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Weisman SM, Ciavarra G, Cooper G. What a pain in the … back: a review of current treatment options with a focus on naproxen sodium. J Pharm Pharm Sci 2024; 27:12384. [PMID: 38384362 PMCID: PMC10880755 DOI: 10.3389/jpps.2024.12384] [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] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 01/24/2024] [Indexed: 02/23/2024]
Abstract
Non-specific low back pain (LBP) represents a challenging and prevalent condition that is one of the most common symptoms leading to primary care physician visits. While established guidelines recommend prioritizing non-pharmacological approaches as the primary course of action, pharmacological treatments are advised when non-pharmacological approaches are ineffective or based on patient preference. These guidelines recommend non-steroidal anti-inflammatory drugs (NSAIDs) or skeletal muscle relaxers (SMRs) as the first-line pharmacological options for acute or subacute LBP, while NSAIDs are the exclusive first-line pharmacological option for chronic LBP. Although SMRs are generally effective for acute LBP, the available evidence does not support the view that they improve functional recovery, and their comparative efficacy to NSAIDs and other analgesics remains unknown, while studies have shown them to introduce adverse events without significantly reducing LBP. Moreover, opioids continue to be widely prescribed for LBP, despite limited evidence for effectiveness and known risks of addiction and overdose. Broader use of non-opioid pharmacotherapy, including the appropriate use of OTC options, is critical to addressing the opioid crisis. The balance of evidence indicates that NSAIDs have a favorable benefit-risk profile when compared to other available pharmacological treatment options for non-specific LBP, a condition that is primarily acute in nature and well-suited for self-treatment with OTC analgesics. While clinical guidelines do not differentiate between NSAIDs, evidence indicates that OTC naproxen sodium effectively relieves pain across multiple types of pain models, and furthermore, the 14-h half-life of naproxen sodium allows sustained, all day pain relief with reduced patient pill burden as compared to shorter acting options. Choosing the most appropriate approach for managing LBP, including non-pharmacological options, should be based on the patient's condition, severity of pain, potential risks, and individual patient preference and needs.
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Affiliation(s)
| | | | - Grant Cooper
- Princeton Spine and Joint Center, Princeton, NJ, United States
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2
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Krekis A, King JN, D'Arcy-Howard D, Stapleton N, Elliott J, Pelligand L. Effect of meloxicam or robenacoxib administration timing on renal function and postoperative analgesia in cats undergoing ovariohysterectomy: A randomized, blinded, controlled clinical trial. J Vet Pharmacol Ther 2024. [PMID: 38235901 DOI: 10.1111/jvp.13427] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 12/10/2023] [Accepted: 01/08/2024] [Indexed: 01/19/2024]
Abstract
We evaluated the effect of administration timing of meloxicam and robenacoxib on renal function, platelet cyclo-oxygenase and perioperative analgesia in 60 cats undergoing ovariohysterectomy, in a prospective randomized blinded controlled study. Twelve cats were randomly allocated to one subcutaneous treatment group: meloxicam (0.2 mg/kg) or robenacoxib (2 mg/kg) at admission (MA, RA), at induction (MI, RI) and robenacoxib at the end of surgery (RE). All cats received the same anaesthesia protocol. Plasma renin activity (PRA), plasma creatinine, drug concentrations and serum thromboxane (TxB2 ) were measured sequentially. Anaesthesia significantly increased PRA, as activity at end of the surgery was higher than 2 h later (mean ± SD: 26.6 ± 2.8 versus 10.0 ± 3.9 ng/mL/h). PRA remained higher at 2 h post-surgery in admission groups compared to induction groups (p = .01). Serum TxB2 was lower with meloxicam than robenacoxib (p = .001), and was lower in the MA than each robenacoxib group at catheter placement. Admission groups (16/24 from RA and MA groups) received earlier rescue analgesia than other groups (p = .033). In conclusion, the renin-angiotensin system was activated during anaesthesia despite cyclo-oxygenase inhibition, possibly due to hypotension or surgical stimulation. There was no effect of drug or timing on the markers of renal function but one cat receiving meloxicam at induction had suspected IRIS grade II acute kidney injury.
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Affiliation(s)
| | | | - Duncan D'Arcy-Howard
- Department of Clinical Science and Services, Beaumont Sainsbury Animal Hospital, Royal Veterinary College, University of London, London, UK
| | - Nadene Stapleton
- Department of Clinical Science and Services, Beaumont Sainsbury Animal Hospital, Royal Veterinary College, University of London, London, UK
| | - Jonathan Elliott
- Department of Comparative Biomedical Sciences, Royal Veterinary College, University of London, London, UK
| | - Ludovic Pelligand
- Department of Comparative Biomedical Sciences, Royal Veterinary College, University of London, London, UK
- Department of Clinical Science and Services, Queen Mother Hospital for Animals, Royal Veterinary College, University of London, London, UK
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3
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Herghelegiu MC, Pănescu VA, Bocoș-Bințințan V, Coman RT, Berg V, Lyche JL, Bruzzoniti MC, Beldean-Galea MS. Simultaneous Determination of Steroids and NSAIDs, Using DLLME-SFO Extraction and HPLC Analysis, in Milk and Eggs Collected from Rural Roma Communities in Transylvania, Romania. Molecules 2023; 29:96. [PMID: 38202679 PMCID: PMC10780084 DOI: 10.3390/molecules29010096] [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: 11/30/2023] [Revised: 12/20/2023] [Accepted: 12/21/2023] [Indexed: 01/12/2024] Open
Abstract
This research aims to determine five steroids and four non-steroidal anti-inflammatory drugs in milk and egg samples collected from rural Roma communities in Transylvania, Romania. Target compounds were extracted from selected matrices by protein precipitation, followed by extract purification by dispersive liquid-liquid microextraction based on solidification of floating organic droplets. The extraction procedure was optimized using a 24 full factorial experimental design. Good enrichment factors (87.64-122.07 milk; 26.97-38.72 eggs), extraction recovery (74.49-103.76% milk; 75.64-108.60% eggs), and clean-up of the sample were obtained. The method detection limits were 0.74-1.77 µg/L for milk and 2.39-6.02 µg/kg for eggs, while the method quantification limits were 2.29-5.46 µg/L for milk and 7.38-18.65 µg/kg for eggs. The steroid concentration in milk samples was
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Affiliation(s)
- Mihaela Cătălina Herghelegiu
- Faculty of Environmental Science and Engineering, Babeș-Bolyai University, 1 Kogălniceanu Str., 400084 Cluj-Napoca, Romania
| | - Vlad Alexandru Pănescu
- Faculty of Environmental Science and Engineering, Babeș-Bolyai University, 1 Kogălniceanu Str., 400084 Cluj-Napoca, Romania
| | - Victor Bocoș-Bințințan
- Faculty of Environmental Science and Engineering, Babeș-Bolyai University, 1 Kogălniceanu Str., 400084 Cluj-Napoca, Romania
| | - Radu-Tudor Coman
- Faculty of Medicine, “Iuliu Hațieganu” University of Medicine and Pharmacy, 8 Babeș Str., 400012 Cluj-Napoca, Romania
| | - Vidar Berg
- Faculty of Veterinary Medicine, Norwegian University of Life Sciences, 1433 Ås-Oslo, Norway
| | - Jan Ludvig Lyche
- Faculty of Veterinary Medicine, Norwegian University of Life Sciences, 1433 Ås-Oslo, Norway
| | | | - Mihail Simion Beldean-Galea
- Faculty of Environmental Science and Engineering, Babeș-Bolyai University, 1 Kogălniceanu Str., 400084 Cluj-Napoca, Romania
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Grohs L, Cheng L, Cönen S, Haddad BG, Bülow A, Toklucu I, Ernst L, Körner J, Schmalzing G, Lampert A, Machtens JP, Hausmann R. Corrigendum: Diclofenac and other non-steroidal anti-inflammatory drugs (NSAIDs) are competitive antagonists of the human P2X3 receptor. Front Pharmacol 2023; 14:1225522. [PMID: 37332347 PMCID: PMC10274573 DOI: 10.3389/fphar.2023.1225522] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 05/22/2023] [Indexed: 06/20/2023] Open
Abstract
[This corrects the article DOI: 10.3389/fphar.2023.1120360.].
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Affiliation(s)
- Laura Grohs
- Institute of Clinical Pharmacology, RWTH Aachen University, Aachen, Germany
- Department of Neurology, University Hospital, RWTH Aachen University, Aachen, Germany
| | - Linhan Cheng
- Institute of Clinical Pharmacology, RWTH Aachen University, Aachen, Germany
| | - Saskia Cönen
- Institute of Clinical Pharmacology, RWTH Aachen University, Aachen, Germany
- Molecular and Cellular Physiology (IBI-1), Institute of Biological Information Processing (IBI), Jülich, Germany
| | - Bassam G. Haddad
- Molecular and Cellular Physiology (IBI-1), Institute of Biological Information Processing (IBI), Jülich, Germany
| | - Astrid Bülow
- Institute of Clinical Pharmacology, RWTH Aachen University, Aachen, Germany
- Department of Plastic Surgery, Hand and Burn Surgery, University Hospital RWTH Aachen, Aachen, Germany
| | - Idil Toklucu
- Institute of Physiology (Neurophysiology), RWTH Aachen University, Aachen, Germany
| | - Lisa Ernst
- Institute for Laboratory Animal Science and Experimental Surgery, RWTH Aachen University, Aachen, Germany
| | - Jannis Körner
- Institute of Physiology (Neurophysiology), RWTH Aachen University, Aachen, Germany
- Department of Anesthesiology, University Hospital RWTH Aachen, Aachen, Germany
| | - Günther Schmalzing
- Institute of Clinical Pharmacology, RWTH Aachen University, Aachen, Germany
| | - Angelika Lampert
- Institute of Physiology (Neurophysiology), RWTH Aachen University, Aachen, Germany
| | - Jan-Philipp Machtens
- Institute of Clinical Pharmacology, RWTH Aachen University, Aachen, Germany
- Molecular and Cellular Physiology (IBI-1), Institute of Biological Information Processing (IBI), Jülich, Germany
| | - Ralf Hausmann
- Institute of Clinical Pharmacology, RWTH Aachen University, Aachen, Germany
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Skarke C, Lordan R, Barekat K, Naik A, Mathew D, Ohtani T, Greenplate AR, Grant GR, Lahens NF, Gouma S, Troisi E, Sengupta A, Weljie AM, Meng W, Luning Prak ET, Lundgreen K, Bates P, Meng H, FitzGerald GA. Modulation of the immune response to SARS-CoV-2 vaccination by NSAIDs. J Pharmacol Exp Ther 2023:jpet.122.001415. [PMID: 37105582 PMCID: PMC10353078 DOI: 10.1124/jpet.122.001415] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Revised: 01/13/2023] [Accepted: 02/09/2023] [Indexed: 04/29/2023] Open
Abstract
Evidence is scarce to guide the use of nonsteroidal anti-inflammatory drugs (NSAIDs) to mitigate SARS-CoV-2 vaccine related adverse effects, given the possibility of blunting the desired immune response. In this pilot study, we deeply phenotyped a small number of volunteers who did or did not take NSAIDs concomitant with SARS-CoV-2 immunizations to seek initial information on the immune response. A SARS-CoV-2 vaccine specific RBD-IgG antibody response and efficacy in the evoked neutralization titers were evident irrespective of concomitant NSAID consumption. Given the sample size, only a large and consistent signal of immunomodulation would have been detectable, and this was not apparent. However, the information gathered may inform the design of a definitive clinical trial. Here, we report a series of divergent omics signals that invite additional hypotheses testing. Significance Statement A SARS-CoV-2 vaccine specific immune response was evident irrespective of concomitant NSAID consumption in a clinical pilot study of small sample size.
