The neuropsychiatric manifestations of COVID-19: Interactions with psychiatric illness and pharmacological treatment

The recent outbreak of the corona virus disease (COVID-19) has had major global impact. The relationship between severe acute respiratory syndrome coronavirus (SARS-CoV-2) infection and psychiatric diseases is of great concern, with an evident link between corona virus infections and various central and peripheral nervous system manifestations. Unmitigated neuro-inflammation has been noted to underlie not only the severe respiratory complications of the disease but is also present in a range of neuro-psychiatric illnesses. Several neurological and psychiatric disorders are characterized by immune-inflammatory states, while treatments for these disorders have distinct anti-inflammatory properties and effects. With inflammation being a common contributing factor in SARS-CoV-2, as well as psychiatric disorders, treatment of either condition may affect disease progression of the other or alter response to pharmacological treatment. In this review, we elucidate how viral infections could affect pre-existing psychiatric conditions and how pharmacological treatments of these conditions may affect overall progress and outcome in the treatment of SARS-CoV-2. We address whether any treatment-induced benefits and potential adverse effects may ultimately affect the overall treatment approach, considering the underlying dysregulated neuro-inflammatory processes and potential drug interactions. Finally, we suggest adjunctive treatment options for SARS-CoV-2-associated neuro-psychiatric symptoms.

Anti-nociceptive and anti-inflammatory activity of synthesized novel benzoxazole derivatives

INTRODUCTION

Pain is an immunological response to any infection or inflammation and long term use of pain management therapy includes use of Nonsteroidal anti-inflammatory drugs which is associated with occurrence of toxicity as well as gastrointestinal bleeding. Therefore, the investigation of new analgesic and anti-inflammatory agents remains a major challenge.

AIMS

The objective of this research study is to undergo the pharmacological evaluation of newly synthesized benzoxazole derivatives. These novel derivatives were evaluated for anti-nociceptive, anti-inflammatory and cytotoxic activity using various in-vivo and ex-vivo methods.

METHODS

The study was carried out using swiss mice (adult male) weighing between 20gm to 30gm and were divided into groups containing (n=6) six animals in each group for treatment. The anti-nociceptive activity was performed by using 0.1ml of 0.6% v/v acetic acid as nociception inducer and evaluated by the diminished number of abdominal writhes. The anti-inflammatory activity was done using 0.1 ml of 2% w/v Carrageenan induced paw edema method was observed which was evaluated by calculating the percent maximum possible effect. Histopathological evaluation and cytotoxic activity of the compounds was carried out.

RESULTS

The results of this research study revealed that synthesized derivatives (a, b, c, d and e) showed promising anti-nociceptive and anti-inflammatory effect along significantly higher cytotoxic activity in MCF-7 cell lines.

CONCLUSION

It can be concluded that synthesized derivatives (a, b, c, d and e) have potential anti-nociceptive and anti-inflammatory effect along with cytotoxic activity and certain modification in structure may result in potent activity.

Methanol extract of Cola nitida ameliorates inflammation and nociception in experimental animals

•

Methanol extract Cola nitida possesses analgesic properties in mice.

•

Methanol extract of Cola nitida showed anti-inflammatory activity.

•

Methanol extract of cola nitida mediates its nociceptive action through cholinergic pathway.

•

Opioid and beta adrenergic pathways do not mediate the analgesic potential of Cola nitida.

Methanol extract of Cola nitida (MECN) was evaluated for its anti-inflammatory and analgesic activities using rats and mice. Inflammatory activity of MECN was assessed by carrageenan-induced paw oedema while analgesic activity was evaluated by acetic acid –induced writhing and formalin paw lick test. Histological analyses of the paws were also carried out. There was evaluation of the mechanism(s) of action of MECN using naloxone, a blocker of opioid receptors; atropine, blocker of muscarinic receptors; and propranolol, blocker of beta adrenergic receptors. Findings from the study revealed that MECN has both anti-inflammatory and analgesic properties. These properties were found to be dose dependent with 200 mg/kg of MECN discovered to be the most potent dose. 200 mg/kg was able to cause statistically significant reduction in paw size (p < 0.001) when compared with the carrageenan group. Histological analysis revealed that rats treated with 200 mg/kg of MECN showed no inflammatory cells in the left paw compared to other groups treated with carrageenan. In the formalin test, the number of paw licking was significantly reduced by MECN at 50 mg/kg, 100 mg/kg and 200 mg/kg in both neurogenic and inflammatory pain responses (p < 0.001) even as 200 mg/kg showed the highest percentage inhibition of 98.17% while 100 mg/kg of aspirin showed percentage inhibition of 93.66%. In acetic acid-induced writhing test, 50 mg/kg, 100 mg/kg and 200 mg/kg of MECN produced significant inhibition of writhes when compared with control as highest inhibition is observed in mice that received 200 mg/kg which is similar to aspirin. Administration of propranolol and naloxone was unable to reverse the analgesic function of MECN. However, atropine administration blocked the analgesic function of MECN. This shows that MECN exhibits its analgesic property through cholinergic pathway and not opioid and adrenergic pathways. Phytochemical screening revealed that MECN contains flavonoids, steroids, saponins, tannins, anthraquinines, terpenoids, and alkanoids. These phytochemical contents may thus be responsible for its analgesic and anti-inflammatory properties.