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Fink PB, Wheeler AR, Smith WR, Brant-Zawadzki G, Lieberman JR, McIntosh SE, Van Tilburg C, Wedmore IS, Windsor JS, Hofmeyr R, Weber D. Wilderness Medical Society Clinical Practice Guidelines for the Treatment of Acute Pain in Austere Environments: 2024 Update. Wilderness Environ Med 2024; 35:198-218. [PMID: 38651342 DOI: 10.1177/10806032241248422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2024]
Abstract
The Wilderness Medical Society (WMS) convened an expert panel to develop evidence-based guidelines for the management of pain in austere environments. Recommendations are graded based on the quality of supporting evidence as defined by criteria put forth by the American College of Chest Physicians. This is an update of the 2014 version of the "WMS Practice Guidelines for the Treatment of Acute Pain in Remote Environments" published in Wilderness & Environmental Medicine 2014; 25:41-49.
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Affiliation(s)
- Patrick B Fink
- Department of Emergency Medicine, University of Utah, Salt Lake City, UT
| | - Albert R Wheeler
- Department of Emergency Medicine, St. John's Health, Jackson, WY
| | - William R Smith
- Department of Emergency Medicine, St. John's Health, Jackson, WY
| | | | | | - Scott E McIntosh
- Department of Emergency Medicine, University of Utah, Salt Lake City, UT
| | | | - Ian S Wedmore
- Uniformed Services University of the Health Sciences, Bethesda, MD
| | | | - Ross Hofmeyr
- Department of Anaesthesia and Perioperative Medicine, University of Cape Town, Cape Town, South Africa
| | - David Weber
- Mountain Rescue Collective, LLC, Park City, UT
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Ravuri HG, Satake N, Balmanno A, Skinner J, Kempster S, Mills PC. Pharmacokinetic Evaluation of a Novel Transdermal Ketoprofen Formulation in Healthy Dogs. Pharmaceutics 2022; 14:pharmaceutics14030646. [PMID: 35336020 PMCID: PMC8953954 DOI: 10.3390/pharmaceutics14030646] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 03/11/2022] [Accepted: 03/13/2022] [Indexed: 02/04/2023] Open
Abstract
Dogs undergo various surgical procedures such as castration, ovariohysterectomy, and other orthopedic procedures, which are known to cause inflammation and pain. Non-steroidal anti-inflammatory drugs (NSAIDs) are very effective analgesics for alleviating postoperative pain in veterinary medicine. Ketoprofen is currently approved in Australia and the United States for treating different painful conditions in dogs. This study evaluated the pharmacokinetic parameters of ketoprofen after intravenous (IV) and transdermal (TD) administration in healthy dogs. A novel transdermal ketoprofen (TDK) formulation containing 20% ketoprofen, dissolved in a combination of 45:45% isopropanol and Transcutol, along with 10% eucalyptus oil, was developed and evaluated for in vitro dermal permeation using Franz diffusion cells. A crossover study was then conducted to determine the pharmacokinetic parameters of the formulation in six dogs following IV ketoprofen (1 mg/kg) and TDK (10 mg/kg) administration. A liquid chromatography–mass spectrometry (LC-M/MS) method was used to measure plasma concentrations of ketoprofen over time, and a non-compartmental analysis determined the pharmacokinetic parameters. The mean terminal elimination half-life (T½ h), AUC0-t (µg·h/mL), and mean residence time (MRT, h) between IV and TDK groups were 4.69 ± 1.33 and 25.77 ± 22.15 h, 15.75 ± 7.72 and 8.13 ± 4.28 µg·h/mL, and 4.86 ± 1.81 and 41.63 ± 32.33 h, respectively. The calculated bioavailability (F%) was ~7%, with a lag time of 30 min to achieve effective plasma concentrations after the application of TDK.