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Affiliation(s)
- Carsten Skarke
- University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA, United States
| | - Ronan Lordan
- University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA, United States
| | - Kayla Barekat
- University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA, United States
| | - Amruta Naik
- University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA, United States
| | - Divij Mathew
- University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA, United States
| | - Takuya Ohtani
- University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA, United States
| | - Allison R Greenplate
- University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA, United States
| | - Gregory R Grant
- University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA, United States
| | - Nicholas F Lahens
- University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA, United States
| | - Sigrid Gouma
- University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA, United States
| | - Elizabeth Troisi
- University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA, United States
| | - Arjun Sengupta
- University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA, United States
| | - Aalim M Weljie
- University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA, United States
| | - Wenzhao Meng
- University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA, United States
| | - Eline T Luning Prak
- University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA, United States
| | - Kendall Lundgreen
- University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA, United States
| | - Paul Bates
- University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA, United States
| | - Hu Meng
- University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA, United States
| | - Garret A FitzGerald
- Center for Experimental Therapeutics, University of Pennsylvania, United States
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6
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Borao Laguna C, Lanas A. Advances in the pharmacotherapeutic management of refractory peptic ulcers. Expert Opin Pharmacother 2023; 24:825-833. [PMID: 37027144 DOI: 10.1080/14656566.2023.2199922] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/08/2023]
Abstract
INTRODUCTION Refractory peptic ulcer is now a rare disease since most peptic ulcers heal with appropriate treatment with proton pump inhibitors (PPIs) and/or Helicobacter pylori eradication. AREAS COVERED The most frequent cause of apparent refractoriness is lack of adherence to treatment. Persistence of H. pylori infection, use or abuse (often surreptitious) of high dose non-steroidal anti-inflammatory drugs (NSAIDs) or aspirin (ASA) are the two major causes of true refractory ulcers. There is a growing number of peptic ulcers which are not linked to either NSAIDs or H. pylori infection. Refractoriness in these ulcers can be linked to gastric acid hypersecretion, rapid PPI metabolization, ischemia, chemo-radiotherapy, immune diseases, more rarely to other drugs or be fully idiopathic. Treatment of the cause of the ulcer, if known, is essential. This review is based on pertinent publications retrieved by a selective search in PubMed, with particular attention to refractory peptic ulcer. EXPERT OPINION High-dose PPI or the new potassium competitive acid blocker or the combination of PPIs with misoprostol can be recommended in these cases. Other more experimental treatment such the topical application of platelet- rich- plasma, or mesenchymal stem cells have also been suggested. Surgery is the last option, but there is no guarantee of success, especially in NSAID or ASA abusers.
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Affiliation(s)
| | - Angel Lanas
- Service of Digestive Disease, University Clinic Hospital, Zaragoza, Spain
- University of Zaragoza, Zaragoza, Spain
- Aragón Health Research Institute (IIS Aragón), Zaragoza, Spain
- Centro de Investigación Biomédica en Red, Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid, Spain
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Rayner MLD, Kellaway SC, Kingston I, Guillemot-Legris O, Gregory H, Healy J, Phillips JB. Exploring the Nerve Regenerative Capacity of Compounds with Differing Affinity for PPARγ In Vitro and In Vivo. Cells 2022; 12:cells12010042. [PMID: 36611836 PMCID: PMC9818498 DOI: 10.3390/cells12010042] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 12/09/2022] [Accepted: 12/10/2022] [Indexed: 12/24/2022] Open
Abstract
Damage to peripheral nerves can cause debilitating consequences for patients such as lifelong pain and disability. At present, no drug treatments are routinely given in the clinic following a peripheral nerve injury (PNI) to improve regeneration and remyelination of damaged nerves. Appropriately targeted therapeutic agents have the potential to be used at different stages following nerve damage, e.g., to maintain Schwann cell viability, induce and sustain a repair phenotype to support axonal growth, or promote remyelination. The development of therapies to promote nerve regeneration is currently of high interest to researchers, however, translation to the clinic of drug therapies for PNI is still lacking. Studying the effect of PPARγ agonists for treatment of peripheral nerve injures has demonstrated significant benefits. Ibuprofen, a non-steroidal anti-inflammatory drug (NSAID), has reproducibly demonstrated benefits in vitro and in vivo, suggested to be due to its agonist action on PPARγ. Other NSAIDs have demonstrated differing levels of PPARγ activation based upon their affinity. Therefore, it was of interest to determine whether affinity for PPARγ of selected drugs corresponded to an increase in regeneration. A 3D co-culture in vitro model identified some correlation between these two properties. However, when the drug treatments were screened in vivo, in a crush injury model in a rat sciatic nerve, the same correlation was not apparent. Further differences were observed between capacity to increase axon number and improvement in functional recovery. Despite there not being a clear correlation between affinity and size of effect on regeneration, all selected PPARγ agonists improved regeneration, providing a panel of compounds that could be explored for use in the treatment of PNI.
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Affiliation(s)
- Melissa L. D. Rayner
- Department of Pharmacology, School of Pharmacy, University College London, London WC1N 1AX, UK
- Centre for Nerve Engineering, University College London, London WC1N 6BT, UK
- Correspondence:
| | - Simon C. Kellaway
- Department of Pharmacology, School of Pharmacy, University College London, London WC1N 1AX, UK
- Centre for Nerve Engineering, University College London, London WC1N 6BT, UK
| | - Isabel Kingston
- Department of Pharmacology, School of Pharmacy, University College London, London WC1N 1AX, UK
- Centre for Nerve Engineering, University College London, London WC1N 6BT, UK
| | - Owein Guillemot-Legris
- Department of Pharmacology, School of Pharmacy, University College London, London WC1N 1AX, UK
- Centre for Nerve Engineering, University College London, London WC1N 6BT, UK
| | - Holly Gregory
- Department of Pharmacology, School of Pharmacy, University College London, London WC1N 1AX, UK
- Centre for Nerve Engineering, University College London, London WC1N 6BT, UK
| | - Jess Healy
- Centre for Nerve Engineering, University College London, London WC1N 6BT, UK
| | - James B. Phillips
- Department of Pharmacology, School of Pharmacy, University College London, London WC1N 1AX, UK
- Centre for Nerve Engineering, University College London, London WC1N 6BT, UK
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Lewandowska P, Szczuka I, Bednarz-Misa I, Szczęśniak-Sięga BM, Neubauer K, Mierzchała-Pasierb M, Zawadzki M, Witkiewicz W, Krzystek-Korpacka M. Modulating Properties of Piroxicam, Meloxicam and Oxicam Analogues against Macrophage-Associated Chemokines in Colorectal Cancer. Molecules 2021; 26:molecules26237375. [PMID: 34885960 PMCID: PMC8659253 DOI: 10.3390/molecules26237375] [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] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 11/19/2021] [Accepted: 12/01/2021] [Indexed: 12/24/2022] Open
Abstract
The mechanisms underlying the antineoplastic effects of oxicams have not been fully elucidated. We aimed to assess the effect of classic and novel oxicams on the expression/secretion of macrophage-associated chemokines (RTqPCR/Luminex xMAP) in colorectal adenocarcinoma cells, and on the expression of upstream the non-steroidal anti-inflammatory drug (NSAID)-activated genes NAG1, NFKBIA, MYD88, and RELA, as well as at the chemokine profiling in colorectal tumors. Meloxicam downregulated CCL4 9.9-fold, but otherwise the classic oxicams had a negligible/non-significant effect. Novel analogues with a thiazine ring substituted with arylpiperazine and benzoyl moieties significantly modulated chemokine expression to varying degree, upregulated NAG1 and NFKBIA, and downregulated MYD88. They inhibited CCL3 and CCL4, and their effect on CCL2 and CXCL2 depended on the dose and exposure. The propylene linker between thiazine and piperazine nitrogens and one arylpiperazine fluorine substituent characterized the most effective analogue. Only CCL19 and CXCL2 were not upregulated in tumors, nor was CXCL2 in tumor-adjacent tissue compared to normal mucosa. Compared to adjacent tissue, CCL4 and CXCL2 were upregulated, while CCL2, CCL8, and CCL19 were downregulated in tumors. Tumor CCL2 and CCL7 increased along with advancing T and CCL3, and CCL4 along with the N stage. The introduction of arylpiperazine and benzoyl moieties into the oxicam scaffold yields effective modulators of chemokine expression, which act by upregulating NAG1 and interfering with NF-κB signaling.
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Affiliation(s)
- Paulina Lewandowska
- Department of Biochemistry and Immunochemistry, Wroclaw Medical University, 50-368 Wroclaw, Poland; (P.L.); (I.S.); (I.B.-M.); (M.M.-P.)
| | - Izabela Szczuka
- Department of Biochemistry and Immunochemistry, Wroclaw Medical University, 50-368 Wroclaw, Poland; (P.L.); (I.S.); (I.B.-M.); (M.M.-P.)
| | - Iwona Bednarz-Misa
- Department of Biochemistry and Immunochemistry, Wroclaw Medical University, 50-368 Wroclaw, Poland; (P.L.); (I.S.); (I.B.-M.); (M.M.-P.)
| | | | - Katarzyna Neubauer
- Department and Clinics of Gastroenterology and Hepatology, Wroclaw Medical University, 50-556 Wroclaw, Poland;
| | - Magdalena Mierzchała-Pasierb
- Department of Biochemistry and Immunochemistry, Wroclaw Medical University, 50-368 Wroclaw, Poland; (P.L.); (I.S.); (I.B.-M.); (M.M.-P.)
| | - Marek Zawadzki
- Department of Oncological Surgery, Regional Specialist Hospital, 51-124 Wroclaw, Poland; (M.Z.); (W.W.)
- Department of Physiotherapy, Wroclaw Medical University, 51-618 Wroclaw, Poland
| | - Wojciech Witkiewicz
- Department of Oncological Surgery, Regional Specialist Hospital, 51-124 Wroclaw, Poland; (M.Z.); (W.W.)
- Research and Development Centre, Regional Specialist Hospital, 51-124 Wroclaw, Poland
| | - Małgorzata Krzystek-Korpacka
- Department of Biochemistry and Immunochemistry, Wroclaw Medical University, 50-368 Wroclaw, Poland; (P.L.); (I.S.); (I.B.-M.); (M.M.-P.)
- Correspondence: ; Tel.: +48-71-784-1370
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Kazama I, Senzaki M. Does immunosuppressive property of non-steroidal anti-inflammatory drugs (NSAIDs) reduce COVID-19 vaccine-induced systemic side effects? Drug Discov Ther 2021; 15:278-280. [PMID: 34707073 DOI: 10.5582/ddt.2021.01094] [Citation(s) in RCA: 3] [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] [Indexed: 11/05/2022]
Abstract
To help stop the coronavirus disease 2019 (COVID-19) pandemic, vaccines are currently the most critical tool. However, the COVID-19 mRNA vaccines frequently cause systemic side effects shortly after the injection, such as fever, headache and generalized fatigue. In our survey, after receiving the second dose of the COVID-19 vaccine, 80% developed fever, 62% headache and 69% generalized fatigue. Among people who required antipyretics, the average durations of fever and headache were significantly shorter in those who took non-steroidal anti-inflammatory drugs (NSAIDs), such as aspirin, loxoprofen and ibuprofen, than those who took acetaminophen. In our patch-clamp studies, NSAIDs effectively suppressed the delayed rectifier K+-channel (Kv1.3) currents in T-lymphocytes and thus exerted immunosuppressive effects. Because of this pharmacological property, the use of NSAIDs should be more effective in reducing the vaccine-induced systemic side effects that are caused primarily by the enhanced cellular immunity.
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Affiliation(s)
- Itsuro Kazama
- School of Nursing, Miyagi University, Taiwa-cho, Miyagi, Japan
| | - Momono Senzaki
- School of Nursing, Miyagi University, Taiwa-cho, Miyagi, Japan
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Salichs M, Badiella L, Sarasola P, Homedes J. Efficacy and safety of enflicoxib for treatment of canine osteoarthritis: A 6-week randomised, controlled, blind, multicentre clinical trial. Vet Rec 2021; 191:e949. [PMID: 34590318 DOI: 10.1002/vetr.949] [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: 04/13/2021] [Revised: 06/29/2021] [Accepted: 09/06/2021] [Indexed: 12/20/2022]
Abstract
BACKGROUND Enflicoxib is a new COX-2 selective NSAID intended for the treatment of pain and inflammation associated with canine osteoarthritis. METHODS A prospective, multisite, blinded, randomised, controlled, parallel-group field study was performed to determine the efficacy and safety of enflicoxib in canine osteoarthritis. A total of 242 dogs were randomised to receive enflicoxib at 4 or 2 mg/kg, mavacoxib at 2 mg/kg or placebo, orally. Enflicoxib and placebo were administered once weekly from day 0 to day 35. Mavacoxib was administered on D0 and day 14. Veterinarians assessed efficacy with a numerical rating scale and owners used the Canine Brief Pain Inventory. RESULTS After 6 weeks, enflicoxib at 4 mg/kg showed the highest percentage of responders as assessed by the veterinarians (68%) and the owners (84%), followed by mavacoxib (62and 83%, respectively), and enflicoxib at 2 mg/kg (57 and 80%, respectively). All treatments reached statistical significance versus placebo, which obtained success rates of 37% and 53%, respectively. No differences in the incidence of adverse reactions were detected among the different groups. CONCLUSIONS Enflicoxib administered weekly for 6 weeks, at 4 mg/kg PO with an initial loading dose of 8 mg/kg, is efficacious and safe for the treatment of canine osteoarthritis.
