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Martinez JA, Wertheim BC, Roe DJ, Chalasani P, Cohen J, Baer L, Chow HHS, Stopeck AT, Thompson PA. Sulindac Improves Stiffness and Quality of Life in Women Taking Aromatase Inhibitors for Breast Cancer. Breast Cancer Res Treat 2022; 192:113-122. [PMID: 35039952 PMCID: PMC8879419 DOI: 10.1007/s10549-021-06485-0] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 12/04/2021] [Indexed: 02/03/2023]
Abstract
PURPOSE To examine benefit of sulindac for relief of musculoskeletal symptoms (MSS) in patients stable on aromatase inhibitors (AIs). METHODS Sulindac was evaluated at 150 mg twice daily for effects on MSS at 3, 6, 9, and 12 months in 50 postmenopausal women stable on AI therapy for a median of 12.5 months for hormone receptor-positive breast cancer. A separate, non-randomized group of 50 similar patients was observed for change in MSS over 12 months. MSS severity was assessed using the Western Ontario and McMaster Universities Osteoarthritis (WOMAC) Index and Brief Pain Inventory Short Form (BPI-SF). The Functional Assessment of Cancer Therapy-General form (FACT-G) measured quality of life (QOL). Change in MSS and QOL across time was assessed in each group using linear mixed effects models. RESULTS Stiffness, not pain, was the main complaint at baseline. At 12 months, sulindac patients reported decreases (improvements) in mean (95% CI) Total WOMAC score [- 5.85 (- 9.73, - 1.96)] and WOMAC pain [- 5.40 (- 10.64, - 0 .18)], Stiffness [- 9.53 (- 14.98, - 4.08)] and Physical Function [- 5.61 (- 9.62, - 1.60)] subscales, but not BPI-SF worst pain. Among sulindac patients with higher baseline MSS severity, 35% experienced ≥ 50% improvement in Total WOMAC and Total FACT-G scores [6.18 (2.08, 10.27); P = 0.003]. For the observation group, MSS and QOL did not improve over 12 months, even among those with higher baseline MSS severity. CONCLUSIONS Sulindac may relieve MSS in AI patients, especially physical function and stiffness. Randomized controlled trials should further evaluate NSAIDs on AI-MSS and AI adherence. TRIAL REGISTRATION NUMBER AND DATE OF REGISTRATION NCT01761877, December, 2012.
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Affiliation(s)
- Jessica A Martinez
- University of Arizona Cancer Center, Tucson, AZ, USA
- Department of Nutritional Sciences, University of Arizona, Tucson, AZ, USA
| | | | - Denise J Roe
- University of Arizona Cancer Center, Tucson, AZ, USA
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, USA
| | - Pavani Chalasani
- University of Arizona Cancer Center, Tucson, AZ, USA
- Department of Medicine, University of Arizona, Tucson, AZ, USA
| | - Jules Cohen
- Department of Medicine, Stony Brook University, Stony Brook, NY, USA
| | - Lea Baer
- Department of Medicine, Stony Brook University, Stony Brook, NY, USA
| | | | - Alison T Stopeck
- Department of Medicine, Stony Brook University, Stony Brook, NY, USA
| | - Patricia A Thompson
- Department of Pathology, Stony Brook University, Stony Brook, NY, USA.
- Department of Medicine, Cedars Sinai Medicine, Samuel Oschin Comprehensive Cancer Institute, Advanced Health Science Pavilion, 127 S San Vicente Blvd, A-8110C, Los Angeles, CA, 90048, USA.
