Hybrids of selective COX-2 inhibitors and active derivatives of edaravone as COX-2 selective NSAIDs with free radical scavenging activity: Design, synthesis and biological activities

Novel hybrids of selective COX-2 inhibitors (coxibs) and active derivatives of free radical scavenger edaravone were designed to overcome the risk of cardiovascular events and stroke increased by NSAIDs (nonsteroidal anti-inflammatory drugs) in this study. All the hybrids were assayed for the COX-2 inhibitory and DPPH (2, 2-diphenyl-1-picrylhydrazyl) free radical scavenging activities in vitro. Finally, we found a series of hybrids with good inhibitory activity and selectivity of COX-2 and excellent free radical scavenging activity in vitro. The most promising compound 6a (WYZ90) exhibited very potent COX-2 inhibitory activity (COX-2, IC50 = 75 nM), weak COX-1 inhibitory activity (COX-1, IC50 = 5734 nM), better free radical scavenging activity (DPPH, IC50 = 19.9 μM) than edaravone, moderate drug-likeness and ADME properties in silico, acceptable pharmacokinetic properties (T1/2 = 4.16 h, 10 mg/kg, o.p.) and oral bioavailability (F% = 36.03 %) in mice. In addition, compound WYZ90 showed similar analgesic activity to the selective COX-2 inhibitor celecoxib in acetic acid-induced mice and better antioxidant activity in Fe2+-induced lipid peroxidation in mouse liver tissue homogenate than edaravone. In conclusion, this study provided a novel class of coxibs containing edaravone moiety as COX-2 selective NSAIDs with free radical scavenging activity and the candidate compound WYZ90 showed not only similar selective COX-2 inhibitory and analgesic activity to celecoxib but also better free radical scavenging and antioxidant activity than edaravone.

Vitamin D ameliorates celecoxib cardiotoxicity in a doxorubicin heart failure rat model via enhancement of the antioxidant defense and minimizing mitochondrial dysfunction

Recent evidence suggests the mechanistic role of mitochondria and oxidative stress in the development of celecoxib-induced cardiotoxicity. On the other, it has reported the positive effects of vitamin D on oxidative stress and the maintenance of mitochondrial functions. This current study examined the cardiac effects of celecoxib, doxorubicin, vitamin D, and a combination of them in rats. The effect of 10 days of celecoxib (100 mg/kg/day), doxorubicin (2.5 mg/kg), vitamin D (60,000 U/kg), and their combination was studied on cardiac function according to serum lactate dehydrogenase (LDH), creatine kinase (CK), glutathione (GSH), and malondialdehyde (MDA) levels as well as mitochondrial succinate dehydrogenases (SDH) activity, reactive oxygen species (ROS) production, mitochondrial swelling, and mitochondrial membrane potential (MMP). Results showed that celecoxib and its combination with doxorubicin led to abnormality in paws and limbs, increased pressure in the eyes, blindness and animal death (in about 75% of the animals under study). Moreover, celecoxib and its combination with doxorubicin significantly increased cardiotoxicity biomarkers, oxidative stress markers (GSH and MDA), and mitochondrial toxicity parameters (SDH, ROS formation, MMP collapse, mitochondrial swelling). However, the combination of vitamin D with celecoxib and celecoxib + doxorubicin caused a significant reversal of deformity in paws and limbs, increased pressure in the eye, blindness, and animal death, as well as cardiotoxicity, oxidative stress, and mitochondrial parameters. This study proved for the first time the beneficial effect of vitamin D on celecoxib-induced cardiotoxicity, which is aggravated in the presence of doxorubicin through the maintenance of mitochondrial functions and its antioxidant potential.