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Affiliation(s)
- Marta Salichs
- Ecuphar Veterinaria SLU (Animalcare Group), Avgda. Río de Janeiro 60 - 66, planta 13, Barcelona, Spain
| | - Llorenç Badiella
- Servei d'Estadística Aplicada, Universitat Autònoma de Barcelona, Bellaterra, Barcelona, Spain
| | | | - Josep Homedes
- Ecuphar Veterinaria SLU (Animalcare Group), Avgda. Río de Janeiro 60 - 66, planta 13, Barcelona, Spain
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Muradian AA, Sychev DA, Blagovestnov DA, Sozaeva ZA, Akmalova KA, Zastrozhin MS, Kerimova LN, Koroshvili VT, Epifanova IA. The effect of CYP2D6 and CYP2C9 gene polymorphisms on the efficacy and safety of the combination of tramadol and ketorolac used for postoperative pain management in patients after video laparoscopic cholecystectomy. Drug Metab Pers Ther 2021; 37:27-34. [PMID: 35385894 DOI: 10.1515/dmpt-2021-0112] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Accepted: 03/06/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVES One of the key components of ERAS is adequate pain control in the postoperative period. There are no rational schemes for postoperative pain relief. At the same time, adequate postoperative pain relief promotes early activation and early rehabilitation of patients and shortens the duration of the postoperative stay, and does not cause postoperative complications associated with analgesia (weakness, intestinal paresis, nausea and vomiting). The aims of the present study are to assess the possible association of CYP2D6 and CYP2C9 polymorphisms with the efficacy and safety of tramadol and ketorolac in postoperative pain. METHODS A total of 107 patients were genotyped for CYP2D6 and CYP2C9 polymorphisms. All patients underwent laparoscopic cholecystectomy. Postoperative pain relief was carried out with ketorolac and tramadol. Postoperative pain syndrome was assessed using a visual analogue scale and McGill pain questionnaire. The profile of side effects was assessed by the dynamics of red blood counts as a possible trigger for the development of gastrointestinal bleeding according to the method of global assessment of triggers. RESULTS Pain was statistically significantly lower in CYP2C9*2 carriers, according to visual analogue scale (VAS): after 12 h - by 1.5 (p=0.002); after 24 h - by 1.1 (p=0.012); after 36 h - by 1.05 (p=0.004); after 48 h - by 0.7 (p=0.026). In CYP2C9*3 carriers the results were not statistically significant. In carriers of CYP2D6*4 pain syndromes were higher at all-time intervals, but statistically reliable results were obtained only after 2 h - by 1.01 (p=0.054) and after 24 h - by 0.8 (p=0.035). The profile of adverse reactions for NSAIDs was evaluated by the dynamics of hemoglobin and erythrocyte indices. A more pronounced decrease in the relative difference in hemoglobin levels was noted in CYP2C9*2 and CYP2C9*3 polymorphism carriers - by 1.7 (p=0.00268) and-by 2.2 (p=0.000143), respectively. CONCLUSIONS CYP2D6 and CYP2C9 can predict analgesic effectiveness of tramadol and ketorolac. CYP2C9 can predict the risk of gastrointestinal bleeding, including those hidden to ketorolac.
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Affiliation(s)
| | - Dmitry Alekseevich Sychev
- Department of Clinical Pharmacology and Therapeutics, Russian Medical Academy of Continuous Professional Education, Moscow, Russia
| | | | - Zhannet Alimovna Sozaeva
- Department of Molecular Medicine, Russian Medical Academy of Continuous Professional Education, Moscow, Russia
| | | | | | - Leyla Nabievna Kerimova
- Department of Urgent and General Surgery, Russian Medical Academy of Continuous Professional Education, Moscow, Russia
| | | | - Irina Alexandrovna Epifanova
- Department of Urgent and General Surgery, Russian Medical Academy of Continuous Professional Education, Moscow, Russia
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12
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Muradian AA, Sychev DA, Blagovestnov DA, Sozaeva ZA, Akmalova KA, Zastrozhin MS, Kerimova LN, Koroshvili VT, Epifanova IA. The effect of CYP2D6 and CYP2C9 gene polymorphisms on the efficacy and safety of the combination of tramadol and ketorolac used for postoperative pain management in patients after video laparoscopic cholecystectomy. Drug Metab Pers Ther 2021; 0:dmdi-2021-0112. [PMID: 34246203 DOI: 10.1515/dmdi-2021-0112] [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: 09/25/2020] [Accepted: 03/06/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVES One of the key components of ERAS is adequate pain control in the postoperative period. There are no rational schemes for postoperative pain relief. At the same time, adequate postoperative pain relief promotes early activation and early rehabilitation of patients and shortens the duration of the postoperative stay, and does not cause postoperative complications associated with analgesia (weakness, intestinal paresis, nausea and vomiting). The aims of the present study are to assess the possible association of CYP2D6 and CYP2C9 polymorphisms with the efficacy and safety of tramadol and ketorolac in postoperative pain. METHODS A total of 107 patients were genotyped for CYP2D6 and CYP2C9 polymorphisms. All patients underwent laparoscopic cholecystectomy. Postoperative pain relief was carried out with ketorolac and tramadol. Postoperative pain syndrome was assessed using a visual analogue scale and McGill pain questionnaire. The profile of side effects was assessed by the dynamics of red blood counts as a possible trigger for the development of gastrointestinal bleeding according to the method of global assessment of triggers. RESULTS Pain was statistically significantly lower in CYP2C9*2 carriers, according to visual analogue scale (VAS): after 12 h - by 1.5 (p=0.002); after 24 h - by 1.1 (p=0.012); after 36 h - by 1.05 (p=0.004); after 48 h - by 0.7 (p=0.026). In CYP2C9*3 carriers the results were not statistically significant. In carriers of CYP2D6*4 pain syndromes were higher at all-time intervals, but statistically reliable results were obtained only after 2 h - by 1.01 (p=0.054) and after 24 h - by 0.8 (p=0.035). The profile of adverse reactions for NSAIDs was evaluated by the dynamics of hemoglobin and erythrocyte indices. A more pronounced decrease in the relative difference in hemoglobin levels was noted in CYP2C9*2 and CYP2C9*3 polymorphism carriers - by 1.7 (p=0.00268) and-by 2.2 (p=0.000143), respectively. CONCLUSIONS CYP2D6 and CYP2C9 can predict analgesic effectiveness of tramadol and ketorolac. CYP2C9 can predict the risk of gastrointestinal bleeding, including those hidden to ketorolac.
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Affiliation(s)
| | - Dmitry Alekseevich Sychev
- Department of Clinical Pharmacology and Therapeutics, Russian Medical Academy of Continuous Professional Education, Moscow, Russia
| | | | - Zhannet Alimovna Sozaeva
- Department of Molecular Medicine, Russian Medical Academy of Continuous Professional Education, Moscow, Russia
| | | | | | - Leyla Nabievna Kerimova
- Department of Urgent and General Surgery, Russian Medical Academy of Continuous Professional Education, Moscow, Russia
| | | | - Irina Alexandrovna Epifanova
- Department of Urgent and General Surgery, Russian Medical Academy of Continuous Professional Education, Moscow, Russia
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13
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Zyryanov SK, Butranova OI, Putsman GA. [The efficacy of the combination of diclofenac and orphenadrine in the treatment of dorsalgia]. Zh Nevrol Psikhiatr Im S S Korsakova 2021; 121:126-133. [PMID: 34184488 DOI: 10.17116/jnevro2021121051126] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The high prevalence of dorsalgia and dorsopathy among the adult population makes a significant contribution to the structure of the financial burden of health care systems. The use of non-steroidal anti-inflammatory drugs (NSAIDs) as the basis for the pharmacotherapy of dorsopathy is recommended by most international clinical guidelines. The pharmacodynamic effects of NSAIDs underlie the clinical efficacy of this group of drugs in patients with pain of musculoskeletal origin, while monotherapy is not always accompanied by the rapid development of a persistent analgesic effect. An urgent direction in the therapy of dorsopathies may include combination of NSAIDs with analgesic drugs of other pharmacological groups capable of additive action. The fixed combination of diclofenac, 75 mg, and orphenadrine, 50 mg, allows achieving an effective analgesic effect in patients with lower back pain of various etiologies. It was demonstrated in a series of clinical cases that included 4 patients with dorsopathy who were treated at the City Clinical Hospital No. 24, Moscow in 2020.
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Affiliation(s)
- S K Zyryanov
- Peoples' Friendship University of Russia, Moscow, Russia.,City Clinical Hospital No. 24, Moscow, Russia
| | - O I Butranova
- Peoples' Friendship University of Russia, Moscow, Russia
| | - G A Putsman
- Peoples' Friendship University of Russia, Moscow, Russia.,City Clinical Hospital No. 24, Moscow, Russia
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14
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Tampio J, Löffler S, Guillon M, Hugele A, Huttunen J, Huttunen KM. Improved l-Type amino acid transporter 1 (LAT1)-mediated delivery of anti-inflammatory drugs into astrocytes and microglia with reduced prostaglandin production. Int J Pharm 2021; 601:120565. [PMID: 33812973 DOI: 10.1016/j.ijpharm.2021.120565] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [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: 02/02/2021] [Revised: 03/26/2021] [Accepted: 03/29/2021] [Indexed: 12/14/2022]
Abstract
Non-steroidal anti-inflammatory drugs (NSAIDs) can have protective effects in the brain by inhibition of cyclooxygenases (COX). However, the delivery into the brain across the blood-brain barrier (BBB) and particularly into the brain parenchymal cells is hindered. Therefore, in the present study, we developed four l-type amino acid transporter 1 (LAT1)-utilizing prodrugs of flurbiprofen, ibuprofen, naproxen, and ketoprofen, since LAT1 is expressed on both, the BBB endothelial cells as well as parenchymal cells. The cellular uptake and utilization of LAT1 by novel prodrugs were studied in mouse cortical primary astrocytes and immortalized microglia (BV2), and the release of the parent NSAID in several tissue and cell homogenates. Finally, the effects of the studied prodrugs on prostaglandin E2 (PGE2) production and cell viability were explored. The gained results showed that all four prodrugs were carried into their target cells via LAT1. They also released their parent NSAIDs via carboxylesterases (CES) and most likely also other un-identified enzymes, which need to be carefully considered when administrating these compounds orally or intravenously. Most importantly, all the studied prodrugs reduced the PGE2 production in astrocytes and microglia after lipopolysaccharide (LPS)-induced inflammation by 29-94% and without affecting the cell viability with the studied concentration (20 µM).
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Affiliation(s)
- Janne Tampio
- School of Pharmacy, Faculty of Health Sciences, University of Eastern Finland, P.O. Box 1627, FI-70211 Kuopio, Finland
| | - Susanne Löffler
- School of Pharmacy, Faculty of Health Sciences, University of Eastern Finland, P.O. Box 1627, FI-70211 Kuopio, Finland
| | - Melina Guillon
- School of Pharmacy, Faculty of Health Sciences, University of Eastern Finland, P.O. Box 1627, FI-70211 Kuopio, Finland
| | - Agathe Hugele
- School of Pharmacy, Faculty of Health Sciences, University of Eastern Finland, P.O. Box 1627, FI-70211 Kuopio, Finland
| | - Johanna Huttunen
- School of Pharmacy, Faculty of Health Sciences, University of Eastern Finland, P.O. Box 1627, FI-70211 Kuopio, Finland
| | - Kristiina M Huttunen
- School of Pharmacy, Faculty of Health Sciences, University of Eastern Finland, P.O. Box 1627, FI-70211 Kuopio, Finland.
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15
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Mahendran SA. Use of fever detection in combination with thoracic ultrasonography to identify respiratory disease, and compare treatments of antimicrobials and NSAID: a randomised study in dairy calves. Vet Rec Open 2020; 7:e000415. [PMID: 33194211 PMCID: PMC7643518 DOI: 10.1136/vetreco-2020-000415] [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] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 09/29/2020] [Accepted: 10/06/2020] [Indexed: 11/13/2022] Open
Abstract
Background This study explored the combined use of fever detection and thoracic ultrasonography to identify calves with early onset bovine respiratory disease (BRD). Thoracic ultrasonography was then used to assess the efficacy of antimicrobial and non-steroidal anti-inflammatory drug (NSAID) treatment for early onset BRD through a randomised study design. Methods Calves were recruited from a single dairy farm in the UK, and fitted with a TempVerified FeverTag, which was activated when a calf developed fever (a temperature of 39.7°C for six hours). On identification of fever, a Wisconsin calf score was used to provide a diagnosis of BRD by exclusion of other causes. Calves were randomly assigned to experimental groups; group 1 (NSAID) received flunixin meglumine, group 2 (antimicrobial) received florfenicol, group 3 (both) received both drugs. A thoracic ultrasound was conducted within 48 hours of fever detection, and again 14 days later to assess lung pathology. Results A total of 152 calves were recruited, with a relative BRD prevalence of 49 per cent (74/152). Thirty-two calves required a secondary treatment (due to continued fever), causing exclusion from statistical analysis of the change in ultrasound score and resulting in the study being underpowered for detecting statistical significance. Initial thoracic ultrasound scores were very low, with 70/74 calves scoring either 0 or 1, indicating few comet tails and no lung consolidation was seen and potential overdiagnosis of BRD. For assessment of therapy efficacy, no effect of experimental group was detected on average daily growth rates (mean 0.85 kg/day, P=0.89). Calves also displayed very few clinical signs at the time of fever detection. These factors combined suggest a high rate of false positive identification (low specificity) for BRD through fever detection alone. Calves given the NSAID only were more likely to require repeat treatments due to fever recurrence (OR=3.10 (95 per cent CI 0.86 to 11.15), P=0.083). Also calves affected by their first case of fever at an older age (21 v 28 days old) were less likely to go on to have further fever episodes (OR=0.95 (95 per cent CI 0.90 to 0.99), P=0.026). Conclusion This study demonstrated calves given only an NSAID at occurrence of fever due to BRD may be more likely to require repeat treatments throughout the preweaning period. The use of fever detection alone for BRD indicated a low specificity for definitive diagnosis as shown by the low thoracic ultrasound scores and lack of clinical signs. The study was underpowered to assess the ultrasonic effects of the different treatment protocols on lung pathology.