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Simon E, Duffek A, Stahl C, Frey M, Scheurer M, Tuerk J, Gehrmann L, Könemann S, Swart K, Behnisch P, Olbrich D, Brion F, Aït-Aïssa S, Pasanen-Kase R, Werner I, Vermeirssen ELM. Biological effect and chemical monitoring of Watch List substances in European surface waters: Steroidal estrogens and diclofenac - Effect-based methods for monitoring frameworks. Environ Int 2022; 159:107033. [PMID: 34979407 DOI: 10.1016/j.envint.2021.107033] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 12/02/2021] [Accepted: 12/03/2021] [Indexed: 06/14/2023]
Abstract
Three steroidal estrogens, 17α-ethinylestradiol (EE2), 17β-estradiol (E2), estrone (E1), and the non-steroidal anti-inflammatory drug (NSAID), diclofenac have been included in the first Watch List of the Water Framework Directive (WFD, EU Directive 2000/60/EC, EU Implementing Decision 2015/495). This triggered the need for more EU-wide surface water monitoring data on these micropollutants, before they can be considered for inclusion in the list of priority substances regularly monitored in aquatic ecosystems. The revision of the priority substance list of the WFD offers the opportunity to incorporate more holistic bioanalytical approaches, such as effect-based monitoring, alongside single substance chemical monitoring. Effect-based methods (EBMs) are able to measure total biological activities (e.g., estrogenic activity or cyxlooxygenase [COX]-inhibition) of specific group of substances (such as estrogens and NSAIDs) in the aquatic environment at low concentrations (pg/L). This makes them potential tools for a cost-effective and ecotoxicologically comprehensive water quality assessment. In parallel, the use of such methods could build a bridge from chemical status assessments towards ecological status assessments by adressing mixture effects for relevant modes of action. Our study aimed to assess the suitability of implementing EBMs in the WFD, by conducting a large-scale sampling and analysis campaign of more than 70 surface waters across Europe. This resulted in the generation of high-quality chemical and effect-based monitoring data for the selected Watch List substances. Overall, water samples contained low estrogenicity (0.01-1.3 ng E2-Equivalent/L) and a range of COX-inhibition activity similar to previously reported levels (12-1600 ng Diclofenac-Equivalent/L). Comparison between effect-based and conventional analytical chemical methods showed that the chemical analytical approach for steroidal estrogens resulted in more (76%) non-quantifiable data, i.e., concentrations were below detection limits, compared to the EBMs (28%). These results demonstrate the excellent and sensitive screening capability of EBMs.
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Affiliation(s)
- Eszter Simon
- Swiss Centre for Applied Ecotoxicology, Dübendorf, Switzerland.
| | - Anja Duffek
- German Environment Agency (UBA), Berlin, Germany
| | - Cordula Stahl
- Steinbeis-Innovationszentrum Zellkulturtechnik, c/o University of Applied Sciences Mannheim, Germany
| | - Manfred Frey
- Steinbeis-Innovationszentrum Zellkulturtechnik, c/o University of Applied Sciences Mannheim, Germany
| | - Marco Scheurer
- TZW: DVGW-Technologiezentrum Wasser (German Water Centre), Karlsruhe, Germany
| | - Jochen Tuerk
- Institut für Energie- und Umwelttechnik e. V. (IUTA, Institute of Energy and Environmental Technology), Duisburg, Germany
| | - Linda Gehrmann
- Institut für Energie- und Umwelttechnik e. V. (IUTA, Institute of Energy and Environmental Technology), Duisburg, Germany
| | - Sarah Könemann
- Eawag, Swiss Federal Institute of Aquatic Science and Technology, Dübendorf, Switzerland
| | - Kees Swart
- BioDetection Systems B.V., Amsterdam, the Netherlands
| | - Peter Behnisch
- National Institute of Industrial Environment and Risks (INERIS), UMR-I 02 SEBIO, Verneuil-en-Halatte, France