Selective COX-2 Inhibitor Is Beneficial in Suppressing Chronic Postsurgical Pain in Esophageal Cancer Patients and May Prolong Patient Survival

INTRODUCTION

Chronic postsurgical pain (CPSP) is a common complication after surgical procedures. Radical resection of esophageal cancer is a complex procedure, one of the most extensive and traumatic surgical procedures in oncological surgery, and the incidence of postoperative chronic pain is high, seriously affecting patients' postoperative recovery. Therefore, this study aimed to investigate the incidence of CPSP in patients with esophageal cancer and to analyze the risk factors associated with its occurrence in order to provide certain prevention and treatment ideas for clinical prevention and reduction of CPSP.

METHODS

Patients with radical esophageal cancer resection were selected as the study subjects, and the clinical data regarding to patients' preoperative comorbidities, ASA grading, surgical method, use of selective COX-2 inhibitors, postoperative analgesic pump use, and patients' postoperative tumor recurrence time were collected. The differences in clinical data between the CPSP group and no-CPSP group were compared to analyze the risk factors for the occurrence of CPSP.

RESULTS

A total of 262 patients were included; 57 (21.76%) developed CPSP, and there were statistical differences between the two groups in terms of selective COX-2 inhibitor and postoperative analgesic pump use rates and surgical modality (p < 0.05), and logistic regression analysis showed that age and length of surgery increased the risk of CPSP, perioperative selective COX-2 inhibitor use decreased the risk of CPSP occurrence (p < 0.05), the extent of tumor infiltration and regional lymph node metastasis were risk factors for shortening tumor-free survival (TFS), and age and use of selective COX-2 inhibitor were influential factors for prolonging TFS (p < 0.05).

CONCLUSION

Patients with esophageal cancer have a high incidence of postoperative chronic pain, with youth and length of surgery being risk factors for CPSP, and perioperative pain management with selective COX-2 inhibitors can reduce the incidence of CPSP and is associated with prolonged TFS.

The early inhibition of the COX-2 pathway in viperid phospholipase A2-induced skeletal muscle myotoxicity accelerates the tissue regeneration

The administration of non-steroidal anti-inflammatory drugs in the treatment of injury and muscle regeneration is still contradictory in effectiveness, especially regarding the timing of their administration. This can interfere with the production of prostaglandins originating from inflammatory isoform cyclooxygenase-2 (COX-2), which is essential to modulate tissue regeneration. The phospholipases A₂ (PLA₂) from viperid venoms cause myotoxicity, therefore constituting a tool for the study of supportive therapies to improve skeletal muscle regeneration. This study investigated the effect of early administration of lumiracoxib (selective inhibitor of COX-2) on the degeneration and regeneration stages of skeletal muscle after injury induced by a myotoxic PLA₂. After 30 min and 48 h of intramuscular injection of PLA₂, mice received lumiracoxib orally and histological, functional, and transcriptional parameters of muscle were evaluated from 6 h to 21 days. Inhibition of COX-2 in the early periods of PLA₂-induced muscle degeneration reduced leukocyte influx, edema, and tissue damage. After the second administration of lumiracoxib, in regenerative stage, muscle showed increase in number of basophilic fibers, reduction in fibrosis content and advanced recovery of functionality characterized by the presence of fast type II fibers. The expression of Pax7 and myogenin were increased, indicating a great capacity for storing satellite cells and advanced mature state of tissue. Our data reveals a distinct role of COX-2-derived products during muscle degeneration and regeneration, in which early administration of lumiracoxib was a therapeutic strategy to modulate the effects of prostaglandins, providing a breakthrough in muscle tissue regeneration induced by a myotoxic PLA_2.