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16
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Greene W, Mylniczenko ND, Storms T, Burns CM, Lewbart GA, Byrd L, Papich MG. Pharmacokinetics of Ketoprofen in Nile Tilapia ( Oreochromis niloticus) and Rainbow Trout ( Oncorhynchus mykiss). Front Vet Sci 2020; 7:585324. [PMID: 33134366 PMCID: PMC7579418 DOI: 10.3389/fvets.2020.585324] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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] [Received: 07/20/2020] [Accepted: 08/18/2020] [Indexed: 12/20/2022] Open
Abstract
The objective of this study was to document the pharmacokinetics of ketoprofen following 3 mg/kg intramuscular (IM) and intravenous (IV) injections in rainbow trout (Oncorhynchus mykiss) and 8 mg/kg intramuscular (IM) injection in Nile tilapia (Oreochromis niloticus). Plasma was collected laterally from the tail vein for drug analysis at various time intervals up to 72 h following the injection of ketoprofen. In trout, area under the curve (AUC) levels were 115.24 μg hr/mL for IM and 135.69 μg hr/mL for IV groups with a half-life of 4.40 and 3.91 h, respectively. In both trout and tilapia, there were detectable ketoprofen concentrations in most fish for 24 h post-injection. In tilapia, there was a large difference between the R- and S-enantiomers, suggesting either chiral inversion from R- to S-enantiomer or more rapid clearance of the R-enantiomer. AUC values of the S- and R-enantiomers were 510 and 194 μg hr/Ml, respectively, corresponding to a faster clearance for the R-enantiomer. This study shows that there were very high plasma concentrations of ketoprofen in trout and tilapia with no adverse effects observed. Future studies on the efficacy, frequency of dosing, analgesia, adverse effects, and route of administration are warranted.
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Affiliation(s)
- Whitney Greene
- Mote Marine Laboratory and Aquarium, Sarasota, FL, United States
| | | | | | - Charlene M Burns
- Mote Marine Laboratory and Aquarium, Sarasota, FL, United States
| | - Gregory A Lewbart
- College of Veterinary Medicine, North Carolina State University, Raleigh, NC, United States
| | - Lynne Byrd
- Mote Marine Laboratory and Aquarium, Sarasota, FL, United States
| | - Mark G Papich
- College of Veterinary Medicine, North Carolina State University, Raleigh, NC, United States
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17
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Lian J, Li YF, Wang XX, Ye B, Zou H, Shi HX. [Temporal and Spatial Occurrence of NSAIDs in Taihu Lake and Relevant Risk Assessment]. Huan Jing Ke Xue 2020; 41:2229-2238. [PMID: 32608840 DOI: 10.13227/j.hjkx.201909233] [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] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Non-steroidal anti-inflammatory drugs (NSAIDs) are a class of drug residues with a high frequency of detection in Taihu Lake. However, little information is available about the occurrence of typical NSAID mixtures in Taihu Lake as a whole across the four seasons. Therefore, for each season, the concentrations of five typical NSAIDs including diclofenac, ibuprofen, indomethacin, naproxen, and ketoprofen were monitored in the water of Taihu Lake by the method of high-performance liquid chromatography-mass spectrometry (HPLC-MS/MS) at 19 transects covering the entire lake. The temporal and spatial occurrence of NSAID mixtures in the water of Taihu Lake and their correlation with environmental factors were analyzed, and the mixture risk quotient (MRQ) model was also used to assess the ecological risk of the NSAID mixtures. The research results are as follows:① The concentrations of NSAIDs in the northern, western, and eastern waters of Taihu Lake are at a higher level compared to those in the central waters. Ketoprofen is the main contributor to the contamination of NSAID mixtures in all regions of Taihu Lake. ② The concentrations of NSAIDs in Taihu Lake are higher in summer (15.9-134.3 ng·L-1) and autumn (16.4-144.6 ng·L-1) but lower in spring (25.3-72.5 ng·L-1) and winter (14.6-57.4 ng·L-1), being significantly correlated with water conductivity and pH, respectively. ③ The MRQ model evaluation reveals that there are nine sections in Taihu Lake showing a high ecological risk (MRQ>1) from NSAID mixtures throughout the year. The ecological risk of the NSAID mixtures at a medium or high level (MRQ>0.1) lasts for a long time spanning the spring, summer, and autumn seasons, of which the risk is greatest in autumn. Overall, the pollution caused by the NSAID mixtures in the water of Taihu Lake should not be ignored, and especially great attention should be paid to the pollution in autumn.
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Affiliation(s)
- Jie Lian
- School of Environmental and Civil Engineering, Jiangnan University, Wuxi 214122, China
| | - Yi-Fei Li
- School of Environmental and Civil Engineering, Jiangnan University, Wuxi 214122, China
| | - Xiao-Xuan Wang
- School of Environmental and Civil Engineering, Jiangnan University, Wuxi 214122, China
| | - Bin Ye
- School of Environmental and Civil Engineering, Jiangnan University, Wuxi 214122, China
| | - Hua Zou
- School of Environmental and Civil Engineering, Jiangnan University, Wuxi 214122, China.,Jiangsu Collaborative Innovation Center of Technology and Material of Water Treatment, Suzhou 215009, China.,State Key Laboratory of Nuclear Biological and Chemical Protection for Civilian, Beijing 102205, China
| | - Hong-Xing Shi
- State Key Laboratory of Nuclear Biological and Chemical Protection for Civilian, Beijing 102205, China
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18
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Umerska A, Bialek K, Zotova J, Skotnicki M, Tajber L. Anticrystal Engineering of Ketoprofen and Ester Local Anesthetics: Ionic Liquids or Deep Eutectic Mixtures? Pharmaceutics 2020; 12:pharmaceutics12040368. [PMID: 32316479 PMCID: PMC7237996 DOI: 10.3390/pharmaceutics12040368] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [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] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 04/13/2020] [Accepted: 04/14/2020] [Indexed: 12/23/2022] Open
Abstract
Ionic liquids (ILs) and deep eutectic mixtures (DEMs) are potential solutions to the problems of low solubility, polymorphism, and low bioavailability of drugs. The aim of this work was to develop and investigate ketoprofen (KET)-based ILs/DEMs containing an ester local anesthetic (LA): benzocaine (BEN), procaine (PRO) and tetracaine (TET) as the second component. ILs/DEMs were prepared via a mechanosynthetic process that involved the mixing of KET with an LA in a range of molar ratios and applying a thermal treatment. After heating above the melting point and quench cooling, the formation of supercooled liquids with Tgs that were dependent on the composition was observed for all KET-LA mixtures with exception of that containing 95 mol% of BEN. The KET-LA mixtures containing either ≥ 60 mol% BEN or 95 mol% of TET showed crystallization to BEN and TET, respectively, during either cooling or second heating. KET decreased the crystallization tendency of BEN and TET and increased their glass-forming ability. The KET-PRO systems showed good glass-forming ability and did not crystallize either during the cooling or during the second heating cycle irrespective of the composition. Infrared spectroscopy and molecular modeling indicated that KET and LAs formed DEMs, but in the KET-PRO systems small quantities of carboxylate anions were present.
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Affiliation(s)
- Anita Umerska
- School of Pharmacy and Pharmaceutical Sciences, Trinity College Dublin, College Green, Dublin 2, Ireland; (A.U.); (K.B.); (J.Z.); (M.S.)
| | - Klaudia Bialek
- School of Pharmacy and Pharmaceutical Sciences, Trinity College Dublin, College Green, Dublin 2, Ireland; (A.U.); (K.B.); (J.Z.); (M.S.)
| | - Julija Zotova
- School of Pharmacy and Pharmaceutical Sciences, Trinity College Dublin, College Green, Dublin 2, Ireland; (A.U.); (K.B.); (J.Z.); (M.S.)
| | - Marcin Skotnicki
- School of Pharmacy and Pharmaceutical Sciences, Trinity College Dublin, College Green, Dublin 2, Ireland; (A.U.); (K.B.); (J.Z.); (M.S.)
- Department of Pharmaceutical Technology, Poznań University of Medical Sciences, 60-780 Poznań, Poland
| | - Lidia Tajber
- School of Pharmacy and Pharmaceutical Sciences, Trinity College Dublin, College Green, Dublin 2, Ireland; (A.U.); (K.B.); (J.Z.); (M.S.)
- Correspondence: ; Tel.: +353-1-896-2787
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19
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Taha DE, Aboumarzouk OM, Koraiem IO, Shokeir AA. Antibiotic therapy in patients with high prostate-specific antigen: Is it worth considering? A systematic review. Arab J Urol 2020; 18:1-8. [PMID: 32082627 PMCID: PMC7006782 DOI: 10.1080/2090598x.2019.1677296] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Accepted: 09/02/2019] [Indexed: 11/04/2022] Open
Abstract
Objective: To address the question of whether antibiotic therapy can obviate the need for prostate biopsy (PBx) in patients presenting with high prostate-specific antigen (PSA) levels. Methods: With the increase in unnecessary PBx in men with high PSA levels, a systematic review was performed according to the Cochrane Reviews guidelines and in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist. Results: The literature search yielded 42 studies, of which 11 were excluded due to irrelevance of data. Most of the studies were retrospective, nine studies were randomised controlled trials, and there were seven prospective non-randomised trials. The age range of the patients was 51–95 years. Antibiotics, predominantly ofloxacin or ciprofloxacin, combined with a non-steroidal anti-inflammatory drug (NSAID) or not, were prescribed for 2–8 weeks. All studies focussed on PSA levels ranging from ≤ 4 to ≥ 10 ng/mL. Furthermore, antibiotic therapy normalised PSA levels by a wide variety of percentages (16–59%), and the PSA level decrease also varied widely and ranged from 17% to 80%. For patients who had unchanged or decreased PSA, carcinoma was found in 40–52% and 7.7–20.3%, respectively. No cancer was detected if the PSA level decreased to < 4 ng/mL. Conclusion: Antibiotic therapy is clinically beneficial in patients with high PSA levels. PSA reduction or normalisation after medical therapy, either antibiotic and/or NSAID, for ≥ 2 weeks can avoid unnecessary PBx. Antibiotic therapy is more beneficial when the PSA level is < 20 ng/mL. Abbreviations: EPS: expressed prostatic secretion; PBx: prostate biopsy; (%f)(f/t)(t)PSA, (percentage free) (free/total) (total) serum PSA; PSAD: PSA density; RCT: randomised controlled trial; VB3: voided bladder urine 3
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Affiliation(s)
- Diaa-Eldin Taha
- Department of Urology, Faculty of Medicine, Kafrelsheikh University, Kafrelsheikh, Egypt
| | - Omar M Aboumarzouk
- Glasgow Urological Research Unit, Department of Urology, Queen Elizabeth University Hospital, Glasgow, UK.,Dentistry and Nursing, School of Medicine, University of Glasgow, Glasgow, UK
| | - Islam Osama Koraiem
- Department of Urology, Damanhour International Medical Institute, Beheira, Egypt
| | - Ahmed A Shokeir
- Department of Urology, Urology and Nephrology Centre, Mansoura University, Mansoura, Egypt
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20
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Sunzini F, De Stefano S, Chimenti MS, Melino S. Hydrogen Sulfide as Potential Regulatory Gasotransmitter in Arthritic Diseases. Int J Mol Sci 2020; 21:ijms21041180. [PMID: 32053981 PMCID: PMC7072783 DOI: 10.3390/ijms21041180] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Revised: 01/30/2020] [Accepted: 02/09/2020] [Indexed: 01/12/2023] Open
Abstract
The social and economic impact of chronic inflammatory diseases, such as arthritis, explains the growing interest of the research in this field. The antioxidant and anti-inflammatory properties of the endogenous gasotransmitter hydrogen sulfide (H2S) were recently demonstrated in the context of different inflammatory diseases. In particular, H2S is able to suppress the production of pro-inflammatory mediations by lymphocytes and innate immunity cells. Considering these biological effects of H2S, a potential role in the treatment of inflammatory arthritis, such as rheumatoid arthritis (RA), can be postulated. However, despite the growing interest in H2S, more evidence is needed to understand the pathophysiology and the potential of H2S as a therapeutic agent. Within this review, we provide an overview on H2S biological effects, on its role in immune-mediated inflammatory diseases, on H2S releasing drugs, and on systems of tissue repair and regeneration that are currently under investigation for potential therapeutic applications in arthritic diseases.