| | - Daniel Olbrich
- Swiss Centre for Applied Ecotoxicology, Dübendorf, Switzerland
| | - Franҫois Brion
- State Secretariat for Economic Affairs (SECO), Labour Directorate Section Chemicals and Work, Bern, Switzerland
| | - Selim Aït-Aïssa
- State Secretariat for Economic Affairs (SECO), Labour Directorate Section Chemicals and Work, Bern, Switzerland
| | - Robert Pasanen-Kase
- State Secretariat for Economic Affairs (SECO), Labour Directorate Section Chemicals and Work, Bern, Switzerland
| | - Inge Werner
- Swiss Centre for Applied Ecotoxicology, Dübendorf, Switzerland
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Bakhtiari T, Azarian S, Ghaderi A, Ahmadzadeh A, Mirshafiey A. Effect of Guluronic Acid (G2013), As a New Anti-inflammatory Drug on Gene Expression of Pro-inflammatory and Anti-inflammatory Cytokines and Their Transcription Factors in Rheumatoid Arthritis Patients. Iran J Allergy Asthma Immunol 2019; 18:639-648. [PMID: 32245307 DOI: 10.18502/ijaai.v18i6.2176] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 05/26/2019] [Accepted: 07/10/2019] [Indexed: 11/24/2022]
Abstract
Rheumatoid arthritis (RA) as a long-term autoimmune disease is characterized by pain, swelling and joints destruction. The therapeutic efficacy of Guluronic acid (G2013) (patented, DEU: 102016113017.6) was reported in phase I/II clinical trial in RA patients. In this study, we aimed to evaluate the effect of G2013 as a novel non-steroidal anti-inflammatory drug (NSAID) with immunosuppressive property on genes expression of anti-inflammatory and pro-inflammatory cytokines and their transcription factors in the blood sample of RA patients. This study was performed on 12 patients with RA who had an inadequate response to conventional treatments which were disease-modifying anti-rheumatic drugs (DMARDs), NSAID, and biologics. G2013 was administered orally at a dose of 500 mg twice daily for 12 weeks. Before and after the treatment of patients with drug G2013, the peripheral blood mononuclear cells (PBMCs) were isolated for evaluating the gene expression level of interleukin 10 (IL10), interleukin 22 (IL22), interferon γ (IFNγ), and transcription factors specific to the T helper cell lineages, forkhead box P3 (Fox-P3), Aryl hydrocarbon receptor (AHR) and T-box-containing protein expressed in T cells (T-bet) using the real-time PCR method. Since these cytokines have a key role in the progression of RA and disease condition expected induction of IFNγ, AHR, IL22, T-bet, and reduction of IL10, Fox-P3. Results indicated a significant reduction in the level of IFNγ, AHR and a significant induction in IL10, Fox-P3 gene expression in comparison with the control group. In conclusion; the results of this investigation showed a part of the immunological mechanism of G2013 as a novel anti-inflammatory that could reduce pro-inflammatory cytokine and their transcription factors. Furthermore, it increased the anti-inflammatory cytokine and its transcription factor (clinical trial identifier: IRCT2016092813739N5).
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Affiliation(s)
- Tahereh Bakhtiari
- Department of Immunology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
| | - ShahinKhadem Azarian
- Department of Immunology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
| | - Afshin Ghaderi
- Department of Internal Medicine, Hematology and Medical Oncology Ward, Cancer Research Centre, Cancer Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
| | - Arman Ahmadzadeh
- Department of Rheumatology, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Abbas Mirshafiey
- Department of Immunology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran AND Research Center for Immunodeficiencies, Children's Medical Centre, Tehran University of Medical Sciences, Tehran, Iran.