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Affiliation(s)
- Halley Gora Ravuri
- School of Veterinary Science, The University of Queensland, Gatton, QLD 4343, Australia
| | - Nana Satake
- School of Veterinary Science, The University of Queensland, Gatton, QLD 4343, Australia
| | - Alexandra Balmanno
- School of Veterinary Science, The University of Queensland, Gatton, QLD 4343, Australia
| | - Jazmine Skinner
- School of Agriculture and Environment, University of Southern Queensland, Toowoomba, QLD 4350, Australia
| | - Samantha Kempster
- School of Veterinary Science, The University of Queensland, Gatton, QLD 4343, Australia
| | - Paul C Mills
- School of Veterinary Science, The University of Queensland, Gatton, QLD 4343, Australia
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Winkler SL, Urbisci AE, Best TM. Sustained acoustic medicine for the treatment of musculoskeletal injuries: a systematic review and meta-analysis. BMC Sports Sci Med Rehabil 2021; 13:159. [PMID: 34922606 PMCID: PMC8684070 DOI: 10.1186/s13102-021-00383-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Accepted: 11/18/2021] [Indexed: 11/10/2022]
Abstract
BACKGROUND Musculoskeletal injuries account for 10 million work-limited days per year and often lead to both acute and/or chronic pain, and increased chances of re-injury or permanent disability. Conservative treatment options include various modalities, nonsteroidal anti-inflammatory drugs, and physical rehabilitation programs. Sustained Acoustic Medicine is an emerging prescription home-use mechanotransductive device to stimulate cellular proliferation, increase microstreaming and cavitation in situ, and to increase tissue profusion and permeability. This research aims to summarize the clinical evidence on Sustained Acoustic Medicine and measurable outcomes in the literature. METHODS A systematic literature review was conducted using PubMed, EBSCOhost, Academic Search Complete, Google Scholar and ClinicalTrials.gov to identify studies evaluating the effects of Sustained Acoustic Medicine on the musculoskeletal system of humans. Articles identified were selected based on inclusion criteria and scored on the Downs and Black checklist. Study design, clinical outcomes and primary findings were extracted from included studies for synthesis and meta-analysis statistics. RESULTS A total of three hundred and seventy-two participants (372) were included in the thirteen clinical research studies reviewed including five (5) level I, four (4) level II and four (4) level IV studies. Sixty-seven (67) participants with neck and back myofascial pain and injury, one hundred and fifty-six (156) participants with moderate to severe knee pain and radiographically confirmed knee osteoarthritis (Kellgren-Lawrence grade II/III), and one hundred forty-nine (149) participants with generalized soft-tissue injury of the elbow, shoulder, back and ankle with limited function. Primary outcomes included daily change in pain intensity, change in Western Ontario McMaster Osteoarthritis Questionnaire, change in Global Rate of Change, and functional outcome measures including dynamometry, grip strength, range-of-motion, and diathermic heating (temperature measurement). CONCLUSION Sustained Acoustic Medicine treatment provides tissue heating and tissue recovery, improved patient function and reduction of pain. When patients failed to respond to physical therapy, Sustained Acoustic Medicine proved to be a useful adjunct to facilitate healing and return to work. As a non-invasive and non-narcotic treatment option with an excellent safety profile, Sustained Acoustic Medicine may be considered a good therapeutic option for practitioners.
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Affiliation(s)
| | | | - Thomas M Best
- UHealth Sports Medicine Institute, University of Miami, Coral Gables, FL, USA.
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Bawazeer S, El-Telbany DFA, Al-Sawahli MM, Zayed G, Keed AAA, Abdelaziz AE, Abdel-Naby DH. Effect of nanostructured lipid carriers on transdermal delivery of tenoxicam in irradiated rats. Drug Deliv 2021; 27:1218-1230. [PMID: 32772730 PMCID: PMC7470136 DOI: 10.1080/10717544.2020.1803448] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Transdermal delivery of non-steroidal anti-inflammatory drugs (NSAIDs) is an effective route of drug administration, as it directs the drug to the inflamed site with reduced incidence of systemic adverse effects such as gastric hemorrhage and ulcers. Tenoxicam (TNX) is a member of NSAIDs that are marketed only as oral tablets due to very poor absorption through the skin. The current study intended to formulate and characterize a hydrogel loaded with nanostructured lipid carriers (NLCs) to enhance the transdermal delivery of TNX. Six formulations of TNX were formulated by slight modifications of high shear homogenization and ultrasonication method. The selected formula was characterized for their particle size, polydispersity index (PDI), zeta potential, entrapment efficiency (EE), in-vitro drug release and ex-vivo skin permeation studies. Moreover, the effectiveness of the developed formula was studied in-vivo using carrageenan-induced paw edema and hyperalgesia model in irradiated rats. Formula F4 was chosen from six formulations, as the average diameter was 679.4 ± 51.3 nm, PDI value of about 0.02, zeta potential of -4.24 mV, EE of 92.36%, globules nanoparticles without aggregations and absence of interactions in the developed formula. Additionally, the in-vivo study showed the efficacy of formula F4 (TNX-NLCs hydrogel) equivalent to oral TNX in reducing the exaggerated inflammatory response induced by carrageenan after irradiation. In conclusion, the present findings suggest that TNX-NLCs hydrogel could be a potential transdermal drug delivery system alternative to the oral formulation for the treatment of various inflammatory conditions.