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Affiliation(s)
- Flavia Sunzini
- Institute of Infection Immunity and Inflammation, University of Glasgow, 120 University, Glasgow G31 8TA, UK;
- Rheumatology, Allergology and clinical immunology, University of Rome Tor Vergata, via Montpelier, 00133 Rome, Italy;
| | - Susanna De Stefano
- Department of Chemical Science and Technologies, University of Rome Tor Vergata, via della Ricerca Scientifica 1, 00133 Rome, Italy;
| | - Maria Sole Chimenti
- Rheumatology, Allergology and clinical immunology, University of Rome Tor Vergata, via Montpelier, 00133 Rome, Italy;
| | - Sonia Melino
- Department of Chemical Science and Technologies, University of Rome Tor Vergata, via della Ricerca Scientifica 1, 00133 Rome, Italy;
- Correspondence: ; Tel.: +39-0672594410
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21
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Zhang JR, Pang DD, Dai SM. Non-steroidal Anti-inflammatory Drugs Are Unlikely to Inhibit Radiographic Progression of Ankylosing Spondylitis: A Systematic Review. Front Med (Lausanne) 2019; 6:214. [PMID: 31637243 PMCID: PMC6788556 DOI: 10.3389/fmed.2019.00214] [Citation(s) in RCA: 5] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Accepted: 09/17/2019] [Indexed: 12/17/2022] Open
Abstract
Objective: To clarify if non-steroidal anti-inflammatory drugs (NSAIDs) could retard the disease progression of ankylosing spondylitis (AS). Methods: A systematic search of Embase, Pubmed, and the Cochrane Central Register of Controlled Trials (CCRCT) databases was conducted. Structural damage of AS was evaluated using spinal radiographs to assess modified Stoke Ankylosing Spondylitis Spine Score (mSASSS). Results: Five full-text papers (from 2 prospective and 2 retrospective studies) were included. Of the 4 studies deemed relevant, 3 reported no significant inhibition of spinal progression in AS patients treated continuously with NSAIDs, as determined by radiograph over 2-3 years. Only the 1st prospective randomized trial demonstrated that 2-year continuous use of celecoxib reduced mean changes in mSASSS of AS patients compared with on-demand treatment. However, the dosage difference of celecoxib between the two groups in the study seemed to be too small to elicit such differences in radiographic progression, while the therapy did not elicit any differences in disease activity, C-reactive protein (CRP) levels or global pain. Of the 3 studies that reported radiographic progression in the subgroup with elevated CRP, only post-hoc analysis of the 1st randomized study revealed that the patients treated continuously with NSAIDs had less radiological progression than those using on-demand NSAIDs. In 2 studies that reported radiographic progression in the patient subgroup with baseline syndesmophytes, both reported that there was no significant inhibition of progression of mSASSS in patients who had received continuous NSAID treatment compared with patients given on-demand NSAIDs. Conclusion: The available evidence suggests that NSAIDs are unable to delay radiographic progression of AS even in patients with elevated CRP levels.
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Affiliation(s)
- Jing-Ru Zhang
- Department of Rheumatology & Immunology, First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China
| | - Dan-Dan Pang
- Department of Rheumatology & Immunology, Changhai Hospital, Second Military Medical University, Shanghai, China
| | - Sheng-Ming Dai
- Department of Rheumatology & Immunology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China
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Ercolano G, De Cicco P, Frecentese F, Saccone I, Corvino A, Giordano F, Magli E, Fiorino F, Severino B, Calderone V, Citi V, Cirino G, Ianaro A. Anti-metastatic Properties of Naproxen-HBTA in a Murine Model of Cutaneous Melanoma. Front Pharmacol 2019; 10:66. [PMID: 30800067 PMCID: PMC6376415 DOI: 10.3389/fphar.2019.00066] [Citation(s) in RCA: 15] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Accepted: 01/18/2019] [Indexed: 12/28/2022] Open
Abstract
The beneficial effects of H2S-release and of COXs-inhibition have been exploited in the design of novel anti-inflammatory drugs, the H2S-releasing non-steroidal anti-inflammatory drugs (H2S-NSAIDs), showing promising potential for chemoprevention in cancers. Here, we evaluated the efficacy of a new H2S-releasing derivative of naproxen, named naproxen-4-hydroxybenzodithioate (naproxen-HBTA), in reducing metastatic melanoma features, both in vitro and in vivo. The novel H2S donor has been prepared following a synthetic scheme that provided high yields and purity. In particular, we investigated the effect of naproxen-HBTA in vitro on several metastatic features of human melanoma cells such as proliferation, migration, invasion, and colonies formation and in vivo in a model of cutaneous melanoma. Cell culture studies demonstrated that naproxen-HBTA induced caspase 3-mediated apoptosis and inhibited motility, invasiveness, and focus formation. Finally, daily oral treatment with naproxen-HBTA significantly suppressed melanoma growth and progression in mice. In conclusion, by using this dual approach we propose that the COX-2 and H2S pathways could be regarded as novel therapeutic targets/tools to generate new treatment options based on "combination therapy" for melanoma.
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Affiliation(s)
- Giuseppe Ercolano
- Department of Pharmacy, University of Naples Federico II, Naples, Italy
| | - Paola De Cicco
- Department of Pharmacy, University of Naples Federico II, Naples, Italy
| | | | - Irene Saccone
- Department of Pharmacy, University of Naples Federico II, Naples, Italy
| | - Angela Corvino
- Department of Pharmacy, University of Naples Federico II, Naples, Italy
| | - Flavia Giordano
- Department of Pharmacy, University of Naples Federico II, Naples, Italy
| | - Elisa Magli
- Department of Pharmacy, University of Naples Federico II, Naples, Italy
| | | | - Beatrice Severino
- Department of Pharmacy, University of Naples Federico II, Naples, Italy
| | | | | | - Giuseppe Cirino
- Department of Pharmacy, University of Naples Federico II, Naples, Italy
| | - Angela Ianaro
- Department of Pharmacy, University of Naples Federico II, Naples, Italy
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Chen J, Stark LA. Crosstalk between NF-κB and Nucleoli in the Regulation of Cellular Homeostasis. Cells 2018; 7:E157. [PMID: 30301139 DOI: 10.3390/cells7100157] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Revised: 09/28/2018] [Accepted: 10/03/2018] [Indexed: 12/30/2022] Open
Abstract
Nucleoli are emerging as key sensors of cellular stress and regulators of the downstream consequences on proliferation, metabolism, senescence, and apoptosis. NF-κB signalling is activated in response to a similar plethora of stresses, which leads to modulation of cell growth and death programs. While nucleolar and NF-κB pathways are distinct, it is increasingly apparent that they converge at multiple levels. Exposure of cells to certain insults causes a specific type of nucleolar stress that is characterised by degradation of the PolI complex component, TIF-IA, and increased nucleolar size. Recent studies have shown that this atypical nucleolar stress lies upstream of cytosolic IκB degradation and NF-κB nuclear translocation. Under these stress conditions, the RelA component of NF-κB accumulates within functionally altered nucleoli to trigger a nucleophosmin dependent, apoptotic pathway. In this review, we will discuss these points of crosstalk and their relevance to anti-tumour mechanism of aspirin and small molecule CDK4 inhibitors. We will also briefly the discuss how crosstalk between nucleoli and NF-κB signalling may be more broadly relevant to the regulation of cellular homeostasis and how it may be exploited for therapeutic purpose.
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Stevenson DD, Gasko JL. A Tale of Two Knee Implants in the Same Person: Narcotics for the First and Anti-inflammatory Drugs for the Second. Clin Med Insights Case Rep 2018; 11:1179547618794650. [PMID: 30158828 PMCID: PMC6111394 DOI: 10.1177/1179547618794650] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2018] [Accepted: 07/06/2018] [Indexed: 11/16/2022]
Abstract
Opioid addiction is a world-wide tragedy, with severe consequences for both the victims and the society that must care for them. The pathways to addiction are multiple but postoperative opioid prescriptions for pain management are a major contributor to this crisis. This case report describes the differences in pain management during 2 different arthroplasties of the knees in the same person. After the first arthroplasty of the right knee 10 years ago, postoperative opioids were used, but after the second arthroplasty of the left knee in 2007, anti-inflammatory drugs took the place of opioids. The first postoperative treatment with opioids was marked by addiction and a nasty withdrawal. The recovery of knee function, driving, and return to work were prolonged. After the second arthroplasty in 2007, a combination of meloxicam (COX-2 inhibitor), high-dose acetaminophen (COX-1 inhibitor at higher doses), and diclofenac topical gel (COX-1 inhibitor with local effects) produced excellent pain control and significant reduction in swelling of the operated knee. The clinical course was smooth and recovery was rapid. The patient was walking normally and driving a car at 2 weeks and took an airplane trip at 4 weeks. After arthroplasty, postoperative opioids may not be necessary for most people.
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Affiliation(s)
- Donald D Stevenson
- Division of Allergy, Asthma and Immunology, Scripps Clinic Carmel Valley, San Diego, CA, USA
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Gladden N, McKeegan D, Viora L, Ellis KA. Postpartum ketoprofen treatment does not alter stress biomarkers in cows and calves experiencing assisted and unassisted parturition: a randomised controlled trial. Vet Rec 2018; 183:414. [PMID: 29960984 DOI: 10.1136/vr.104913] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [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: 02/28/2018] [Revised: 05/30/2018] [Accepted: 06/06/2018] [Indexed: 11/03/2022]
Abstract
Dystocia is considered painful and stressful for both the dam and the calf, although systematic evidence of this is limited. Few studies have investigated biochemical markers of stress and pain postpartum and whether any adverse effects are ameliorated by administration of analgesia. In this study, cow-calf pairs experiencing both mild to moderate farmer assistance and no assistance at parturition were randomly assigned to either treatment or placebo group in a two-by-two design (animals subject to veterinary intervention were excluded). The treatments were the NSAID ketoprofen or saline, administered within three hours of parturition. Blood samples taken in the immediate postpartum period, and at 24 hours, 48 hours and 7 days after parturition, were analysed for plasma concentrations of creatine kinase and cortisol (cows and calves) and plasma L-lactate and total protein concentration (calves). Stress biomarkers were highest in the immediate postpartum period and declined over time (P<0.05). Cow plasma cortisol was higher in animals experiencing assisted parturition in the immediate postpartum period (P=0.023); by 24 hours no difference was evident. Intervention with NSAID analgesia did not result in beneficial changes in stress biomarkers. Based on biomarkers alone, this suggests limited benefits of NSAID treatment in unassisted or mild to moderately assisted parturition.
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Affiliation(s)
- Nicola Gladden
- Scottish Centre for Production Animal Health and Food Safety, University of Glasgow School of Veterinary Medicine, Glasgow, UK
| | - Dorothy McKeegan
- Institute of Biodiversity, Animal Health & Comparative Medicine, University of Glasgow School of Veterinary Medicine, Glasgow, UK
| | - Lorenzo Viora
- Scottish Centre for Production Animal Health and Food Safety, University of Glasgow School of Veterinary Medicine, Glasgow, UK
| | - Kathryn Amanda Ellis
- Scottish Centre for Production Animal Health and Food Safety, University of Glasgow School of Veterinary Medicine, Glasgow, UK
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Sodeifian G, Razmimanesh F. Diffusional interaction behavior of NSAIDs in lipid bilayer membrane using molecular dynamics (MD) simulation: Aspirin and Ibuprofen. J Biomol Struct Dyn 2018; 37:1666-1684. [PMID: 29695194 DOI: 10.1080/07391102.2018.1464956] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [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: 12/17/2022]
Abstract
In this research, for the first time, molecular dynamics (MD) method was used to simulate aspirin and ibuprofen at various concentrations and in neutral and charged states. Effects of the concentration (dosage), charge state, and existence of an integral protein in the membrane on the diffusion rate of drug molecules into lipid bilayer membrane were investigated on 11 systems, for which the parameters indicating diffusion rate and those affecting the rate were evaluated. Considering the diffusion rate, a suitable score was assigned to each system, based on which, analysis of variance (ANOVA) was performed. By calculating the effect size of the indicative parameters and total scores, an optimum system with the highest diffusion rate was determined. Consequently, diffusion rate controlling parameters were obtained: the drug-water hydrogen bond in protein-free systems and protein-drug hydrogen bond in the systems containing protein.