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Bakhtiari T, Azarian S, Ghaderi A, Ahmadzadeh A, Mirshafiey A. Effect of Guluronic Acid (G2013), As a New Anti-inflammatory Drug on Gene Expression of Pro-inflammatory and Anti-inflammatory Cytokines and Their Transcription Factors in Rheumatoid Arthritis Patients. Iran J Allergy Asthma Immunol 2019; 18:639-648. [PMID: 32245307 DOI: 10.1850/ijaai.v18i6.2176] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 05/26/2019] [Accepted: 07/10/2019] [Indexed: 05/20/2023]
Abstract
Rheumatoid arthritis (RA) as a long-term autoimmune disease is characterized by pain, swelling and joints destruction. The therapeutic efficacy of Guluronic acid (G2013) (patented, DEU: 102016113017.6) was reported in phase I/II clinical trial in RA patients. In this study, we aimed to evaluate the effect of G2013 as a novel non-steroidal anti-inflammatory drug (NSAID) with immunosuppressive property on genes expression of anti-inflammatory and pro-inflammatory cytokines and their transcription factors in the blood sample of RA patients. This study was performed on 12 patients with RA who had an inadequate response to conventional treatments which were disease-modifying anti-rheumatic drugs (DMARDs), NSAID, and biologics. G2013 was administered orally at a dose of 500 mg twice daily for 12 weeks. Before and after the treatment of patients with drug G2013, the peripheral blood mononuclear cells (PBMCs) were isolated for evaluating the gene expression level of interleukin 10 (IL10), interleukin 22 (IL22), interferon γ (IFNγ), and transcription factors specific to the T helper cell lineages, forkhead box P3 (Fox-P3), Aryl hydrocarbon receptor (AHR) and T-box-containing protein expressed in T cells (T-bet) using the real-time PCR method. Since these cytokines have a key role in the progression of RA and disease condition expected induction of IFNγ, AHR, IL22, T-bet, and reduction of IL10, Fox-P3. Results indicated a significant reduction in the level of IFNγ, AHR and a significant induction in IL10, Fox-P3 gene expression in comparison with the control group. In conclusion; the results of this investigation showed a part of the immunological mechanism of G2013 as a novel anti-inflammatory that could reduce pro-inflammatory cytokine and their transcription factors. Furthermore, it increased the anti-inflammatory cytokine and its transcription factor (clinical trial identifier: IRCT2016092813739N5).
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Affiliation(s)
- Tahereh Bakhtiari
- Department of Immunology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
| | - ShahinKhadem Azarian
- Department of Immunology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
| | - Afshin Ghaderi
- Department of Internal Medicine, Hematology and Medical Oncology Ward, Cancer Research Centre, Cancer Institute, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
| | - Arman Ahmadzadeh
- Department of Rheumatology, Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Abbas Mirshafiey
- Department of Immunology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran AND Research Center for Immunodeficiencies, Children's Medical Centre, Tehran University of Medical Sciences, Tehran, Iran.
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Sostres C, Carrera-Lasfuentes P, Lanas A. Non-steroidal anti-inflammatory drug related upper gastrointestinal bleeding: types of drug use and patient profiles in real clinical practice. Curr Med Res Opin 2017; 33:1815-1820. [PMID: 28569554 DOI: 10.1080/03007995.2017.1338178] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND The best available evidence regarding non-steroidal anti-inflammatory drug (NSAID)-related gastrointestinal (GI) bleeding comes from randomized controlled trials including patients who use NSAIDs to manage chronic rheumatic diseases; however, patients with varying background profiles commonly take NSAIDs for many other reasons, often without prescription, and such usage has not been well studied. OBJECTIVES AND METHODS To define the characteristics of patients hospitalized for upper GI bleeding in clinical practice, we conducted a case-control study among patients with endoscopy-proven major upper GI bleeding due to gastroduodenal peptic lesions and control subjects. We used adjusted logistic regression models to estimate bleeding risks. Data analysis was performed using SPSS 22.0. RESULTS Our analysis included 3785 cases and 6540 controls, including 1270 cases (33.55%) and 834 controls (12.75%) reporting recent use (<30 days) of NSAIDs including high-dose acetylsalicylic acid (ASA). NSAID use was associated with increased risk of upper GI bleeding, with an adjusted relative risk of 4.86 (95% CI, 4.32-5.46). Acute musculoskeletal pain (36.1%), chronic osteoarthritis (13.5%), and headache (13.6%) were the most common reasons for NSAID use. Among cases, only 17.31% took NSAIDs and 6.38% took high dose ASA due to chronic osteoarthritis. Demographic characteristics significantly differed between subjects with chronic vs. acute musculoskeletal pain. Proton pump inhibitor use was significantly higher in patients who used NSAIDs due to chronic osteoarthritis compared to patients with acute musculoskeletal pain. NSAID (65.15%) or high-dose ASA use (65.83%) preceding upper GI bleeding was most often short-term. In over half of cases (63.62%), the upper GI bleeding event was not preceded by dyspeptic warning symptoms. CONCLUSIONS The majority of patients hospitalized due to NSAID-related upper GI bleeding reported short-term NSAID use for reasons other than chronic rheumatic disease. These findings suggest that current prevention strategies may not reach a wide population of short-term NSAID users.