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Affiliation(s)
- Saud Bawazeer
- Pharmaceutical Chemistry Department, Faculty of Pharmacy, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Dalia Farag A El-Telbany
- Department of Pharmaceutics, Faculty of Pharmacy, Modern University for Technology and Information, Cairo, Egypt
| | - Majid Mohammad Al-Sawahli
- Department of Pharmaceutical Technology, Faculty of Pharmacy, Kafrelsheikh University, Kafrelsheikh, Egypt
| | - Gamal Zayed
- Department of Pharmaceutics and Industrial Pharmacy, Faculty of Pharmacy, Al-Azhar University, Assiut, Egypt
| | | | - Abdelaziz E Abdelaziz
- Department of Pharmaceutical Technology, Faculty of Pharmacy, Kafrelsheikh University, Kafrelsheikh, Egypt
| | - Doaa H Abdel-Naby
- Department of Drug Radiation Research, National Centre for Radiation Research and Technology, Atomic Energy Authority, Cairo, Egypt
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Antony R, Raveendran J, Biju PG. Anti-inflammatory Activity of Mollugo cerviana Methanolic Extract in LPS-induced Acute Inflammatory RAW 264.7 Macrophages. Comb Chem High Throughput Screen 2021; 25:1661-1671. [PMID: 33653239 DOI: 10.2174/1386207324666210302101204] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 12/23/2020] [Accepted: 01/19/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND The management of acute inflammation, which arises from complex biological responses to harmful stimuli, is an important determinant in recovery of the system from an otherwise detrimental outcome such as septicemia. However, the side effects and limitations of current therapeutics necessitate the development of newer and safer alternatives. Mollugo cerviana is a common medicinal herb of the Indian subcontinent and has been traditionally used for its fever mitigating, anti-microbial and hepatoprotective action. We have already reported the rich presence of radical scavenging phytochemicals in the plant extracts and their strong antioxidant properties. OBJECTIVE In the present study, we have evaluated the anti-inflammatory effects of methanolic extract (ME) of the areal parts of M. cerviana in a lipopolysaccharide (LPS)-induced acute inflammatory cell culture model. METHOD RAW 264.7 mouse macrophages cell were stimulated by the bacterial endotoxin LPS at a concentration of 1 µg/mL. Cytotoxicity and anti-inflammatory potential of ME were carried out. RESULTS M. cerviana extract concentration up to 150 µg/ml was found to be non-toxic to cells (MTT and NRU assay). LPS induces acute inflammation by binding to TLR-4 receptors, initiating downstream signalling cascade that result in pro-inflammatory cytokine secretion. Extract treatment at 100 µg/ml suppressed LPS-induced gene expression (qPCR) and secretion (ELISA) of pro-inflammatory cytokines IL-1β, IL-6 and TNF-α, and the chemokine CCL2, indicating a dampening of the acute inflammatory cascade. LPS-induced elevation of ROS level (DCFDA method) was significant reduced by extract treatment. Nitric oxide production, as indicated by nitrite level, was significantly reduced post extract treatment. CONCLUSION From this study, it is demonstrated that M. cerviana methanolic extract has potent anti-inflammatory effect in the in vitro acute inflammation model of LPS-stimulated RAW 264.7 cells. There is not reported study so far on the anti-inflammatory properties of M. cerviana in an LPS-induced acute inflammatory model which closely mimics a human bacteremia response. Hence, this study highlights the therapeutic potential of this extract as a source of anti-inflammatory lead molecules.