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Affiliation(s)
- Gholamhossein Sodeifian
- a Faculty of Engineering, Department of Chemical Engineering, Modeling and Simulation Centre , University of Kashan , Kashan 87317-53153 , Iran
| | - Fariba Razmimanesh
- a Faculty of Engineering, Department of Chemical Engineering, Modeling and Simulation Centre , University of Kashan , Kashan 87317-53153 , Iran
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Matsui T, Nakagawa K, Yamazaki K, Wada T, Kadoya M, Kaida K. [An anti-RNP antibody-positive case of aseptic meningitis induced by non-steroidal anti-inflammatory drugs in a young woman]. Rinsho Shinkeigaku 2018; 58:25-29. [PMID: 29269694 DOI: 10.5692/clinicalneurol.cn-001085] [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: 06/07/2023]
Abstract
A 19-year-old woman developed high fever, headache, and nausea after taking Loxoprofen for pharyngitis, followed by disturbed consciousness and nuchal stiffness. The patient and her mother had a history of Raynaud's phenomenon. Cerebrospinal fluid (CSF) examination indicated a diagnosis of aseptic meningitis and revealed high levels of Q albumin and IgG index. Anti-RNP antibodies were positive in serum and CSF. Her symptoms disappeared immediately after cessation of Loxoprofen and a drug lymphocyte stimulation test was negative, confirming a diagnosis of non-steroidal anti-inflammatory drugs (NSAIDs)-induced aseptic meningitis. It should be kept in mind that an immune abnormality such as serum and CSF anti-RNP antibodies may play a role in development of NSAIDs-induced aseptic meningitis. A history of usage of NSAIDs and a thorough examination of collagen diseases are useful for identification of the origin of aseptic meningitis in a young woman.
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Affiliation(s)
- Taro Matsui
- Department of Neurology, Anti-aging and Vascular Medicine, National Defense Medical College
| | - Keiichi Nakagawa
- Department of Neurology, Anti-aging and Vascular Medicine, National Defense Medical College
| | - Keishi Yamazaki
- Department of Neurology, Anti-aging and Vascular Medicine, National Defense Medical College
| | - Taishi Wada
- Department of Neurology, Anti-aging and Vascular Medicine, National Defense Medical College
| | - Masato Kadoya
- Department of Neurology, Anti-aging and Vascular Medicine, National Defense Medical College
| | - Kenichi Kaida
- Department of Neurology, Anti-aging and Vascular Medicine, National Defense Medical College
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Maniar KH, Jones IA, Gopalakrishna R, Vangsness CT. Lowering side effects of NSAID usage in osteoarthritis: recent attempts at minimizing dosage. Expert Opin Pharmacother 2017; 19:93-102. [PMID: 29212381 DOI: 10.1080/14656566.2017.1414802] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [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: 01/24/2023]
Abstract
INTRODUCTION Osteoarthritis is a burdensome disease that causes progressive damage to articular cartilage. Non-steroidal anti-inflammatory drugs (NSAIDs) are one of the preferred treatments for symptomatic relief. However, NSAIDs can cause serious dose-dependent side effects, which has prompted experts to recommend the minimization of NSAID dosage. AREAS COVERED This review focuses on three broad strategies that are currently being investigated or implemented to minimize NSAID dosage: nano-formulation, encapsulation, and topical delivery. The benefits, challenges and current status of these methods are discussed. EXPERT OPINION Multiple strategies are under investigation to lower NSAID dosage. There is great potential in developing formulations that utilize more than one of these strategies together. However, there are challenges to developing these lower dose preparations. In order to maximize the clinical potential of the abundance of NSAIDs that are both available and being developed, there is a major need for additional clinical studies directly comparing safety and efficacy of different preparations.
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Affiliation(s)
- Kevin H Maniar
- a Keck School of Medicine of USC , Los Angeles , CA , USA
| | - Ian A Jones
- b Department of Orthopaedic Surgery , Keck School of Medicine of USC , Los Angeles , CA , USA
| | - Rayudu Gopalakrishna
- c Department of Integrative Anatomical Sciences , Keck School of Medicine of USC , Los Angeles , CA , USA
| | - C Thomas Vangsness
- b Department of Orthopaedic Surgery , Keck School of Medicine of USC , Los Angeles , CA , USA
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Li P, Zheng Y, Chen X. Drugs for Autoimmune Inflammatory Diseases: From Small Molecule Compounds to Anti-TNF Biologics. Front Pharmacol 2017; 8:460. [PMID: 28785220 PMCID: PMC5506195 DOI: 10.3389/fphar.2017.00460] [Citation(s) in RCA: 210] [Impact Index Per Article: 30.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Accepted: 06/27/2017] [Indexed: 12/14/2022] Open
Abstract
Although initially described as an anti-tumor mediator, tumor necrosis factor-alpha (TNF) is generally considered as the master pro-inflammatory cytokine. It plays a crucial role in the pathogenesis of inflammatory diseases, such as rheumatoid arthritis (RA), inflammatory bowel disease, ankylosing spondylitis (AS), and psoriasis. Consequently, anti-TNF therapy has become mainstay treatment for autoimmune diseases. Historically, anti-inflammatory agents were developed before the identification of TNF. Salicylates, the active components of Willow spp., were identified in the mid-19th century for the alleviation of pain, fever, and inflammatory responses. Study of this naturally occurring compound led to the discovery of aspirin, which was followed by the development of non-steroidal anti-inflammatory drugs (NSAIDs) due to the chemical advances in the 19th–20th centuries. Initially, the most of NSAIDs were organic acid, but the non-acidic compounds were also identified as NSAIDs. Although effective in the treatment of inflammatory diseases, NSAIDs have some undesirable and adverse effect, such as ulcers, kidney injury, and bleeding in the gastrointestinal tract. In the past two decades, anti-TNF biologics were developed. Drugs belong to this class include soluble TNF receptor 2 fusion protein and anti-TNF antibodies. The introduction of anti-TNF therapeutics has revolutionized the management of autoimmune diseases, such as RA, psoriatic arthritis (PsA), plaque psoriasis (PP), AS, CD and ulcerative colitis (UC). Nevertheless, up to 40% of patients have no response to anti-TNF treatment. Furthermore, this treatment is associated with some adverse effects such as increased risk of infection, and even triggered the de novo development of autoimmune diseases. Such harmful effect of anti-TNF treatment is likely caused by the global inhibition of TNF biological functions. Therefore, specific inhibition of TNF receptor (TNFR1 or TNFR2) may represent a safer and more effective treatment, as proposed by some recent studies. In this review article, the historical development of anti-inflammatory drugs after World War II as briefly described above will be reviewed and analyzed. The future trend in the development of novel TNF receptor-targeting therapeutics will be discussed in the context of latest progress in the research of TNF biology.
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Affiliation(s)
- Ping Li
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macau, China
| | - Ying Zheng
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macau, China
| | - Xin Chen
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macau, China
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McDonald J, McBain L, Dowell AC, Morris C. GPs' views and experiences of prescribing non-steroidal anti-inflammatory drugs: a qualitative study. BJGP Open 2017; 1:bjgpopen17X100869. [PMID: 30564663 DOI: 10.3399/bjgpopen17X100869] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background Non-steroidal anti-inflammatory drugs (NSAIDs) are widely prescribed in primary care despite being a high-risk drug group causing significant adverse events, yet little is known about GPs’ perceptions of NSAID risks and benefits. Aim To explore GPs’ experiences with NSAID prescribing and views about the risks and benefits of this group of medicines. Design & setting A qualitative, inductive study in general practice. Method Individual interviews with 15 GPs using a semi-structured interview guide. Interviews were audiorecorded and transcribed. An inductive, thematic approach was used for analysis. Sampling continued until data saturation was achieved. Results Three main themes illustrate GPs’ key concerns with managing NSAID risks. The first theme was perceptions of risks and benefits of NSAIDs: GPs expressed differing attitudes towards prescribing medication generally. GPs were aware of the general risks of NSAIDs but weighed these up against specific risk factors and potential benefits for particular patients. They were most concerned about long-term use, risks for children, older people, and patients with comorbidities. The second theme was assessing and mitigating risks when prescribing NSAIDs: GPs considered gastric, cardiac, and renal risks of patients as well as drug interactions. Mitigation strategies included alternative treatment, choice and dose of NSAID, and use of gastroprotective agents. The final theme was other factors impacting on NSAID risks: particularly patient expectations and over-the-counter (OTC) availability. Conclusion NSAID prescribing is a complex balance between pragmatism and potential adverse events. Given the costs of morbidity, hospitalisation, and patient demand there is an urgent need to secure a more detailed evidence base and develop practical pathways to support safer prescribing.
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Kono Y, Kawano S, Takaki A, Shimomura Y, Onji M, Ishikawa H, Takahashi S, Horii J, Kobayashi S, Kawai D, Yamamoto K, Okada H. Oxidative stress controlling agents are effective for small intestinal injuries induced by non-steroidal anti-inflammatory drugs. J Gastroenterol Hepatol 2017; 32:136-145. [PMID: 27118323 DOI: 10.1111/jgh.13424] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [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] [Accepted: 04/18/2016] [Indexed: 01/22/2023]
Abstract
BACKGROUND AND AIM Video-capsule endoscopy (VCE) has shown that intestinal ulcers are common in non-steroidal anti-inflammatory drugs (NSAIDs) users, although the mechanisms and management have not been clearly defined. To explore the contribution of oxidative stress and potential of anti-oxidants for NSAIDs-induced intestinal ulcers, we assessed human serum oxidative stress balance and the effect of anti-oxidants using a mouse model. METHODS A total of 30 NSAIDs users (17 aspirin and 13 non-aspirin users) received VCE. Serum reactive oxygen metabolite (d-ROM) and antioxidative OXY-adsorbent test (OXY) were measured. The indomethacin (IND)-induced mouse intestinal ulcer model was used to assess the effect of anti-oxidants. Eight-week-old mice were divided into four groups; control diet and diet including IND (N group), IND and L-carnitine (NC group), and IND and vitamin E (NE group). RESULTS Serum OXY levels among non-aspirin users were lower in the mucosal injuries positive group than the negative group (P < 0.05). In the mouse models, the degree of mucosal injuries was lower in NC and NE than N (P < 0.01). Serum d-ROM levels were lower in NC and NE than N (P < 0.01), and OXY levels were higher in NC than N and NE (P < 0.01). The degeneration of intestinal mitochondria was mild in NC and NE. The serum KC/CXCL-1 level and hepatic expression of the anti-oxidant molecule Gpx4 were lower in NC than N. CONCLUSIONS Non-aspirin NSAID-induced intestinal ulcers are related to decreased anti-oxidative stress function. Anti-oxidants, especially L-carnitine, are good candidates for intestinal ulcers.
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Affiliation(s)
- Yoshiyasu Kono
- Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Seiji Kawano
- Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Akinobu Takaki
- Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Yasuyuki Shimomura
- Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Masahiro Onji
- Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Hisashi Ishikawa
- Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Sakuma Takahashi
- Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Joichiro Horii
- Department of Gastroenterology, Fukuyama Medical Center, Fukuyama, Japan
| | - Sayo Kobayashi
- Department of Internal Medicine, Fukuyama City Hospital, Fukuyama, Japan
| | - Daisuke Kawai
- Department of Internal Medicine, Tsuyama Chuo Hospital, Tsuyama, Japan
| | - Kazuhide Yamamoto
- Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Hiroyuki Okada
- Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
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Gejjalagere Honnappa C, Mazhuvancherry Kesavan U. A concise review on advances in development of small molecule anti-inflammatory therapeutics emphasising AMPK: An emerging target. Int J Immunopathol Pharmacol 2016; 29:562-571. [PMID: 27707958 DOI: 10.1177/0394632016673369] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [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: 02/18/2016] [Accepted: 06/21/2016] [Indexed: 12/12/2022] Open
Abstract
Inflammatory diseases are complex, multi-factorial outcomes of evolutionarily conserved tissue repair processes. For decades, non-steroidal anti-inflammatory drugs and cyclooxygenase inhibitors, the primary drugs of choice for the management of inflammatory diseases, addressed individual targets in the arachidonic acid pathway. Unsatisfactory safety and efficacy profiles of the above have necessitated the development of multi-target agents to treat complex inflammatory diseases. Current anti-inflammatory therapies still fall short of clinical needs and the clinical trial results of multi-target therapeutics are anticipated. Additionally, new drug targets are emerging with improved understanding of molecular mechanisms controlling the pathophysiology of inflammation. This review presents an outline of small molecules and drug targets in anti-inflammatory therapeutics with a summary of a newly identified target AMP-activated protein kinase, which constitutes a novel therapeutic pathway in inflammatory pathology.