Optimization of pyrazole-based compounds with 1,2,4-triazole-3-thiol moiety as selective COX-2 inhibitors cardioprotective drug candidates: Design, synthesis, cyclooxygenase inhibition, anti-inflammatory, ulcerogenicity, cardiovascular evaluation, and molecular modeling studies

The cardiovascular side effects associated with COX-2 selective drugs were the worst for coxibs leading to their withdrawal from the market a few years after their discovery. Therefore, the design of new series of pyrazole (4a,b 5a,b, 7a,b, 9a,b, 10a-h, and 11a-f) substituted with a triazole moiety as selective COX-2 inhibitors with cardioprotective effect was aimed in this paper. The target compounds were prepared and evaluated in-vitro against COX-1 and COX-2 enzymes. Compound 5-(5-Methyl-1-phenyl-1H-pyrazol-4-yl)-4H-1,2,4-triazole-3-thiol (7a) showed the highest selectivity towards COX-2 enzyme (S.I. = 27.56) and was the most active anti-inflammatory agent. Interestingly, its cardiovascular profile showed the cardiac biomarkers (ALP, AST, CK-MB, and LDH), as well as inflammatory cytokines named (TNF-α and IL-6) nearly similar to the control. Besides, a histopathological study of the heart muscle and the stomach was also included. The results confirmed that compound 7a has a more favorable cardio profile than celecoxib. Moreover, docking simulation for the most selective compounds 4b, 7a, 10e, 11c, and 11e inside COX-2 active site was performed to explain their binding mode. Finally, an ADME study was applied and proved the promising activity of the new compounds as a new oral anti-inflammatory agent. In conclusion, the newly developed compound 7a represents a potential selective COX-2 NSAID candidate with minimum cardiovascular risks.

Design, synthesis and biological assessment of new selective COX-2 inhibitors including methyl sulfonyl moiety

Nonsteroidal anti-inflammatory drugs (NSAIDs) cause peptic lesions in the gastrointestinal mucosa by inhibiting the cyclooxygenase-1 (COX-1) enzyme. Selective COX-2 inhibition causes decreased side effects over current NSAIDs. Therefore, the studies about selective inhibition of COX-2 enzyme are very important for new drug development. The design, synthesis and biological activity evaluation of novel derivatives bearing thiazolylhydrazine-methyl sulfonyl moiety as selective COX-2 inhibitors were aimed in this paper. The structures of synthesized compounds were assigned using different spectroscopic techniques such as ¹H NMR, ¹³C NMR and HRMS. In addition, the estimation of ADME parameters for all compounds was carried out using in silico process. The evaluation of in vitro COX-1/COX-2 enzyme inhibition was applied according to the fluorometric method. According to the enzyme inhibition results, synthesized compounds showed the selectivity against COX-2 enzyme inhibition as expected. Compounds 3a, 3e, 3f, 3g, 3i and 3j demonstrated significant COX-2 inhibition potencies. Among them, compound 3a was found to be the most effective derivative with an IC₅₀ value of 0.140 ± 0.006 μM. Moreover, it was seen that compound 3a displayed a more potent inhibition profile at least 12-fold than nimesulide (IC₅₀ = 1.684 ± 0.079 μM), while it showed inhibitory activity at a similar rate of celecoxib (IC₅₀ = 0.132 ± 0.005 μM). Molecular modelling studies aided in the understanding of the interaction modes between this compound and COX-2 enzyme. It was found that compound 3a had a significant binding property. In addition, the selectivity of obtained derivatives on COX-2 enzyme could be explained and discussed by molecular docking studies.

The efficacy and safety of selective COX-2 inhibitors for postoperative pain management in patients after total knee/hip arthroplasty: a meta-analysis

BACKGROUND

Many selective cyclooxygenase (COX-2) inhibitors are currently used in clinical practice. COX-2 inhibitors have good anti-inflammatory, analgesic, antipyretic effects, and gastrointestinal safety. However, the analgesic effects and adverse reactions of COX-2 after total knee/hip arthroplasty (TKA/THA) are not fully known.

OBJECTIVE

To evaluate the efficacy and safety of selective COX-2 inhibitors in postoperative pain management in patients receiving TKA/THA.

METHODS

Randomized controlled trials (RCTs) were retrieved from medical literature databases. Risk ratios (RR) Std mean difference (SMD) and 95% confidence intervals (CI) were calculated to analyze the primary and safety endpoints.