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Affiliation(s)
- Carlos Sostres
- a Service of Digestive Diseases, University Clinic Hospital Lozano Blesa , Zaragoza , Spain
- b Aragón Health Research Institute (IIS Aragón) , Spain
- c CIBERehd , Madrid , Spain
- d University of Zaragoza , Zaragoza , Spain
| | | | - Angel Lanas
- a Service of Digestive Diseases, University Clinic Hospital Lozano Blesa , Zaragoza , Spain
- b Aragón Health Research Institute (IIS Aragón) , Spain
- c CIBERehd , Madrid , Spain
- d University of Zaragoza , Zaragoza , Spain
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De La Zerda DJ, Stokes JA, Do J, Go A, Fu Z, Powell FL. Ibuprofen does not reverse ventilatory acclimatization to chronic hypoxia. Respir Physiol Neurobiol 2017; 256:29-35. [PMID: 28757366 DOI: 10.1016/j.resp.2017.07.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [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: 04/07/2017] [Revised: 07/18/2017] [Accepted: 07/20/2017] [Indexed: 01/13/2023]
Abstract
Ventilatory acclimatization to hypoxia involves an increase in the acute hypoxic ventilatory response that is blocked by non-steroidal anti-inflammatory drugs administered during sustained hypoxia. We tested the hypothesis that inflammatory signals are necessary to sustain ventilatory acclimatization to hypoxia once it is established. Adult, rats were acclimatized to normoxia or chronic hypoxia (CH, [Formula: see text] =70Torr) for 11-12days and treated with ibuprofen or saline for the last 2days of hypoxia. Ventilation, metabolic rate, and arterial blood gas responses to O2 and CO2 were not affected by ibuprofen after acclimatization had been established. Immunohistochemistry and image analysis showed acute (1h) hypoxia activated microglia in a medullary respiratory center (nucleus tractus solitarius, NTS) and this was blocked by ibuprofen administered from the beginning of hypoxic exposure. Microglia returned to the control state after 7days of CH and were not affected by ibuprofen administered for 2 more days of CH. In contrast, NTS astrocytes were activated by CH but not acute hypoxia and activation was not reversed by administering ibuprofen for the last 2days of CH. Hence, ibuprofen cannot reverse ventilatory acclimatization or astrocyte activation after they have been established by sustained hypoxia. The results are consistent with a model for microglia activation or other ibuprofen-sensitive processes being necessary for the induction but not maintenance of ventilatory acclimatization to hypoxia.
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Affiliation(s)
- D J De La Zerda
- Division of Pulmonary and Critical Care Medicinea, Department of Medicine, University of California, 9500 Gilman Drive La Jolla, Medicine San Diego, CA 92093, United States; Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of Miami, 1600 NW 10th Ave RMSB, Suite 7063, Miami, FL 33136, United States.
| | - J A Stokes
- Division of Physiology, Department of Medicine, University of California, 9500 Gilman Drive La Jolla, San Diego, CA 92093, United States.
| | - J Do
- Division of Physiology, Department of Medicine, University of California, 9500 Gilman Drive La Jolla, San Diego, CA 92093, United States
| | - A Go
- Division of Physiology, Department of Medicine, University of California, 9500 Gilman Drive La Jolla, San Diego, CA 92093, United States.
| | - Z Fu
- Division of Physiology, Department of Medicine, University of California, 9500 Gilman Drive La Jolla, San Diego, CA 92093, United States.
| | - F L Powell
- Division of Physiology, Department of Medicine, University of California, 9500 Gilman Drive La Jolla, San Diego, CA 92093, United States.