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Andreasson KI, Bachstetter AD, Colonna M, Ginhoux F, Holmes C, Lamb B, Landreth G, Lee DC, Low D, Lynch MA, Monsonego A, O’Banion MK, Pekny M, Puschmann T, Russek-Blum N, Sandusky LA, Selenica MLB, Takata K, Teeling J, Town T, Van Eldik LJ, Russek-Blum N, Monsonego A, Low D, Takata K, Ginhoux F, Town T, O’Banion MK, Lamb B, Colonna M, Landreth G, Andreasson KI, Sandusky LA, Selenica MLB, Lee DC, Holmes C, Teeling J, Lynch MA, Van Eldik LJ, Bachstetter AD, Pekny M, Puschmann T. Targeting innate immunity for neurodegenerative disorders of the central nervous system. J Neurochem 2016; 138:653-93. [PMID: 27248001 PMCID: PMC5433264 DOI: 10.1111/jnc.13667] [Citation(s) in RCA: 94] [Impact Index Per Article: 11.8] [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: 02/05/2016] [Revised: 04/01/2016] [Accepted: 04/30/2016] [Indexed: 12/21/2022]
Abstract
Neuroinflammation is critically involved in numerous neurodegenerative diseases, and key signaling steps of innate immune activation hence represent promising therapeutic targets. This mini review series originated from the 4th Venusberg Meeting on Neuroinflammation held in Bonn, Germany, 7-9th May 2015, presenting updates on innate immunity in acute brain injury and chronic neurodegenerative disorders, such as traumatic brain injury and Alzheimer disease, on the role of astrocytes and microglia, as well as technical developments that may help elucidate neuroinflammatory mechanisms and establish clinical relevance. In this meeting report, a brief overview of physiological and pathological microglia morphology is followed by a synopsis on PGE2 receptors, insights into the role of arginine metabolism and further relevant aspects of neuroinflammation in various clinical settings, and concluded by a presentation of technical challenges and solutions when working with microglia and astrocyte cultures. Microglial ontogeny and induced pluripotent stem cell-derived microglia, advances of TREM2 signaling, and the cytokine paradox in Alzheimer's disease are further contributions to this article. Neuroinflammation is critically involved in numerous neurodegenerative diseases, and key signaling steps of innate immune activation hence represent promising therapeutic targets. This mini review series originated from the 4th Venusberg Meeting on Neuroinflammation held in Bonn, Germany, 7-9th May 2015, presenting updates on innate immunity in acute brain injury and chronic neurodegenerative disorders, such as traumatic brain injury and Alzheimer's disease, on the role of astrocytes and microglia, as well as technical developments that may help elucidate neuroinflammatory mechanisms and establish clinical relevance. In this meeting report, a brief overview on physiological and pathological microglia morphology is followed by a synopsis on PGE2 receptors, insights into the role of arginine metabolism and further relevant aspects of neuroinflammation in various clinical settings, and concluded by a presentation of technical challenges and solutions when working with microglia cultures. Microglial ontogeny and induced pluripotent stem cell-derived microglia, advances of TREM2 signaling, and the cytokine paradox in Alzheimer's disease are further contributions to this article.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Niva Russek-Blum
- The Dead Sea and Arava Science Center, Central Arava Branch, Yair Station, Hazeva, Israel
| | - Alon Monsonego
- The Shraga Segal Dept. of Microbiology, Immunology and Genetics, The Faculty of Health Sciences: The National Institute of Biotechnology in the Negev, and Zlotowski Center for Neuroscience, Ben-Gurion University, Beer-Sheva 84105, Israel
| | - Donovan Low
- Singapore Immunology Network (SIgN), Agency for Science, Technology and Research (A*STAR), Singapore
| | - Kazuyuki Takata
- Singapore Immunology Network (SIgN), Agency for Science, Technology and Research (A*STAR), Singapore
- Department of Clinical and Translational Physiology, Kyoto Pharmaceutical University, Kyoto, Japan
| | - Florent Ginhoux
- Singapore Immunology Network (SIgN), Agency for Science, Technology and Research (A*STAR), Singapore
| | - Terrence Town
- Departments of Physiology and Biophysics, Zilkha Neurogenetic Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA 90089,
| | - M. Kerry O’Banion
- Departments of Neuroscience and Neurology, Del Monte Neuromedicine Institute, University of Rochester School of Medicine & Dentistry, Rochester, NY 14642,
| | - Bruce Lamb
- Department of Neurosciences, Cleveland Clinic, Cleveland, OH 44106
| | - Marco Colonna
- Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, MO 63110
| | - Gary Landreth
- Department of Neurosciences, Case Western Reserve University 44106
| | - Katrin I. Andreasson
- Department of Neurology and Neurological Sciences, Stanford Neuroscience Institute, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Leslie A. Sandusky
- USF Health Byrd Alzheimer’s Institute, Tampa, FL 33613
- College of Pharmacy & Pharmaceutical Sciences, Tampa, FL 33613
| | - Maj-Linda B. Selenica
- USF Health Byrd Alzheimer’s Institute, Tampa, FL 33613
- College of Pharmacy & Pharmaceutical Sciences, Tampa, FL 33613
| | - Daniel C. Lee
- USF Health Byrd Alzheimer’s Institute, Tampa, FL 33613
- College of Pharmacy & Pharmaceutical Sciences, Tampa, FL 33613
| | - Clive Holmes
- Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton General Hospital, Tremona Road, Southampton, SO16 7YD, United Kingdom
| | - Jessica Teeling
- Centre for Biological Sciences, University of Southampton, Southampton General Hospital, Tremona Road, Southampton, SO16 7YD, United Kingdom
| | | | | | | | - Milos Pekny
- Center for Brain Repair and Rehabilitation, Department of Clinical Neuroscience and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy at the University of Gothenburg, SE-405 30 Gothenburg, Sweden
- Florey Institute of Neuroscience and Mental Health, Parkville, Victoria, Australia
- Hunter Medical Research Institute, University of Newcastle, New South Wales, Australia
| | - Till Puschmann
- Center for Brain Repair and Rehabilitation, Department of Clinical Neuroscience and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy at the University of Gothenburg, SE-405 30 Gothenburg, Sweden
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Köhler O, Petersen L, Benros ME, Mors O, Gasse C. Concomitant NSAID use during antipsychotic treatment and risk of 2-year relapse - a population-based study of 16,253 incident patients with schizophrenia. Expert Opin Pharmacother 2016; 17:1055-62. [PMID: 26988274 DOI: 10.1517/14656566.2016.1168400] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [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: 12/17/2022]
Abstract
OBJECTIVE Clinical trials have indicated antipsychotic effects of non-steroidal anti-inflammatory drugs (NSAIDs) among incident patients with schizophrenia. We aimed to study, in a population-based setting, whether concomitant use of NSAIDs or paracetamol, changed 2-year relapse risk for schizophrenia. METHODS We identified all incident patients with schizophrenia in Denmark diagnosed 1996-2012 initiating antipsychotic treatment within the year after diagnosis. We calculated concomitant treatment intervals for antipsychotic and NSAID or paracetamol use. Hazard rate ratios (HRR) were estimated using Cox regression adjusted for important covariates. MAIN OUTCOME MEASURES 2-year relapse, i.e. (re)-hospitalizations with schizophrenia. RESULTS Among 16,235 incident patients with schizophrenia using antipsychotics, 1480 (9.1%) used NSAIDs and 767 (4.7%) paracetamol. Concomitant use of NSAIDs was associated with an increased risk of schizophrenia relapse (HRR = 1.21; 95%-CI = 1.11-1.31), particularly associated with acetylsalicylic acid and diclofenac. Concomitant use of paracetamol was not associated with schizophrenia relapse (HRR = 0.97; 95%-CI = 0.87-1.08). Subgroup analyses showed that individuals with somatic comorbidity and NSAID use had an increased relapse-risk, except for individuals with a prior hospital diagnosis for musculoskeletal disease and NSAID use who had a decreased relapse-risk (HRR = 0.82; 95%-CI = 0.71-0.94). CONCLUSIONS The increased relapse risk associated with concomitant NSAID use among incident patients with schizophrenia may indicate a potential impact of underlying somatic comorbidity.
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Affiliation(s)
- Ole Köhler
- a Psychosis Research Unit , Aarhus University Hospital , Risskov , Denmark.,b Psychosis Research Unit , Aarhus University Hospital , Risskov , Denmark
| | - Liselotte Petersen
- b Psychosis Research Unit , Aarhus University Hospital , Risskov , Denmark.,c National Centre for Register-based Research , Aarhus University , Aarhus , Denmark
| | - Michael Eriksen Benros
- d Mental Health Centre Copenhagen, Faculty of Health Sciences , University of Copenhagen , Copenhagen , Denmark
| | - Ole Mors
- a Psychosis Research Unit , Aarhus University Hospital , Risskov , Denmark.,b Psychosis Research Unit , Aarhus University Hospital , Risskov , Denmark.,e CIRRAU , Aarhus University , Aarhus , Denmark
| | - Christiane Gasse
- c National Centre for Register-based Research , Aarhus University , Aarhus , Denmark
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Schwier N, Tran N. Non-Steroidal Anti-Inflammatory Drugs and Aspirin Therapy for the Treatment of Acute and Recurrent Idiopathic Pericarditis. Pharmaceuticals (Basel) 2016; 9:E17. [PMID: 27023565 DOI: 10.3390/ph9020017] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2015] [Revised: 03/15/2016] [Accepted: 03/16/2016] [Indexed: 01/08/2023] Open
Abstract
Aspirin (ASA) and non-steroidal anti-inflammatory drugs (NSAIDs) are a mainstay of therapy for the treatment of idiopathic pericarditis (IP). A comprehensive review consisting of pertinent clinical literature, pharmacokinetic, and pharmacodynamic considerations, has not been released in recent years. This review will facilitate the clinician's understanding of pharmacotherapeutic considerations for using ASA/NSAIDs to treat IP. Data were compiled using clinical literature consisting of case reports, cohort data, retrospective and prospective studies, and manufacturer package inserts. ASA, ibuprofen, indometacin, and ketorolac relatively have the most evidence in the treatment of IP, provide symptomatic relief of IP, and should be tapered accordingly. ASA is the drug of choice in patients with coronary artery disease (CAD), heart failure (HF), or renal disease, but should be avoided in patients with asthma and nasal polyps, who are naïve to ASA therapy. Ibuprofen is an inexpensive and relatively accessible option in patients who do not have concomitant CAD, HF, or renal disease. Indometacin is not available over-the-counter in the USA, and has a relatively higher incidence of central nervous system (CNS) adverse effects. Ketorolac is an intravenous option; however, clinicians must be mindful of the maximum dose that can be administered. While ASA/NSAIDs do not ameliorate the disease process of IP, they are part of first-line therapy (along with colchicine), for preventing recurrence of IP. ASA/NSAID choice should be dictated by comorbid conditions, tolerability, and adverse effects. Additionally, the clinician should be mindful of considerations such as tapering, high-sensitivity CRP monitoring, bleeding risk, and contraindications to ASA/NSAID therapy.
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Środa-Pomianek K, Wesołowska O, Szczęśniak-Sięga B, Puła B, Dzięgiel P, Maniewska J, Malinka W, Palko-Łabuz A, Michalak K. Effect of new oxicam derivatives on efflux pumps overexpressed in resistant a human colorectal adenocarcinoma cell line. Anticancer Res 2015; 35:2835-2840. [PMID: 25964564] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
BACKGROUND Oxicams are non-steroidal anti-inflammatory drugs (NSAIDs). Antitumor potential of NSAIDs has often been reported in literature. We studied antitumor activity of newly synthesized oxicam derivatives (PR17 and PR18) against doxorubicin-sensitive and resistant human colorectal adenocarcinoma cells (LoVo and LoVo/Dx). MATERIALS AND METHODS The cytotoxicity of oxicam derivatives alone and in combination with doxorubicin was assessed. Inhibition of P-glycoprotein (ABCB1) transport activity was monitored by flow cytometry. Expression of ABCB1 gene was analyzed by semi-quantitative reverse transcription PCR, while ABCB1 protein expression was assessed by western blotting. RESULTS Oxicam derivative PR18 was more cytotoxic to cancer cells than PR17. PR18 was observed to sensitize LoVo/Dx cells to doxorubicin and was identified as an effective multidrug resistance modulator. Additionally, ABCB1 expression was reduced in the presence of PR18. CONCLUSION PR18 was identified as an effective modulator in LoVo/Dx resistant human colorectal adenocarcinoma cells which overexpressed ABCB1 efflux pump.
