Res 2023; 41:546-558. [PMID: 37821782 PMCID: PMC10682165 DOI: 10.1007/s12640-023-00672-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 09/21/2023] [Accepted: 09/27/2023] [Indexed: 10/13/2023]
Abstract
Alzheimer's disease (AD), the most common neurodegenerative disorder, is characterized by behavioral, cognitive, and progressive memory impairments. Extensive neuronal loss, extracellular accumulation of insoluble senile amyloid-β (Aβ) plaques, and intracellular neurofibrillary tangles (NFTs) are the major pathological features. The present study aimed to investigate the therapeutic effect of donepezil (DON) and pentoxifylline (PTX) in combination to combat the neurodegenerative disorders (experimental AD) induced by CuSO4 intake in experimental rats. Thirty adult male Wistar rats (140-160 g) were used in this study. AD was first induced in rats by CuSO4 supplement to drinking water (10 mg/L) for 14 weeks. The AD group received no further treatment. Oral treatment with DON (10 mg/kg/day), PTX (100 mg/kg/day), or DON + PTX for the other three groups was started from the 10th week of CuSO4 intake for 4 weeks. Cortex markers like acetylcholine (ACh), acetylcholinesterase (AChE), total antioxidant capacity (TAC), and malondialdehyde (MDA) and hippocampus markers like β-amyloid precursor protein cleaving enzyme 1 (BACE1), phosphorylated Tau (p-tau), Clusterin (CLU), tumor necrosis factor-α (TNF-α), caspase-9 (CAS-9), Bax, and Bcl-2 were measured. The histopathology studies were done by using hematoxylin and eosin and Congo red stains as well as immunohistochemistry for neurofilament. CuSO4 induced adverse histological and biochemical changes. The histological injury in the hippocampus was inhibited following the administration of the DON and PTX. The brain tissue levels of AChE, MDA, BACE1, p-tau, CLU, CAS-9, Bax, and TNF-α were significantly increased, while brain tissue levels of ACh, TAC, and Bcl-2 were significantly decreased in CuSO4-treated rats as compared with the untreated control group. The effects induced by either DON or PTX on most studied parameters were comparable. Combined treatment of DON and PTX induced remarkable results compared with their individual use. However, more clinical and preclinical studies are still required to further confirm and prove the long-term efficacy of such combination.
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Affiliation(s)
- Mohamed M Elseweidy
- Department of Biochemistry, Faculty of Pharmacy, Zagazig University, Zagazig, 44519, Egypt.
| | - Mohamed Mahrous
- Department of Biochemistry, Faculty of Pharmacy, Port-Said University, Port-Said, 42526, Egypt
| | - Sousou I Ali
- Department of Biochemistry, Faculty of Pharmacy, Zagazig University, Zagazig, 44519, Egypt
| | - Mohamed A Shaheen
- Department of Histology and Cell Biology, Faculty of Human Medicine, Zagazig University, Zagazig, 44519, Egypt
| | - Nahla N Younis
- Department of Biochemistry, Faculty of Pharmacy, Zagazig University, Zagazig, 44519, Egypt
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Fan Z, Bin L. Will Sirtuin 2 Be a Promising Target for Neuroinflammatory Disorders? Front Cell Neurosci 2022; 16:915587. [PMID: 35813508 PMCID: PMC9256990 DOI: 10.3389/fncel.2022.915587] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 05/30/2022] [Indexed: 11/13/2022] Open
Abstract
Neuroinflammatory disorder is a general term that is associated with the progressive loss of neuronal structure or function. At present, the widely studied diseases with neuroinflammatory components are mainly divided into neurodegenerative and neuropsychiatric diseases, namely, Alzheimer’s disease, Parkinson’s disease, depression, stroke, and so on. An appropriate neuroinflammatory response can promote brain homeostasis, while excessive neuroinflammation can inhibit neuronal regeneration and damage the central nervous system. Apart from the symptomatic treatment with cholinesterase inhibitors, antidepressants/anxiolytics, and neuroprotective drugs, the treatment of neuroinflammation is a promising therapeutic method. Sirtuins are a host of class III histone deacetylases, that require nicotinamide adenine dinucleotide for their lysine residue deacetylase activity. The role of sirtuin 2 (SIRT2), one of the sirtuins, in modulating senescence, myelin formation, autophagy, and inflammation has been widely studied. SIRT2 is associated with many neuroinflammatory disorders considering it has deacetylation properties, that regulate the entire immune homeostasis. The aim of this review was to summarize the latest progress in regulating the effects of SIRT2 on immune homeostasis in neuroinflammatory disorders. The overall structure and catalytic properties of SIRT2, the selective inhibitors of SIRT2, the relationship between immune homeostasis and SIRT2, and the multitasking role of SIRT2 in several diseases with neuroinflammatory components were discussed.
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Affiliation(s)
- Zhang Fan
- Beijing Key Laboratory of Basic Research With Traditional Chinese Medicine (TCM) on Infectious Diseases, Beijing Institute of Chinese Medicine, Beijing Hospital of TCM, Capital Medical University, Beijing, China
| | - Li Bin
- Beijing Key Laboratory of Acupuncture Neuromodulation, Acupuncture and Moxibustion Department, Beijing Hospital of TCM, Capital Medical University, Beijing, China
- *Correspondence: Li Bin,
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