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Mortazavi-Jahromi SS, Jamshidi MM, Farazmand A, Aghazadeh Z, Yousefi M, Mirshafiey A. Pharmacological effects of β-d-mannuronic acid (M2000) on miR-146a, IRAK1, TRAF6 and NF-κB gene expression, as target molecules in inflammatory reactions. Pharmacol Rep 2017; 69:479-484. [PMID: 28324845 DOI: 10.1016/j.pharep.2017.01.021] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [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] [Received: 10/12/2016] [Accepted: 01/05/2017] [Indexed: 11/17/2022]
Abstract
BACKGROUND Impaired expression and function of microRNAs (miRNAs) are involved in the pathogenesis of many autoimmune and inflammatory diseases. Moreover, there is a close relationship between TLRs and miRNAs and impairment in regulating their expression which can play a vital role in the immunopathogenesis of many inflammatory reactions. This research aimed to study the pharmaceutical effects of M2000 (β-d-mannuronic acid) on the expression of miR-146a and its two target molecules (IRAK1 and TRAF6), and the transcription factor NF-κB in the HEK-Blue hTLR2 cell line. METHODS The cytotoxicity of M2000 was assessed by the MTT assay, and the qRT-PCR technique was employed in the presence and absence of M2000 treatment to measure gene-expression levels of miR-146a, IRAK1, TRAF6, and NF-κB. RESULTS MTT assay indicated that M2000 (before the concentration of 500μg/ml) had no cytotoxic effect on HEK-Blue hTLR2 cells. Our results showed that M2000 at low and high doses (5 and 25μg/well) could significantly reduce gene expression levels of miR-146a (p<0.01). Furthermore, it was found that this medication at two different doses could considerably decrease IRAK1 and TRAF6 gene expression (p<0.001). Moreover, this study revealed that expression level of NF-κB also significantly declined at these two doses (p<0.01). CONCLUSIONS This study for the first time shows that M2000 as a novel NSAID with immunosuppressive properties is able to modify TLR signaling through suppressing the adaptor molecules IRAK1 and TRAF6, the transcription factor NF-κB and miR-146a as a new therapeutic approach.
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Affiliation(s)
- Seyed Shahabeddin Mortazavi-Jahromi
- Department of Cellular and Molecular Biology, Kish International Campus, University of Tehran, Kish, Iran; School of Biology, University College of Science, University of Tehran, Tehran, Iran
| | - Mehdi Malek Jamshidi
- Department of Cellular and Molecular Biology, Kish International Campus, University of Tehran, Kish, Iran; School of Biology, University College of Science, University of Tehran, Tehran, Iran
| | - Ali Farazmand
- Department of Cellular and Molecular Biology, Kish International Campus, University of Tehran, Kish, Iran; School of Biology, University College of Science, University of Tehran, Tehran, Iran
| | - Zahra Aghazadeh
- Department of Immunology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehdi Yousefi
- Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Abbas Mirshafiey
- Department of Immunology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
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King G, Byrne A, Fleming P. A case of severe NSAID exacerbated respiratory disease (NERD) following a dental procedure in a child. Eur Arch Paediatr Dent 2016; 17:277-81. [PMID: 27179970 DOI: 10.1007/s40368-016-0233-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Accepted: 04/15/2016] [Indexed: 10/21/2022]
Abstract
BACKGROUND An allergic reaction following a dental procedure is a rare event. A local anaesthetic (LA) may initially be suspected as a causative agent but allergy to dental LA solutions is extremely rare. CASE REPORT This report concerns a 13 year old child who underwent dental treatment and was exposed to Lignospan Special(®) LA, mouthwash, latex gloves, ibuprofen medication, and a Magnum(®) (almond) ice cream all within 45 min. He subsequently developed acute symptoms of nasal rhinorrhoea, facial flushing, peri-orbital and lip angioedema, followed by throat tightness and wheeze (respiratory compromise). His acute reaction was treated by his medical practitioner with oral anti-histamines, steroid and nebulised salbutamol. The child was referred to a local allergist. The child underwent detailed allergic investigations including skin prick tests, blood tests, incremental local anaesthetic challenge and ibuprofen challenge. The patient was diagnosed with NSAID exacerbated respiratory disease (NERD), a hypersensitivity reaction to ibuprofen. FOLLOW-UP The patient was advised to avoid NSAIDs and to wear a medic-alert (allergy) bracelet. A detailed written report was sent to the patient's dentist and GP. CONCLUSIONS In the context of a suspected reaction post dental procedure, local anaesthetic should be considered a possible allergen but other important considerations include analgesics, antibiotics, and latex. All genuine allergic reactions need to be investigated. This report highlights NERD as a possible adverse outcome following dental treatment.