RESULTS

In total, 18 articles (23 trial comparisons) were retrieved comprising 3104 patients. Among them, 1910 patients (61.5%) were randomized to the experimental group whereas 1194 patients (38.5%) were randomized to the control group. The primary endpoints were the patients' VAS score at rest or on ambulation (within 3 days). We found that VAS score in patients that received selective COX-2 inhibitor was significantly lower compared to those of the control group.

CONCLUSION

This meta-analysis shows that selective COX-2 inhibitor therapy is effective, safe, and reliable in relieving postoperative pain of THA/TKA.

Effect of Celecoxib on Surgical Site Inflammation after Total Knee Arthroplasty: A Randomized Controlled Study

OBJECTIVE

To evaluate the anti-inflammatory effectiveness of celecoxib and its effect on the rehabilitation of joint function after total knee arthroplasty.

METHODS

72 patients presented between 2016 and 2017 and were divided into two groups. The experimental group was given 200 mg celecoxib twice daily with tramadol hydrochloride 50 mg twice daily (as required); the control group was given tramadol hydrochloride 50 mg twice daily for 6 weeks from the first day after total knee arthroplasty. Skin temperature around the knee was measured 1 day before surgery, on postoperative days 1 and 3, and at weeks 1, 2, and 6. Inflammatory markers (white blood cell count, C-reactive protein, erythrocyte sedimentation rate, and interleukin-6) were measured preoperatively, on postoperative day 3, and at weeks 1 and 6. Knee Society Score was recorded preoperatively and at postoperative weeks 1, 2, and 6.

RESULTS

Except for preoperative skin temperature, the recorded skin temperatures of the experimental group were significantly different compared to those of the control group (p = 0.001, 0.024, 0.030, 0.041, 0.047, respectively). Levels of C-reactive protein were significantly different at the 1st and the 6th week after surgery, differing by 19.3 ± 4.64 mg/L (p < 0.001) and 2.6 ± 0.92 mg/L (p = 0.006). Levels of interleukin-6 showed a significant difference of 6.61 ± 2.36 pg/mL (p = 0.007) at the 1st week after surgery. Until the 6th week after surgery, the erythrocyte sedimentation rate in the experimental group and the control group differed by 17 ± 4.6 mm/h (p = 0.001).

CONCLUSIONS

Celecoxib has a significant inhibitory effect on postoperative aseptic inflammation.

Folic acid ameliorates celecoxib cardiotoxicity in a doxorubicin heart failure rat model

CONTEXT

The cardiotoxic effect of selective cyclo-oxygenase-2 inhibitors is well known. While rofecoxib and valdecoxib have been withdrawn, celecoxib remains on the market. Folic acid, a naturally occurring vitamin, has been shown to reduce myocardial ischemia and post-reperfusion injury in rats.

OBJECTIVE

This study examined the cardiac effects of celecoxib and folic acid on doxorubicin-induced cardiomyopathy in rats.

MATERIALS AND METHODS

Cardiomyopathy was induced in male Wistar rats with six intraperitoneal injections of 2.5 mg/kg doxorubicin over a period of two weeks. The effect of 28 days of celecoxib (100 mg/kg/day) and its combination with folic acid (10 mg/kg/day) was studied on doxorubicin-induced cardiomyopathy according to serum lactate dehydrogenase (LDH), creatine kinase (CK-MB), troponin-T (Tn-T), tumor necrosis factor alpha (TNF-α), cardiac thiobarbituric acid reactive substance (TBARS), and glutathione (GSH) levels as well as systolic blood pressure (SBP), heart rate (HR) and ultrastructural studies.

RESULTS

Celecoxib cardiotoxicity was manifested by significant increases in the LDH, Tn-T, TNF-α, CK-MB, SBP, HR (p < 0.001) and TBARS (p < 0.01) levels and a significant decrease in the GSH (p < 0.05) level when used alone or administered with doxorubicin. However, the combination of folic acid with celecoxib caused a significant reversal of these parameters and reduced the cardiotoxicity of celecoxib that was aggravated by doxorubicin. The ultrastructural study also revealed myocardial protection with this combination.