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Affiliation(s)
- Robina Antony
- Department of Biochemistry, University of Kerala, Kariavattom campus, Thiruvananthapuram, Kerala 695581. India
| | - Jijin Raveendran
- Department of Biochemistry, University of Kerala, Kariavattom campus, Thiruvananthapuram, Kerala 695581. India
| | - Prabath Gopalakrishnan Biju
- Department of Biochemistry, University of Kerala, Kariavattom campus, Thiruvananthapuram, Kerala 695581. India
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Madzia A, Agrawal C, Jarit P, Petterson S, Plancher K, Ortiz R. Sustained Acoustic Medicine Combined with A Diclofenac Ultrasound Coupling Patch for the Rapid Symptomatic Relief of Knee Osteoarthritis: Multi-Site Clinical Efficacy Study. Open Orthop J 2020; 14:176-185. [PMID: 33408796 PMCID: PMC7784557 DOI: 10.2174/1874325002014010176] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 09/07/2020] [Accepted: 09/17/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Sustained Acoustic Medicine (SAM) is an emerging, non-invasive, non-narcotic, home-use ultrasound therapy for the daily treatment of joint pain. The aim of this multi-site clinical study was to examine the efficacy of long-duration continuous ultrasound combined with a 1% diclofenac ultrasound gel patch in treating pain and improving function in patients with knee osteoarthritis. METHODS The Consolidated Standards of Reporting Trials (CONSORT) were followed. Thirty-two (32) patients (18-males, 14-females) 54 years of average age with moderate to severe knee pain and radiographically confirmed knee osteoarthritis (Kellgren-Lawrence (KL) grade II/III) were enrolled for treatment with the SAM device and diclofenac patch applied daily to the treated knee. SAM ultrasound (3 MHz, 0.132 W/cm2, 1.3 W) and 6 grams of 1% diclofenac were applied with a wearable device for 4 hours daily for 1 week, delivering 18,720 Joules of ultrasound energy per treatment. The primary outcome was the daily change in pain intensity using a numeric rating scale (NRS 0-10), which was assessed prior to intervention (baseline, day 1), before and after each daily treatment, and after 1 week of daily treatment (day 7). Rapid responders were classified as those patients exhibiting greater than a 1-point reduction in pain following the first treatment. Change in Western Ontario McMaster Osteoarthritis Questionnaire (WOMAC) score from baseline to day 7 was the secondary functional outcome measure. Additionally, a series of daily usability and user experience questions related to devising ease of use, functionality, safety, and effectiveness, were collected. Data were analyzed using t-tests and repeated measure ANOVAs. RESULTS The study had a 94% retention rate, and there were no adverse events or study-related complaints across 224 unique treatment sessions. Rapid responders included 75% of the study population. Patients exhibited a significant mean NRS pain reduction over the 7-day study of 2.06-points (50%) for all subjects (n=32, p<0.001) and 2.96-points (70%) for rapid responders (n=24, p<0.001). The WOMAC functional score significantly improved by 351 points for all subjects (n=32, p<0.001), and 510 points for rapid responders (n=24, p<0.001). Over 95% of patients found the device safe, effective and easy to use, and would continue treatment for their knee OA symptoms. CONCLUSION Sustained Acoustic Medicine combined with 1% topical diclofenac rapidly reduced pain and improved function in patients with moderate to severe osteoarthritis-related knee pain. The clinical findings suggest that this treatment approach may be used as a conservative, non-invasive treatment option for patients with knee osteoarthritis. Additional research is warranted on non-weight bearing joints of the musculoskeletal system as well as different topical drugs that could benefit from improved localized delivery.Clinical Trial Registry Number: (NCT04391842).
