Repercussion of nonsteroidal anti-inflammatory drugs on the gene expression of human osteoblasts

Localized and sustained delivery of indomethacin using poly(lactic-co-glycolic acid)-based microspheres to prevent traumatic heterotopic ossification

Traumatic heterotopic ossification (THO) is a pathological condition characterized by abnormal bone formation in non-skeletal tissues, commonly occurring after surgery or trauma. Current treatments, including non-steroidal anti-inflammatory drugs and surgery, are often hindered by adverse effects and high recurrence rates. In this study, we explore the potential of indomethacin-loaded PLGA microspheres (INDO-PLGA MPs) as a targeted therapeutic strategy for THO prevention. Through emulsifying solvent volatilization, sustained release of INDO was effectively achieved, with the 30% drug loading exhibiting optimal encapsulation efficiency and an ideal release profile. Cellular and animal experiments further confirm the excellent biocompatibility of INDO-PLGA MPs. In vitro and in vivo analyses revealed that these microspheres effectively inhibited osteogenic and chondrogenic differentiation, which are critical pathways driving the progression of THO. Notably, the 30% INDO-PLGA MPs exhibited optimal efficacy in reducing ectopic bone volume and delaying THO onset in a tenotomy and burn rat model. Collectively, our findings highlight the promising potential of PLGA microspheres in enhancing the localized and sustained delivery of INDO, providing effective prevention of THO and offering a transformative approach to its management.

Comparison of Two Synthesis Methods for 3D PLA-Ibuprofen Nanofibrillar Scaffolds

OBJECTIVES

This study aimed to synthesize polylactic acid (PLA) nanofibrillar scaffolds loaded with ibuprofen (IBU) using electrospinning (ES) and air-jet spinning (AJS). The scaffolds were evaluated for their physicochemical properties, drug release profiles, and biocompatibility to assess their potential for local analgesic applications.

METHODS

Solutions of 10% (w/v) PLA combined with IBU at concentrations of 10%, 20%, and 30% were processed into nanofibrillar membranes using ES and AJS. The scaffolds were characterized using scanning electron microscopy (SEM), differential scanning calorimetry (DSC), thermogravimetric analysis (TGA), and Fourier-transformed infrared (FT-IR) spectroscopy. The drug release profile was assessed by ultraviolet-visible spectrophotometry (UV-Vis), and cell adhesion and viability were evaluated using fibroblast culture assays. Statistical analyses included qualitative analyses, t-tests, and Likelihood ratio tests.

RESULTS

SEM revealed randomly arranged nanofibers forming reticulated meshes, with more uniform dimensions observed in the AJS group. TGA and DSC analyses confirmed the thermodynamic stability of the scaffolds and enthalpy changes consistent with IBU incorporation, which FT-IR and UV-Vis validated. Drug release was sustained over 384 h, showing no significant differences between ES and AJS scaffolds (p > 0.05). Cytotoxicity and cell viability assays confirmed scaffold biocompatibility, with cellular responses proportional to drug concentration but within safe limits.

CONCLUSIONS

PLA-IBU nanofibrillar scaffolds were successfully synthesized using ES and AJS. Both methods yielded biocompatible systems with stable properties and controlled drug release. Further, in vivo studies are necessary to confirm their clinical potential.

Non-steroidal anti-inflammatory drugs influence cartilage healing

BACKGROUND

Retrograde intramedullary nailing is commonly performed to stabilize distal femoral shaft fractures which may lead to iatrogenic injuries of the knee articular cartilage. The limited regenerative capability of cartilage may further be hindered by intake of non-steroidal anti-inflammatory drugs (NSAIDs) which are usually advised for injuries of the musculoskeletal system. The current study was designed to evaluate the histological changes in the femoral articular cartilage of knee joint after retrograde femoral nailing of rats.

METHODS

Retrograde intramedullary nailing was performed in 36 adult male Wistar rats, divided into three groups of 12 each. Groups 1 and 2 were given nonselective and selective COX 2 inhibitors, respectively, while the third group was taken as control. Half of the animals from each group were sacrificed at the second week, and remainder on the seventh week, and samples of the femoral articular cartilage were assessed for cartilage regeneration according to the modified Mankin scoring on histology while BMP-2 expression was evaluated on immunohistochemistry.

RESULTS

Mean modified Mankin scores for cartilage degradation were increased in animals taking NSAIDs at the second and seventh weeks of healing (P = 0.02, P < 0.001 respectively). There was a significant decrease in chondrocytes at the second week (P = 0.001), along with the loss of proteoglycan content in these animals at both time points (P = 0.001). The BMP-2 expression was significantly enhanced in the control group at the second (P = 0.001) and seventh weeks (P = 0.001).

CONCLUSION

The results reveal that intake of NSAIDs hinders the process of cartilage healing by reducing the number of chondrocytes and loss of proteoglycan content and decreased expression of BMP-2.