DISCUSSION AND CONCLUSION

Folic acid protects against the cardiotoxic effects of celecoxib, which are aggravated in the presence of doxorubicin. Folic acid may act as a useful adjunct in patients who are taking celecoxib.

Selective cyclooxygenase-2 inhibitor compound 11b improves haloperidol-induced catatonia by enhancing the striatum dopaminergic neurotransmission

The aim of this research was to investigate the Cyclooxygenase-2 (COX-2) selective inhibition effect on haloperidol-induced catatonia. In this study, the effect of orally, acutely and Sub-chronically administrations of compound 11b [1-(phenyl)-5-(4-methylsulfonylphenyl)-2-ethylthioimidazole] (2, 4 and 8 mg/kg), a newly selective COX-2 inhibitor, was investigated against the haloperidol-induced catatonia phenomenon comparing to the standard drug scopolamine (1 mg/Kg) followed by microdialysis analysis of Striatum dopaminergic neurotransmission. The results showed a great potency for compound 11b in improvement of catalepsy followed by enhancing the dopaminergic neurotransmission p < 0.05. In addition, our statistical analysis showed that the protective effect of compound 11b against haloperidol-induced catatonia was both dose- and time-dependent. These findings are additional pharmacological data that suggest the effectiveness of compound 11b in treatment of schizophrenic drug overdoses and also Parkinson's disease (PD) affiliated rigidity.

Selective COX-2 inhibitor celecoxib inhibits liver fibrogenesis in rats

AIM: To investigate whether celecoxib, a selective cyclooxygenase-2 (COX-2) inhibitor, protects from carbon tetrachloride (CCl4)-induced liver fibrosis in rats.

METHODS: Fifty male SD rats were randomly divided into six groups. Group A (n = 10) was subcutaneously injected with 50% 1 mL/kg CCl4 olive oil solution, twice per week, to induce hepatic fibrosis and intragastrically given saline. Groups B (n = 10), C (n = 10) and D (n = 10) were also subjected to induction of hepatic fibrosis and intragastrically given celecoxib 15 mg/kg once daily from day 1, week 3, and week 5 after CCl4 injection. Group E (n = 5) was subcutaneously injected with equal volume of olive oil and intragastrically given the same dose of celecoxib, while group F (n = 5) was subcutaneously injected with equal volume of olive oil and intragastrically given saline. The treatment lasted for 8 weeks. At the end of the experiment, blood samples were collected to measure serum ALT, HA and LN levels, while hepatic tissue samples were taken to evaluate the degree of liver fibrosis by HE staining and to detect the expression of type I collagen, alpha SMA, COX-1, and COX-2 by immunohistochemistry.

RESULTS: Compared to group F, significant hepatic fibrosis was observed in group A (P < 0.01). Compared to group A, liver fibrosis was significantly reduced (P < 0.01), serum ALT, HA and LN levels significantly decreased (100.4 U/L ± 8.7 U/L vs 287.8 U/L ± 9.6 U/L, 189.6 μg/L ± 83.0 μg/L vs 382.6 μg/L ± 136.0 μg/L, 71.4 μg/L ± 4.6 μg/L vs 108.7 μg/L ± 9.8 μg/L, all P < 0.01), and the areas positive for type I collagen, alpha SMA, and COX-2 were reduced (all P < 0.01). The above parameters showed significant differences among groups B, C and D (all P < 0.05). No significant differences were observed in the above parameters between groups E and F. COX-1-positive area showed no significant difference among each group.

CONCLUSION: COX-2 plays an important role in liver fibrogenesis. Celecoxib can reduce or prevent liver fibrosis in a time-dependent manner probably by inhibiting hepatic stellate cell activation and inflammation.