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Brewer CB, Bentley JP, Day LB, Waddell DE. Resistance exercise and naproxen sodium: effects on a stable PGF2α metabolite and morphological adaptations of the upper body appendicular skeleton. Inflammopharmacology 2015; 23:319-27. [PMID: 26289996 DOI: 10.1007/s10787-015-0248-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [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: 05/14/2015] [Accepted: 08/01/2015] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Exercise-induced inflammation has been shown to be necessary for successful skeletal muscle regeneration post-injury. Accordingly, numerous investigations have demonstrated consequences of COX-inhibitors, anti-inflammatory drugs which prevent prostaglandin formation. In addition to its roles in inflammation, prostaglandin F2α (PGF2α) also mediates vital regenerative processes The majority of research to report consequences of suppressing inflammation has utilized acute injury models in combination with acute COX-inhibitor administration. To address the limited research investigating regular consumption of COX-inhibitors over time in exercising humans, the purpose of this study was to determine effects of a non-selective COX-inhibitor on a PGF2α metabolite and morphological adaptations of the upper body appendicular skeleton during periodized resistance training. Twenty-three (N = 23) recreationally trained college-aged males were randomly assigned to receive placebo (n = 11) or naproxen sodium (n = 12). Treatments were prophylactically administered in double-blind fashion with supervised upper body resistance exercise performed twice per week for 6 weeks. Venous blood was sampled pre- and post-exercise and analyzed for 13, 14-dihydro-15-keto PGF2α using enzyme immunoassay. Factorial mixed-design repeated-measures ANOVAs were utilized to examine relative changes in the plasma PGF2α metabolite and upper body appendicular morphology over the training period. RESULTS Naproxen sodium significantly reduced the acute PGF2α metabolite response to exercise (p = 0.013); however, this effect diminished over time (p = 0.02), and both treatment groups exhibited significant increases in dominant arm skeletal muscle tissue (p = 0.037). CONCLUSION Despite acute inhibition of the PGF2α metabolite at early time points, naproxen sodium did not hinder positive morphological adaptations of the upper body in response to resistance training.
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Affiliation(s)
- Christi B Brewer
- Physical Education, Health, and Recreation, Eastern Washington University, 200 Physical Education Building, Cheney, WA, 99004, USA.
| | - John P Bentley
- Department of Pharmacy Administration, School of Pharmacy, University of Mississippi, Oxford, MS, USA.
| | - Lainy B Day
- Department of Biology, University of Mississippi, Oxford, MS, USA.
| | - Dwight E Waddell
- Department of Electrical Engineering, University of Mississippi, 308 Anderson Hall, Oxford, MS, USA.
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Zhu SH, Zhou LJ, Jiang H, Chen RJ, Lin C, Feng S, Jin J, Chen JH, Wu JY. Protective effect of indomethacin in renal ischemia-reperfusion injury in mice. J Zhejiang Univ Sci B 2015; 15:735-42. [PMID: 25091992 DOI: 10.1631/jzus.b1300196] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE To evaluate the renoprotection effects of non-steroidal anti-inflammatory drugs (NSAIDs) in renal ischemia-reperfusion injury (IRI) and the cyclooxygenase (COX)-1/2 blockade association by indomethacin (IMT) in the mice model. METHODS After the left renal pedicle of mice was clamped, IMT was administrated by intraperitoneal injection with four doses: 1, 3, 5, and 7 mg/kg. Blood and kidney samples were collected 24 h after IRI. The renal functions were assayed by the cytokines and serum creatinine (SCr) using enzyme-linked immunosorbent assay (ELISA) kits. Kidney samples were analyzed by hematoxylin and eosin (H&E) and immunohistochemistry stainings. RESULTS The mice administered with 5 mg/kg IMT had a marked reduction in SCr and significantly less tubular damage. The tumor necrosis factor α (TNF-α) activity in renal homogenates and interleukin 6 (IL-6) activity in serum had a marked reduction at doses of 5 and 7 mg/kg IMT. The administration of 3 and 5 mg/kg IMT had a marked reduction in the ratio of thromboxane B2 to 6-keto-prostaglandin F1α. COX-1 and COX-2 stainings were weaker in 5 mg/kg IMT groups than that in the other groups. CONCLUSIONS There was a dose response in the IMT function of renal IRI in mice, and IMT had a protective effect in a certain dose range. The effect of IMT on mice IRI was related to COX-1/2 blockades.