Comparison of the analgesic efficacy of spray and tablet flurbiprofen for pain after soft tissue surgery

The aim of this randomized clinical study was to assess the comparative efficacy of flurbiprofen in tablet and spray formulations for postoperative pain management in oral soft tissue wounds undergoing primary closure while investigating the feasibility of achieving optimal analgesia with reduced dosage and risk. Forty patients who underwent epulis fissuratum and frenulum excision for pre-prosthetic surgery were randomly assigned to receive either tablet or spray forms of flurbiprofen. The lesion dimensions were measured preoperatively, followed by excision and primary closure. The tablet group received oral tablets containing 100 mg of flurbiprofen twice daily, whereas the spray group received an oral spray containing 0.25% flurbiprofen, administered as two sprays thrice daily. Postoperative pain was assessed using the Numerical Rating Scale (NRS) until the 7th day. Lesion size, drug consumption, and rescue analgesic use were compared between the groups. There were no statistically significant differences in the lesion size between the groups. However, the mean NRS score in the spray group was significantly lower in the spray group compared to than that in the tablet group at 6th hour postoperatively (p = 0.037). Significant differences favoring the tablet group were observed in the first three doses of the drug (p = 0.001). No patients required rescue analgesics. The spray formulation of flurbiprofen demonstrated effective and safe pain relief in oral soft tissue wounds undergoing primary closure, with no reported adverse effects.

Modulation of Osteogenic Gene Expression by Human Osteoblasts Cultured in the Presence of Bisphenols BPF, BPS, or BPAF

Bone effects attributed to bisphenols (BPs) include the inhibition of growth and differentiation. This study analyzes the effect of BPA analogs (BPS, BPF, and BPAF) on the gene expression of the osteogenic markers RUNX2, osterix (OSX), bone morphogenetic protein-2 (BMP-2), BMP-7, alkaline phosphatase (ALP), collagen-1 (COL-1), and osteocalcin (OSC). Human osteoblasts were obtained by primary culture from bone chips harvested during routine dental work in healthy volunteers and were treated with BPF, BPS, or BPAF for 24 h at doses of 10^-5, 10^-6, and 10^-7 M. Untreated cells were used as controls. Real-time PCR was used to determine the expression of the osteogenic marker genes RUNX2, OSX, BMP-2, BMP-7, ALP, COL-1, and OSC. The expression of all studied markers was inhibited in the presence of each analog; some markers (COL-1; OSC, BMP2) were inhibited at all three doses and others only at the highest doses (10^-5 and 10^-6 M). Results obtained for the gene expression of osteogenic markers reveal an adverse effect of BPA analogs (BPF, BPS, and BPAF) on the physiology of human osteoblasts. The impact on ALP, COL-1, and OSC synthesis and therefore on bone matrix formation and mineralization is similar to that observed after exposure to BPA. Further research is warranted to determine the possible contribution of BP exposure to the development of bone diseases such as osteoporosis.

Gene Expression in MC3T3-E1 Cells Treated with Diclofenac and Methylprednisolone

Nonsteroidal anti-inflammatory drugs (NSAIDs) and glucocorticoids (GCs) are often used to treat articular-skeletal disorders. The extended use of NSAIDs and GCs have adverse effects on bone metabolism, reducing bone quality and impairing fracture healing. In the present study, we used mouse pre-osteoblast cells MC3T3-E1 to demonstrate the effects of diclofenac (DF) and methylprednisolone (MP) on cell proliferation and gene expression. Cells were incubated with three doses of DF or MP: 0.5 µM, 5 µM, and 50 µM. MP decreased cell viability even after 24 h, but DF inhibited cell viability after only seven days of treatment. The cells were lysed after one, two, three, and seven days of treatment, and gene expression was analyzed by reverse transcription and quantitative PCR (RT-qPCR) assays. DF did not significantly affect the expression of the osteogenic marker genes. MP modified the expression of Osx, Runx, and Col1a1. We concluded that MP is a more potent inhibitor of mouse pre-osteoblast differentiation and viability than is DF. Our results suggest that prolonged DF treatment could be less harmful to osteoblasts than MP treatment.

