[Prominent efficacy from capecitabine mono-therapy for a case with lymphangiosis carcinomatosa derived from recurrent breast cancer]

We met a 61-year-old woman who had been suffering from dyspnea due to pleuritis carcinomatosa derived from recurrent breast cancer for which no former chemotherapy had been effective. Capecitabine mono-therapy could exert a drastic anticancer effect for lymphangiosis carcinomatosa causing more severe symptoms of dyspnea. This therapeutic option could be selected for patients with recurrent breast cancer for which the first- or second-line chemotherapy could not provide a sufficient anti-cancer efficacy and possibly serve to sustain the life quality of the patients.

Escin exerts synergistic anti-inflammatory effects with low doses of glucocorticoids in vivo and in vitro

Escin, a natural mixture of triterpenoid saponins isolated from the seed of the horse chestnut (Aesculus hippocastanum), had been demonstrated to possess anti-edematous and anti-inflammatory effects. The present study was designed to investigate whether escin exhibits synergistic anti-inflammatory effects when combined with glucocorticoids. The carrageenan-induced paw edema and pleuritis in bilaterally adrenalectomized rats were used to investigate the anti-inflammatory effects of escin and glucocorticoid alone or combined. The carrageenan-induced paw edema was inhibited only when escin and corticosterone (Cort) were administered together. Co-administration of escin with Cort significantly reduced the volume of exudates and the number of white blood cells of exudates in bilaterally adrenalectomized rats with pleuritis, but treatment with escin or Cort alone at a suboptimal concentration did not show any effect on the pleuritis rats. After the murine macrophagic RAW264.7 cells stimulated by lipopolysaccharide (LPS), they were treated with escin, Cort or escin and Cort. Then nitric oxide (NO), tumor necrosis factor-α (TNF-α) and interleukin 1β (IL-1β) of cell culture supernatants were analyzed. Escin or Cort markedly reduced the content of NO, TNF-α and IL-1β secreted by LPS-stimulated RAW264.7 macrophage cells. The combination of suboptimal concentrations of escin with Cort, which alone could not markedly inhibit the release of inflammatory factors, inhibited the secretion of NO, TNF-α and IL-1β in LPS-stimulated RAW264.7 macrophage cells. The findings suggest escin can synergize with glucocorticoids to enhance their anti-inflammatory effect.

Anti-inflammatory and immunomodulatory effects of Ulomoides dermestoides on induced pleurisy in rats and lymphoproliferation in vitro

The following study aimed to evaluate, in vitro and in vivo, the anti-inflammatory effect of Ulomoides dermestoides, a beetle commonly used as a remedy for a variety of diseases including respiratory disorders and asthma. We used an acute inflammation model of injury, injection of carrageenan into the pleural cavity of rats. The rats were treated intraperitoneally with the aqueous extract of U. dermestoides 8 and 16 mg/kg. The exudate volume, protein concentration, polymorphonuclear leukocytes (PMNs) and total leukocyte were measured. The peripheral blood mononuclear cells (PBMCs) were isolated from the blood of healthy subjects and we investigated the immunomodulatory and cytotoxic effect of aqueous extract of U. dermestoides. In conclusion, in vitro we observed a non-cytotoxic effect and antiproliferative activity on the dose of 12.5 mg/dL. In vivo, this paper clarifies the great clinical relevance of the aqueous extract of U. dermestoides in elucidating its role as an anti-inflammatory agent.

Pericarditis and pleuritis associated with human parvovirus B19 infection in a systemic lupus erythematosus patient

Human parvovirus B19 (PVB19) infection sometimes shows systemic lupus erythematosus (SLE)-like symptoms. We present an SLE patient showing pericarditis and pleuritis with a fever and an acute swelling of extremities 2 months after the fist consultation. Initially, a diagnosis of SLE exacerbation was made. Additional laboratory examination showed positive results for immunoglobulin M (IgM) antibody to PVB19 and PVB19 DNA in serum and pleural effusion at that time. After 1 month, PVB19 DNA in serum and IgM antibody to PVB19 was negative. Based on these findings, a final diagnosis of PVB19 infection in an SLE patient was made. PVB19 infection should be taken into consideration for SLE with acute swelling of the extremities and fever, as these symptoms are often observed in adult cases of PVB19 infection. Steroid pulse therapy rapidly improved these symptoms, and later the dose of steroid was reduced to 5 mg/day of prednisolone. Thus, steroids may be one of the choices for severe and/or rapidly progressive symptoms of pericarditis and pleuritis due to PVB19 infection.

Non-tuberculous mycobacterial pleurisy: an 8-year single-centre experience in Taiwan

OBJECTIVE

To investigate the clinical characteristics and outcomes of patients with pleurisy due to non-tuberculous mycobacteria (NTM), which are currently unclear.