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Affiliation(s)
- Alex Madzia
- Department of Biomedical Engineering, University of Cincinnati, Cincinnati, OH 45219, USA
| | - Chirag Agrawal
- Department of Biomedical Engineering, University of Cincinnati, Cincinnati, OH 45219, USA
| | - Paddy Jarit
- Sport and Orthopaedic Physical Therapy, Fairfield, CT 06824, USA
| | | | - Kevin Plancher
- Albert Einstein College of Medicine, Bronx, NY, New York, USA
- Weill Cornell Medical College, New York, NY 13053, USA
- Plancher Orthopaedics & Sports Medicine, New York, NY 13053, USA
| | - Ralph Ortiz
- Medical Pain Consultants, Dryden, NY 13053, USA
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Dudhipala N, Ali Youssef AA, Banala N. Colloidal lipid nanodispersion enriched hydrogel of antifungal agent for management of fungal infections: Comparative in-vitro, ex-vivo and in-vivo evaluation for oral and topical application. Chem Phys Lipids 2020; 233:104981. [PMID: 33031802 DOI: 10.1016/j.chemphyslip.2020.104981] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 09/21/2020] [Accepted: 09/28/2020] [Indexed: 11/25/2022]
Abstract
Ketoconazole (KZ) is broad spectrum antifungal drug, used for the treatment of fungal infections. KZ's clinical topical use has been associated with some adverse effects in healthy adults particularly local reactions, such as stinging, severe irritation, and pruritus. However, bioavailability of KZ after oral administration is low from tablets due to its low aqueous solubility. The objective of this investigation was development and characterization of KZ-containing solid lipid nanoparticles (KZ-SLNs) and SLN-containing hydrogel (KZ-SLN-H) for oral and topical delivery of KZ. KZ-SLNs were prepared using homogenization-sonication method. Optimal KZ-SLN formulation was selected based on physicochemical and in-vitro release studies. Optimized KZ-SLN converted to KZ-SLN hydrogel (KZ-SLN-H) using gelling polymers and optimized with rheological and in-vitro studies. Further, optimized KZ-SLN and KZ-SLN-H formulations evaluated for crystallinity, morphology, stability, ex-vivo and in-vivo pharmacokinetic (PK) studies in rats, comparison with KZ suspension (KZ-S) and KZ-S hydrogel (KZ-SH). Optimized KZ-SLN formulation showed desirable characters. KZ-SLN and KZ-SLN-H formulations exhibited spherical shape, converted to amorphous, sustained release behaviour and enhanced permeability (p < 0.05). Moreover, both formulations were stable for three months at 4 °C and 25 °C. PK studies revealed 1.9 and 1.5-folds, 3.5 and 2.8-folds enhancement of bioavailability of optimized KZ-SLN and KZ-SLN-H formulations (p < 0.05) compared with KZ-S and KZ-SH formulations, respectively. Overall, SLN and SLN-H formulations could be considered as an efficient delivery vehicles for KZ through oral and topical administration for better control over topical and systemic fungal infections.
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Affiliation(s)
- Narendar Dudhipala
- Depratment of Pharmaceutics, Vaagdevi College of Pharmacy, Warangal, 50 6005, Telangana State, India.
| | - Ahmed Adel Ali Youssef
- Department of Pharmaceutical Technology, Faculty of Pharmacy, Kafrelsheikh University, Kafrelsheikh, 33516, Egypt
| | - Nagaraj Banala
- Department of Nanotechnology, University College of Pharmaceutical Sciences, Kakatiya University, Warangal, Telangana State, India
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Dudhipala N, AY AA. Amelioration of ketoconazole in lipid nanoparticles for enhanced antifungal activity and bioavailability through oral administration for management of fungal infections. Chem Phys Lipids 2020; 232:104953. [DOI: 10.1016/j.chemphyslip.2020.104953] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 07/31/2020] [Accepted: 08/11/2020] [Indexed: 12/15/2022]
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Dudhipala N, Phasha Mohammed R, Adel Ali Youssef A, Banala N. Effect of lipid and edge activator concentration on development of aceclofenac-loaded transfersomes gel for transdermal application: in vitro and ex vivo skin permeation. Drug Dev Ind Pharm 2020; 46:1334-1344. [DOI: 10.1080/03639045.2020.1788069] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Narendar Dudhipala
- Nanotechnology and Novel Drug Delivery Laboratory, Department of Pharmaceutics, University College of Pharmaceutical Sciences, Kakatiya University, Warangal, India
| | - Riyaz Phasha Mohammed
- Nanotechnology and Novel Drug Delivery Laboratory, Department of Pharmaceutics, University College of Pharmaceutical Sciences, Kakatiya University, Warangal, India
| | - Ahmed Adel Ali Youssef