Macroporous scaffold surface modified with biological macromolecules and piroxicam-loaded gelatin nanofibers toward meniscus cartilage repair

Meniscus cartilage has poor self-healing capacity in the inner zone and its damage leads to articular cartilage degeneration. Here we have developed hybrid constructs using polycaprolactone (PCL) and polyurethane (PU) surface modified by gelatin (G), chitosan (C), and hyaluronic acid (H) biomacromolecules and piroxicam-loaded gelatin nanofibers (PCL/PU/GCH/P). The surface of constructs was crosslinked using EDC and NHS. The scaffolds were investigated by SEM, FTIR spectroscopy, swelling test, degradation rate, mechanical tests, and in vitro piroxicam release assay. Furthermore, the cell-seeded scaffolds were evaluated by SEM, viability assay, dapi staining, cell migration, proliferation, and gene expression of chondrocytes within these scaffolds. Finally, the animal study was performed in a rabbit model. Chondrocyte and rabbit adipose-derived mesenchymal stem cells (ASCs) from the infrapatellar fat pad (Hoffa's fat pad) were used. Swelling and degradation rate were increased in the modified scaffolds. Tensile and compressive Young's modulus also were near to human native meniscus tissue. The highest expression level of chondrocyte marker genes was observed for the PCL/PU/GCH scaffold. A significant regeneration was obtained in rabbits treated with ASCs-loaded PCL/PU/GCH/P scaffold after 3 months. The surface-modified scaffolds with or without ASCs could successfully accelerate meniscus regeneration and exhibit potential application in meniscus tissue engineering.

Effects of NSAIDs on pre-osteoblast viability and osteogenic differentiation

Non-steroidal anti-inflammatory drugs (NSAIDs) are widely used in the treatment of a variety of musculoskeletal conditions, injuries and after surgery for postoperative pain management. Their use has been associated with impaired bone healing, possibly due to a multifactorial function, which may include inhibition of osteoblast recruitment and differentiation. However, up to date, there is no consensus regarding the impact of NSAIDs on bone-healing. The aim of the current study was to investigate the effects of five NSAIDs on the cellular functions of mouse MC3T3-E1 pre-osteoblasts. Cells were treated with the non-selective COX inhibitors lornoxicam and diclofenac, the COX-2 selective inhibitors parecoxib, meloxicam and paracetamol, as well as steroidal prednisolone at different doses and exposure times. The PrestoBlue™ technique was used to measure cell viability, an enzymatic assay was employed for alkaline phosphatase (ALP) activity and alizarin red S mineral staining was used to determine osteogenic differentiation. All drugs had a negative impact on pre-osteoblast cell growth, with the exception of paracetamol. Lornoxicam, diclofenac and meloxicam reduced ALP activity, while the other NSAIDs had no effect and prednisolone strongly increased ALP activity. In contrast, calcium deposits were either unaffected or increased by NSAID treatments but were significantly decreased by prednisolone. These results provide evidence that NSAIDs may adversely affect the viability of mouse pre-osteoblast cells but their actions on the osteogenic differentiation are drug-specific. The direct comparison of the effects of different NSAIDs and prednisolone on pre-osteoblasts may serve to place some NSAIDs in a preferential position for analgesic and anti-inflammatory therapy during bone repair.

Prospective of extracellular matrix and drug correlations in disease management

The extracellular matrix (ECM) comprises of many structural molecules that constitute the extracellular environment. ECM molecules are characterized by specific features like diversity, complexity and signaling, which are also results of improvement or development of disease mediated by some physiological changes. Several drugs have also been used to manage diseases and they have been reported to modulate ECM assembly, including physiological changes, beyond their primary targets and ECM metabolism. This review highlights the alteration of ECM environment for diseases and effect of different classes of drugs like nonsteroidal anti-inflammatory drugs, immune suppressant drug, steroids on ECM or its components. Thus, it is summarized from previously conducted researches that diseases can be managed by targeting specific components of ECM which are involved in the pathophysiology of diseases. Moreover, the drug delivery focused on targeting the ECM components also has the potential for the discovery of targeted and site specific release of drugs. Therefore, ECM or its components could be future targets for the development of new drugs for controlling various disease conditions including neurodegenerative diseases and cancers.

Effects of Therapeutic Doses of Celecoxib on Several Physiological Parameters of Cultured Human Osteoblasts

Non-steroidal anti-inflammatory drugs (NSAIDs), including cyclooxygenase-2 (COX-2)-selective NSAIDs, are associated with adverse effects on bone tissue. These drugs are frequently the treatment of choice but are the least studied with respect to their repercussion on bone. The objective of this study was to determine the effects of celecoxib on cultured human osteoblasts. Human osteoblasts obtained by primary culture from bone samples were treated with celecoxib at doses of 0.75, 2, or 5μM for 24 h. The MTT technique was used to determine the effect on proliferation; flow cytometry to establish the effect on cell cycle, cell viability, and antigenic profile; and real-time polymerase chain reaction to measure the effect on gene expressions of the differentiation markers RUNX2, alkaline phosphatase (ALP), osteocalcin (OSC), and osterix (OSX). Therapeutic doses of celecoxib had no effect on osteoblast cell growth or antigen expression but had a negative impact on the gene expression of RUNX2 and OSC, although there was no significant change in the expression of ALP and OSX. Celecoxib at therapeutic doses has no apparent adverse effects on cultured human osteoblasts and only inhibits the expression of some differentiation markers. These characteristics may place this drug in a preferential position among NSAIDs used for analgesic and anti-inflammatory therapy during bone tissue repair.