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Affiliation(s)
| | - Olga Wesołowska
- Department of Biophysics, Wroclaw Medical University, Wroclaw, Poland
| | | | - Bartosz Puła
- Department of Histology and Embryology, Wroclaw Medical University, Wroclaw, Poland
| | - Piotr Dzięgiel
- Department of Histology and Embryology, Wroclaw Medical University, Wroclaw, Poland
| | - Jadwiga Maniewska
- Department of Chemistry of Drugs, Wroclaw Medical University, Wroclaw, Poland
| | - Wiesław Malinka
- Department of Chemistry of Drugs, Wroclaw Medical University, Wroclaw, Poland
| | - Anna Palko-Łabuz
- Department of Biophysics, Wroclaw Medical University, Wroclaw, Poland
| | - Krystyna Michalak
- Department of Biophysics, Wroclaw Medical University, Wroclaw, Poland
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Xu L, Croix BS. Improving VEGF-targeted therapies through inhibition of COX-2/PGE2 signaling. Mol Cell Oncol 2014; 1:e969154. [PMID: 27308371 PMCID: PMC4905212 DOI: 10.4161/23723548.2014.969154] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [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] [Received: 08/21/2014] [Revised: 08/22/2014] [Accepted: 08/22/2014] [Indexed: 12/30/2022]
Abstract
Antiangiogenic agents targeting the vascular endothelial growth factor A (VEGFA) pathway play an important role in current cancer treatment modalities but are limited by alternative angiogenesis mechanisms. Recent studies suggest that enhanced signaling through a COX-2/PGE2 axis contributes to VEGF-independent tumor angiogenesis. Thus, COX-2/PGE2 inhibition may potentiate VEGF therapies.
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Affiliation(s)
- Lihong Xu
- Tumor Angiogenesis Section; Mouse Cancer Genetics Program; National Cancer Institute at Frederick; NIH ; Frederick, MD USA
| | - Brad St Croix
- Tumor Angiogenesis Section; Mouse Cancer Genetics Program; National Cancer Institute at Frederick; NIH ; Frederick, MD USA
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Chopra A, Saluja M, Tillu G, Sarmukkaddam S, Venugopalan A, Narsimulu G, Handa R, Sumantran V, Raut A, Bichile L, Joshi K, Patwardhan B. Ayurvedic medicine offers a good alternative to glucosamine and celecoxib in the treatment of symptomatic knee osteoarthritis: a randomized, double-blind, controlled equivalence drug trial. Rheumatology (Oxford) 2013; 52:1408-17. [PMID: 23365148 DOI: 10.1093/rheumatology/kes414] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.0] [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: 11/14/2022] Open
Abstract
OBJECTIVE To demonstrate clinical equivalence between two standardized Ayurveda (India) formulations (SGCG and SGC), glucosamine and celecoxib (NSAID). METHODS Ayurvedic formulations (extracts of Tinospora cordifolia, Zingiber officinale, Emblica officinalis, Boswellia serrata), glucosamine sulphate (2 g daily) and celecoxib (200 mg daily) were evaluated in a randomized, double-blind, parallel-efficacy, four-arm, multicentre equivalence drug trial of 24 weeks duration. A total of 440 eligible patients suffering from symptomatic knee OA were enrolled and monitored as per protocol. Primary efficacy variables were active body weight-bearing pain (visual analogue scale) and modified WOMAC pain and functional difficulty Likert score (for knee and hip); the corresponding a priori equivalence ranges were ±1.5 cm, ±2.5 and ±8.5. RESULTS Differences between the intervention arms for mean changes in primary efficacy variables were within the equivalence range by intent-to-treat and per protocol analysis. Twenty-six patients showed asymptomatic increased serum glutamic pyruvic transaminase (SGPT) with otherwise normal liver function; seven patients (Ayurvedic intervention) were withdrawn and SGPT normalized after stopping the drug. Other adverse events were mild and did not differ by intervention. Overall, 28% of patients withdrew from the study. CONCLUSION In this 6-month controlled study of knee OA, Ayurvedic formulations (especially SGCG) significantly reduced knee pain and improved knee function and were equivalent to glucosamine and celecoxib. The unexpected SGPT rise requires further safety assessment. TRIAL REGISTRATION Clinical Drug Trial Registry-India, www.ctri.nic.in, CTRI/2008/091/000063.
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Affiliation(s)
- Arvind Chopra
- Center for Rheumatic Diseases, 1988 Convent Street, Camp, Pune, India.
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Peng YL, Leu HB, Luo JC, Huang CC, Hou MC, Lin HC, Lee FY. Diabetes is an independent risk factor for peptic ulcer bleeding: a nationwide population-based cohort study. J Gastroenterol Hepatol 2013; 28:1295-9. [PMID: 23488965 DOI: 10.1111/jgh.12190] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/26/2013] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND AIMS Diabetic patients reportedly have a higher incidence of peptic ulcer disease. The aim of this study was to investigate if type II diabetic patients have higher risk of developing peptic ulcer bleeding (PUB) and to identify possible risk factors of PUB in diabetic patients. METHODS Using the National Health Insurance Research Database of Taiwan, records of 5699 type II diabetic patients and 11,226 age- and sex-matched non-diabetic patients in a 1:2 ratio were extracted for comparison from a cohort dataset of 1,000,000 randomly sampled subjects. Log-rank test was used to analyze differences in cumulative hazard of PUB between the two groups. Cox proportional hazard regressions were used to evaluate independent risk factors for PUB in all patients and identified risk factors of PUB in type II diabetic patients. RESULTS In a 7-year follow-up period, type II diabetic patients had significantly higher cumulative hazard of PUB than the controls (P < 0.001, log-rank test). By Cox proportional hazard regression analysis, diabetes was independently associated with increased risk of PUB (hazard ratio 1.44, 95% confidence interval 1.11-1.86; P < 0.001) after adjusting for age, sex, comorbidities (e.g. hypertension, coronary heart disease, heart failure, chronic renal disease, cirrhosis, and peptic ulcer disease), and ulcerogenic medication. Age, chronic renal disease, history of peptic ulcer disease, and use of non-steroidal anti-inflammatory drugs were risk factors for PUB in diabetic patients. CONCLUSIONS Type II diabetic patients have significantly higher risk of PUB even after adjustments for possible confounding factors like age, sex, underlying comorbidities, and ulcerogenic medication.
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Affiliation(s)
- Yen-Ling Peng
- Department of Medicine, National Yang-Ming University, School of Medicine, Taipei, Taiwan
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Nagano Y, Matsui H, Shimokawa O, Hirayama A, Nakamura Y, Tamura M, Rai K, Kaneko T, Hyodo I. Bisphosphonate-induced gastrointestinal mucosal injury is mediated by mitochondrial superoxide production and lipid peroxidation. J Clin Biochem Nutr 2012; 51:196-203. [PMID: 23170047 PMCID: PMC3491244 DOI: 10.3164/jcbn.12-41] [Citation(s) in RCA: 12] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2012] [Accepted: 03/28/2012] [Indexed: 01/29/2023] Open
Abstract
Bisphosphonates such as alendronate and risedronate are commonly used for the treatment of postmenopausal osteoporosis. They have the gastrointestinal adverse effects such as erosions and ulcers in stomach and small intestine. However, the detailed biological mechanism remains to be elucidated. Since alendronate is suggested to increase the risk of non-steroidal anti-inflammatory drug-related gastropathy, we hypothesized that bisphosphonates and non-steroidal anti-inflammatory drugs have the same pathophysiological mechanisms in gastrointestinal mucosa: Bisphosphonates may induce cellular lipid peroxidation by inducing the production of mitochondrial superoxide. We also hypothesized that geranylgeranylacetone, an antiulcer drug, may prevent lipid peroxidation by reducing superoxide production. We treated gastric RGM1 cells and small intestinal IEC6 cells with alendronate or risedronate, and examined cellular injury, lipid peroxidation and superoxide production with specific fluorescent dyes, and underwent electron paramagnetic resonance spectroscopy to detect the production of superoxide in vitro. The results indicated that bisphosphonates indeed induced cellular injury, cellular lipid peroxidation, and superoxide production. We also demonstrated that the pretreatment of geranylgeranylacetone decreased superoxide production and prevented cellular lipid peroxidation. These results suggested that bisphosphonates, like non-steroidal anti-inflammatory drugs, induce lipid peroxidation by producing mitochondrial superoxide, which was prevented by geranylgeranylacetone.
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Affiliation(s)
- Yumiko Nagano
- The Graduate School of Comprehensive Human Sciences, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-8575, Japan ; Cell Engineering Division, RIKEN BioResource Center, 3-1-1 Koyadai, Tsukuba, Ibaraki 305-0074, Japan
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Norwood S, Liao J, Hammock BD, Yang GY. Epoxyeicosatrienoic acids and soluble epoxide hydrolase: potential therapeutic targets for inflammation and its induced carcinogenesis. Am J Transl Res 2010; 2:447-457. [PMID: 20733953 PMCID: PMC2923867] [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] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2010] [Accepted: 07/20/2010] [Indexed: 05/29/2023]
Abstract
Chronic inflammation is an important factor contributing to human carcinoma, and non-steroidal anti-inflammatory drugs (NSAIDs) have been shown to have a preventive effect in the development of various types of carcinoma. However, NSAIDs also have adverse side effects including increased cardiovascular events, making them less than ideal for routine chemoprevention. Soluble epoxide hydrolase (sEH) is an enzyme that converts endogenous anti-inflammatory compounds, the epoxyeicosatrienoic acids (EETs), to the less anti-inflammatory dihydroxyeicosatrienoic acids (DHETs). Inhibition of sEH, by a highly selective and potent sEH inhibitor (sEHI), increases EETs leading to decreased inflammation. In our studies, administration of a sEHI in mouse colitis models led to decreased ulcer incidence and number of ulcers compared to controls, with no adverse side effects seen. In human tissue, sEH showed an increase in expression, as seen immunohistochemically, in ulcerative colitis (UC), UC-induced dysplasia, and UC-induced carcinoma. Thus, inhibition of sEH may be a novel biomarker and potential therapeutic target in inflammation and inflammation-induced carcinoma.
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Affiliation(s)
- Stephanie Norwood
- Department of Pathology, Northwestern University, Feinberg School of Medicine303 East Chicago Avenue, Chicago, IL 60611, USA
| | - Jie Liao
- Department of Pathology, Northwestern University, Feinberg School of Medicine303 East Chicago Avenue, Chicago, IL 60611, USA
| | | | - Guang-Yu Yang
- Department of Pathology, Northwestern University, Feinberg School of Medicine303 East Chicago Avenue, Chicago, IL 60611, USA
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Kotake S, Yago T, Kawamoto M, Nanke Y. Effects of NSAIDs on Differentiation and Function of Human and Murine Osteoclasts - Crucial 'Human Osteoclastology'. Pharmaceuticals (Basel) 2010; 3:1394-1410. [PMID: 27713309 PMCID: PMC4033988 DOI: 10.3390/ph3051394] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [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] [Received: 04/01/2010] [Revised: 04/21/2010] [Accepted: 04/29/2010] [Indexed: 02/07/2023] Open
Abstract
Osteoclasts play a critical role in both normal bone metabolism and bone resorption in the joints of patients with rheumatoid arthritis. It has been reported that non-steroidal anti-inflammatory drugs (NSAIDs) inhibit murine osteoclastogenesis in vitro and murine arthritis models in vivo, but not the destruction of joints of patients with rheumatoid arthritis. In the current review article, we review the recent findings in the effect of NSAIDs on the formation and function of human and murine osteoclasts both in vitro and in vivo, underlining the importance of studies using human osteoclasts. Since 2009, we have suggested a novel term ‘human osteoclastology’.
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Affiliation(s)
- Shigeru Kotake
- Institute of Rheumatology, Tokyo Women's Medical University, 10-22 Kawada-cho, Shinjuku-ku, Tokyo 162-0054, Japan.
| | - Toru Yago
- Institute of Rheumatology, Tokyo Women's Medical University, 10-22 Kawada-cho, Shinjuku-ku, Tokyo 162-0054, Japan.
| | - Manabu Kawamoto
- Institute of Rheumatology, Tokyo Women's Medical University, 10-22 Kawada-cho, Shinjuku-ku, Tokyo 162-0054, Japan.
| | - Yuki Nanke
- Institute of Rheumatology, Tokyo Women's Medical University, 10-22 Kawada-cho, Shinjuku-ku, Tokyo 162-0054, Japan.
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