- Department of Pharmaceutical Technology, Faculty of Pharmacy, Kafrelsheikh University, Kafrelsheikh, Egypt
| | - Nagaraj Banala
- Nanotechnology and Novel Drug Delivery Laboratory, Department of Pharmaceutics, University College of Pharmaceutical Sciences, Kakatiya University, Warangal, India
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Dai X, Ding M, Zhang W, Xuan Z, Liang J, Yang D, Zhang Q, Su B, Zhu H, Jia X. Anti-Inflammatory Effects of Different Elution Fractions of Er-Miao-San on Acute Inflammation Induced by Carrageenan in Rat Paw Tissue. Med Sci Monit 2019; 25:7958-7965. [PMID: 31645050 PMCID: PMC6822334 DOI: 10.12659/msm.916977] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Er-Miao-San (EMS) is used in traditional Chinese medicine. This study aimed to investigate the effect of different elution fractions of EMS on acute inflammation induced by carrageenan in the rat paw and the possible mechanisms of action. MATERIAL AND METHODS Different aqueous fractions of EMS added to an AB-8 macroporous resin column and eluted with 0, 30%, 60%, and 90% ethanol. The content of berberine was evaluated by ultra-performance liquid chromatography (UPLC). Following injection of carrageenan and elution fractions of EMS into the rat paw, the volume of edema, levels of prostaglandin E2 (PGE2), tumor necrosis factor-alpha (TNF-alpha), interleukin (IL)-1ß, and IL-10 in the rat tissue were quantified by enzyme-linked immunosorbent assay (ELISA). Myeloperoxidase (MPO) activity and nitric oxide (NO) levels were measured by spectrophotometry. RESULTS The 60% and 90% ethanol elution fractions of EMS contained berberine, and both inhibited edema after carrageenan injection, with inhibitory rates of 31.04-40.86% and 48.84-52.18%, respectively, and with a significant reduction in MPO activity and NO production. The 60% ethanol elution fraction of EMS significantly decreased IL-1ß levels and increased IL-10 levels, and the 30%, 60%, and 90% ethanol EMS elution fractions considerably reduced the levels of TNF-alpha. The 60% and 90% ethanol EMS elution fractions significantly reduced PGE2 levels in the rat paw. CONCLUSIONS The 60% and 90% ethanol elution fractions of EMS had an anti-inflammatory effect following injection of carrageenan in the rat paw.
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Affiliation(s)
- Xing Dai
- School of Pharmacy, Anhui University of Chinese Medicine, Hefei, Anhui, China (mainland).,The First Clinical Medical College, Anhui Medical University, Hefei, Anhui, China (mainland)
| | - Meihuizi Ding
- School of Pharmacy, Anhui University of Chinese Medicine, Hefei, Anhui, China (mainland).,Key Laboratory of Chinese Medicinal Formula Research, Anhui University of Chinese Medicine, Hefei, Anhui, China (mainland)
| | - Wei Zhang
- School of Pharmacy, Anhui University of Chinese Medicine, Hefei, Anhui, China (mainland).,Key Laboratory of Chinese Medicinal Formula Research, Anhui University of Chinese Medicine, Hefei, Anhui, China (mainland)
| | - Zihua Xuan
- School of Pharmacy, Anhui University of Chinese Medicine, Hefei, Anhui, China (mainland).,Key Laboratory of Chinese Medicinal Formula Research, Anhui University of Chinese Medicine, Hefei, Anhui, China (mainland)
| | - Juan Liang
- School of Pharmacy, Anhui University of Chinese Medicine, Hefei, Anhui, China (mainland).,Key Laboratory of Chinese Medicinal Formula Research, Anhui University of Chinese Medicine, Hefei, Anhui, China (mainland)
| | - Dongping Yang
- School of Pharmacy, Anhui University of Chinese Medicine, Hefei, Anhui, China (mainland).,Key Laboratory of Chinese Medicinal Formula Research, Anhui University of Chinese Medicine, Hefei, Anhui, China (mainland)
| | - Qiying Zhang
- School of Pharmacy, Anhui University of Chinese Medicine, Hefei, Anhui, China (mainland).,Key Laboratory of Chinese Medicinal Formula Research, Anhui University of Chinese Medicine, Hefei, Anhui, China (mainland)
| | - Bo Su
- School of Pharmacy, Anhui University of Chinese Medicine, Hefei, Anhui, China (mainland).,Key Laboratory of Chinese Medicinal Formula Research, Anhui University of Chinese Medicine, Hefei, Anhui, China (mainland)
| | - Housheng Zhu
- School of Pharmacy, Anhui University of Chinese Medicine, Hefei, Anhui, China (mainland).,Key Laboratory of Chinese Medicinal Formula Research, Anhui University of Chinese Medicine, Hefei, Anhui, China (mainland)
| | - Xiaoyi Jia
- School of Pharmacy, Anhui University of Chinese Medicine, Hefei, Anhui, China (mainland).,Key Laboratory of Chinese Medicinal Formula Research, Anhui University of Chinese Medicine, Hefei, Anhui, China (mainland)
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