Celecoxib inhibits the expression of MMP-2 and ICAM-1 in hepatocellular carcinoma xenografts in nude mice

AIM: To investigate the antitumor effects of celecoxib (a selective cyclooxygenase-2 inhibitor) against hepatocellular carcinoma in vivo.

METHODS: Human hepatoma cells (HepG2, BEL-7402 and SMMC-7721) were injected beneath the hepatic capsule of six-week-old nude mice. The mice were then randomly divided into three groups: negative control group (intragastrically given normal saline), experimental group (intragastrically given celecoxib), and positive control group (intragastrically given normal saline and intraperitoneally injected with adriamycin). Three weeks later, tumor tissue samples were taken for immunohistochemical analysis to examine the expression of matrix metalloproteinase-2 (MMP-2), tissue inhibitor of metalloproteinases-2 (TIMP-2) and intercellular adhesion molecule-1 (ICAM-1).

RESULTS: Compared to the negative control group, the expression of MMP-2 was down-regulated (P < 0.05) and that of TIMP-2 was up-regulated (P < 0.05) in hepatocellular carcinoma xenografts derived from HepG2, BEL-7402 and SMMC-7721 cells in the experimental group. The expression of ICAM-1 was also down-regulated in hepatocellular carcinoma xenografts derived from BEL-7402 and SMMC-7721 cells in the experimental group when compared with the negative control group (P < 0.05).

CONCLUSION: Celecoxib may be able to inhibit the metastasis and improve the prognosis of hepatocellular carcinoma.

Therapeutic effects of selective cyclooxygenase-2 inhibitor PC407 on 2,4,6-trinitrobenzene sulfonic acid-induced ulcerative colitis in rats

AIM: To explore the therapeutic effects of a new selective cyclooxygenase-2 (COX-2) inhibitor PC407 on rat ulcerative colitis induced by 2,4,6-trinitrobenzene sulfonic acid (TNBS) and its possible mechanism.

METHODS: A rat colitis model was induced by TNBS and ethonal enema. The rats were randomly divided into 5 groups: normal group, model control group, celecoxib group (18 mg/kg) and PC407 groups (9, 18mg/kg). Celecoxib and PC407 were administered intragastrically once per day for 6 days and the loose stool were recorded. All the rats were anesthetized to separate colon, thymus gland and spleen on the 7th day. The body weights of experimental rats before anesthesia were documented and the macroscopic and histological changes of the colon were observed. The effects in treatment groups were evaluated by loose stool rate, colon index, ulcer ratio, thymus index and spleen index. The protein products of COX-2, tumor necrosis factor-α (TNF-α) in mucosa were analyzed by immunohistochemistry.

RESULTS: In comparison with that in model control group, the body weight was increased significantly in 18 mg/kg-PC407 group (258.9 g vs 223.6 g, P < 0.05), but the loose stool rate was decreased markedly (30% vs 80 %, P < 0.01); moreover, 18 mg/kg PC407 significantly ameliorated the lesions and pathological changes in colon caused by TNBS, improved the indexes such as colon index (5.03 ± 1.26 mg/g vs 7.60 ± 2.07 mg/g, P < 0.01), ulcer ratio (24.69% ± 2.83% vs 36.13% ± 9.64%, P < 0.01), thymus index (1.96 ± 0.48 mg/g vs 1.08 ± 0.32 mg/g, P < 0.01) and spleen index (2.85 ± 0.33 mg/g vs 3.87 ± 0.96 mg/g, P < 0.01), and down-regulated the colonic mucosal expression of COX-2 (30.6% ± 7.0% vs 67.4% ± 1.2%, P < 0.01) and TNF-α (19.5% ± 3.0% vs 52% ± 4.7%, P < 0.01). PC407 at a dose of 9 mg/kg also could improve the above indexes, but the effects were less than PC407 at 18 mg/kg.

CONCLUSION: PC407 has significant therapeutic effects on TNBS-induced colitis in rats, and the mechanism may relate to its regulation on COX-2 and TNF-α expression.