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Affiliation(s)
- Sheng-hong Zhu
- Kidney Disease Center, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, China; Kidney Disease Center, Shaoxing Second Hospital, Shaoxing 312000, China
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Rosenblat JD, Cha DS, Mansur RB, McIntyre RS. Inflamed moods: a review of the interactions between inflammation and mood disorders. Prog Neuropsychopharmacol Biol Psychiatry 2014; 53:23-34. [PMID: 24468642 DOI: 10.1016/j.pnpbp.2014.01.013] [Citation(s) in RCA: 390] [Impact Index Per Article: 39.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2013] [Revised: 12/22/2013] [Accepted: 01/20/2014] [Indexed: 02/06/2023]
Abstract
Mood disorders have been recognized by the World Health Organization (WHO) as the leading cause of disability worldwide. Notwithstanding the established efficacy of conventional mood agents, many treated individuals continue to remain treatment refractory and/or exhibit clinically significant residual symptoms, cognitive dysfunction, and psychosocial impairment. Therefore, a priority research and clinical agenda is to identify pathophysiological mechanisms subserving mood disorders to improve therapeutic efficacy. During the past decade, inflammation has been revisited as an important etiologic factor of mood disorders. Therefore, the purpose of this synthetic review is threefold: 1) to review the evidence for an association between inflammation and mood disorders, 2) to discuss potential pathophysiologic mechanisms that may explain this association and 3) to present novel therapeutic options currently being investigated that target the inflammatory-mood pathway. Accumulating evidence implicates inflammation as a critical mediator in the pathophysiology of mood disorders. Indeed, elevated levels of pro-inflammatory cytokines have been repeatedly demonstrated in both major depressive disorder (MDD) and bipolar disorder (BD) patients. Further, the induction of a pro-inflammatory state in healthy or medically ill subjects induces 'sickness behavior' resembling depressive symptomatology. Potential mechanisms involved include, but are not limited to, direct effects of pro-inflammatory cytokines on monoamine levels, dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis, pathologic microglial cell activation, impaired neuroplasticity and structural and functional brain changes. Anti-inflammatory agents, such as acetyl-salicylic acid (ASA), celecoxib, anti-TNF-α agents, minocycline, curcumin and omega-3 fatty acids, are being investigated for use in mood disorders. Current evidence shows improved outcomes in mood disorder patients when anti-inflammatory agents are used as an adjunct to conventional therapy; however, further research is needed to establish the therapeutic benefit and appropriate dosage.
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Affiliation(s)
- Joshua D Rosenblat
- Mood Disorders Psychopharmacology Unit (MDPU), University Health Network, University of Toronto, Toronto, Canada; Schulich School of Medicine and Dentistry, Western University, London, Canada
| | - Danielle S Cha
- Mood Disorders Psychopharmacology Unit (MDPU), University Health Network, University of Toronto, Toronto, Canada
| | - Rodrigo B Mansur
- Mood Disorders Psychopharmacology Unit (MDPU), University Health Network, University of Toronto, Toronto, Canada; Interdisciplinary Laboratory of Clinical Neuroscience (LINC), Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil; Program for Recognition and Intervention in Individuals in At-Risk Mental States (PRISMA), Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil
| | - Roger S McIntyre
- Mood Disorders Psychopharmacology Unit (MDPU), University Health Network, University of Toronto, Toronto, Canada.
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