Exploring the pathophysiological influence of heme oxygenase-1 on neuroinflammation and depression: A study of phytotherapeutic-based modulation

BACKGROUND

The heme oxygenase (HO) system plays a significant role in neuroprotection and reduction of neuroinflammation and neurodegeneration. The system, via isoforms HO-1 and HO-2, regulates cellular redox balance. HO-1, an antioxidant defense enzyme, is highlighted due to its association with depression, characterized by heightened neuroinflammation and impaired oxidative stress responses.

METHODOLOGY

We observed the pathophysiology of HO-1 and phytochemicals as its modulator. We explored Science Direct, Scopus, and PubMed for a comprehensive literature review. Bibliometric and temporal trend analysis were done using VOSviewer.

RESULTS

Several phytochemicals can potentially alleviate neuroinflammation and oxidative stress-induced depressive symptoms. These effects result from inhibiting the MAPK and NK-κB pathways - both implicated in the overproduction of pro-inflammatory factors - and from the upregulation of HO-1 expression mediated by Nrf2. Bibliometric and temporal trend analysis further validates these associations.

CONCLUSION

In summary, our findings suggest that antidepressant agents can mitigate neuroinflammation and depressive disorder pathogenesis via the upregulation of HO-1 expression. These agents suppress pro-inflammatory mediators and depressive-like symptoms, demonstrating that HO-1 plays a significant role in the neuroinflammatory process and the development of depression.

An Experimental Study of Ethanolic Extract of Myristica fragrans in Morphine Dependence

Objective: To evaluate the role of ethanolic extract of Myristica fragrans in morphine dependence. Methods: Wistar albino rats were made moderate and severe grade morphine dependence by administering morphine sulphate in dose of 10 mg /kg (i.p.), twice daily for 4 days and by increasing doses of 10-100 mg/kg (i.p.), twice daily for 7 days, respectively. The signs of spontaneous abstinence syndrome were recorded 12 hours in both studies after the last dose of morphine for 30 minutes and quantified by ‘counted’ and ‘checked’ signs. Ethanolic extract of Myristica fragrans (EEMF) was administered p.o. in different regimen: (a) EEMF 200 mg/kg along with morphine twice daily for 4 days and 7 days in moderately and severely induced morphine dependence group, respectively. (b) EEMF 400 mg/kg (p.o.), single dose10 hours after the last dose of morphine in both moderately and severely induced morphine dependence rats.Result: Oral administration of EEMF in both study groups caused significant reduction in the scores of counted and checked signs of morphine abstinence syndrome as compared to active morphine control group. The reduction was significantly more in regimen ‘a’ as compared to regimen ‘b’.Conclusion: Ethanolic extract of Myristica fragrans seed significantly reduced the mean scores of various’counted signs’ and ‘checked signs’ of morphine withdrawal syndrome and might give a solution as a substitute therapy in morphine de-addiction.Bangladesh Journal of Medical Science Vol.15(2) 2016 p.224-229

An experimental study of ethanolic extract and methanolic fraction of Delphinium denudatum Wall in morphine withdrawal syndrome

Objective: To evaluate the role of ethanolic extract and methanolic fraction of the roots of Delphinium denudatum Wall. in morphine dependence. Methods: Wistar albino rats were made moderately and severely morphine dependent by administering morphine sulphate in a dose of 10 mg /kg (i.p.) for 4 days and by increasing doses of 10 -100 mg/kg (i.p.) for 7 days twice daily, respectively. The signs of spontaneous abstinence syndrome in both studies were recorded 12 hours after the last dose of morphine for 30 minutes and quantified by the 'counted' and 'checked' signs. Ethanolic extract (EEDD) and methanolic fraction (MFDD) of Delphinium denudatum was administered p.o. in different regimen: (a) 300 mg/kg (p.o.) of ethanolic extract or 200 mg/kg (p.o.) of methanolic fraction along with morphine twice daily for 4 days in moderately and 7 days in severely induced morphine dependence group, (b) Single dose of ethanolic extract 600 mg/kg (p.o.) or methanolic fraction of 400 mg/kg (p.o.) 10 h after the last dose of morphine in both moderately and severely induced morphine dependence rats. Result: Administration of EEDD and MFDD orally in both morphine dependent groups caused significant reduction in scores of counted and checked signs of morphine abstinence syndrome as compared to morphine control group. The reduction was observed more in regimen 'b' as compared to regimen 'a'. Conclusion: EEDD and MFDD of Delphinium denudatum root significantly reduced the mean scores of various 'counted signs' and 'checked signs’ of morphine withdrawal syndrome and could thus be proved to be an alternative remedy in morphine de-addiction.

Phacoemulsification in vitrectomized eyes under topical anesthesia

PURPOSE

To study phacoemulsification in vitrectomized eyes under topical anesthesia, assessing anesthetic and intraoperative characteristics and complications.

METHODS

A prospective study was performed on 52 eyes of 51 patients who underwent phacoemulsification of cataract with intraocular lens implantation under topical anesthesia, having previously undergone pars plana vitrectomy. Surgical and anesthetic observations and complications were recorded, as were visual outcomes.

RESULTS

Ninety-two percent of patients had improved visual acuity postoperatively with only one patient having visual loss as a result of surgery. The most common intraoperative observations were of a deep anterior chamber, posterior capsular plaques, posterior synechiae, and nuclear sclerotic cataracts. Topical anesthesia proved satisfactory in 96%, with only two patients requiring intracameral lignocaine 1%; no patients required conversion to injection anesthesia. There were no major operative or postoperative complications.

CONCLUSIONS

Phacoemulsification in vitrectomized eyes can be challenging, but is visually rewarding. Topical anesthesia proved satisfactory for the vast majority of cases, with none of our patients requiring conversion to injection anesthesia.

Intravitreal triamcinolone acetonide for macular oedema owing to retinal vein occlusion

PURPOSE

To assess the long-term safety and efficacy of intravitreal triamcinolone acetonide injection in the management of macular oedema caused by central, hemi-, and branch retinal vein occlusion (CRVO, HRVO, or BRVO).

METHODS

This prospective, interventional case series included 13 patients (13 eyes) with retinal vein occlusion and macular oedema. They received an intravitreal injection of 4 mg triamcinolone acetonide. Follow-up was for 1 year with repeat injections where appropriate. Outcome measures were visual acuity and macular thickness measured using ocular coherence tomography (OCT).

RESULTS

There were four patients with CRVO, one with HRVO, and eight with BRVO (13 eyes). Mean duration of symptoms before intravitreal triamcinolone acetonide injection was 6.8 months (SD 4.5 months). Eight eyes (62%) responded well with improved visual acuity and macular thickness 1-3 months postinjection. All eight eyes developed recurrent macular oedema and five received repeat injections. Three patients declined a second injection. No improvement in visual acuity or OCT macular thickness was seen after the second injection with visual acuity returning to baseline levels at 1-year follow-up. Three eyes (23%) showed no response to the initial injection (no improvement in macular thickness or visual acuity). Seven patients (54%) had a rise in intraocular pressure with six (46%) requiring treatment.

CONCLUSIONS

Intravitreal injection of triamcinolone acetonide is effective as a short-term treatment of macular oedema owing to retinal vein occlusion, improving both visual acuity and macular thickness. However, this effectiveness is not maintained after 1 year despite repeat injections.