DESIGN

From 2000 to 2007, patients with NTM and Mycobacterium tuberculosis isolated from pleural effusion (PE) samples were identified and compared.

RESULTS

Thirty-five NTM patients and 140 tuberculosis (TB) patients were reviewed. Patients with NTM pleurisy were less likely to have lung involvement and receive anti-mycobacterial treatment compared with those with tuberculous pleurisy. NTM pleurisy had a higher PE leukocyte count and a lower percentage of lymphocytes. M. avium complex (MAC) was the most common pathogen in NTM pleurisy. Patients with MAC pleurisy were younger and tended to have more extra-pleural involvement and immune dysfunction. One-year mortality in the NTM pleurisy group was 37%, and anti-NTM treatment was associated with better survival. Patients with additional diagnostic evidence were more likely to receive anti-NTM treatment.

CONCLUSION

NTM pleurisy is common and has a high 1-year mortality rate. Anti-NTM treatment may provide better 1-year survival and should be considered once NTM pleurisy is diagnosed.

Anti-inflammatory evaluation of Coronopus didymus in the pleurisy and paw oedema models in mice

ETHNOPHARMACOLOGICAL RELEVANCE

Mastrunço (Coronopus didymus--CD) is currently considered as a medicinal specie often used in Brazil, especially in southeast region, for the treatment of several diseases in which pain and inflammation are common. Treatment with the plant can be done by infusion, decoction, or through food. The aim of this study was: to investigate the anti-inflammatory effect of hydroalcoholic extract obtained from the leaves of CD following the traditional procedure.

MATERIALS AND METHODS

The anti-inflammatory activity was determined using mouse of pleurisy and paw oedema models, both process being induced by different flogistic agents such as: carrageenan (Cg), bradykinin (BK), histamine (HIS), substance P (SP), dextran (DEX) or prostaglandin E(2) (PGE(2)). We evaluated the effect of CD (200-600 mg/kg) administered by oral route (p.o.) upon leukocytes migration, myeloperoxidase (MPO), and adenosine-deaminase (ADA) activities and nitric oxide (NO) levels.

RESULTS

CD (200-600 mg/kg) inhibited the leukocytes by 60.0+/-1.42%, neutrophils by 82.75+/-1.29%, MPO by 42.30+/-4.23%, and ADA activities by 57.89+/-1.94%, as well as NO levels by 64.28+/-2.15% in Cg induced pleurisy. CD also inhibited total and differential leukocytes in the pleurisy induced by BK (1.30+/-0.11/0.29+/-0.02), HIS (1.20+/-0.09/0.42+/-0.05) and SP (0.74+/-0.06/0.14+/-0.01). In addition, CD was effective in reducing paw oedema induced by Cg by 72.79+/-1.13%, SP by 68.26.+/-0.78%, BK by 66.66.+/-0.77%, PGE(2) by 53.346.+/-1.18 and DEX by 65.14+/-2.35%.

CONCLUSION

Several mechanisms, including the inhibition of enzymes (MPO and ADA) and mediators (BK, HIS, SP, NO and PGE(2)) release and/or action, appear to account for the anti-inflammatory effect of Coronopus didymus.

A case of aseptic pleuropericarditis in a patient with chronic plaque psoriasis under methotrexate therapy

Methotrexate may rarely provoke serositis, even with low doses and after just a few weeks of therapy. We report here a rare case of pleuropericarditis due to methotrexate. The effusion resolved after the withdrawal of the drug and the beginning of anti-inflammatory therapy; there was no relapse during a 10-month follow-up.

Cyclooxygenase enzymes and their products in the carrageenan-induced pleurisy in rats

Rodent models of inflammation have helped in our understanding of the inflammatory process and also for the screening of compounds with anti-inflammatory potential. Although they do not represent a particular inflammatory disease in humans, cavity models of inflammation in rodents are easy to induce and to quantify the inflammatory reaction as well as to harvest the inflammatory exudates for cytological, biochemical and molecular biological analysis. Of these models, the carrageenan-induced pleurisy model has been extensively used to study the role of the cyclooxygenase (COX) enzymes and the prostaglandins in acute inflammation and also for the screening of COX-inhibiting anti-inflammatory drugs.

[Severe disseminated constrictive polyserositis in a patient with rheumatoid arthritis]

Constrictive polyserositis (pleuritis, pericarditis) is a syndrome within the underlying disease (tuberculosis, periodic disease, rheumatoid arthritis, systemic lupus erythematosus, asbestos, silicosis, uremia, some genetic diseases), a complication due to chest surgery or radiation or drug therapy, is occasionally idiopathic (fibrosing mediastinitis). There are frequently great difficulties in making its nosological diagnosis. The paper describes a patient in whom the onset of disease was exudative pleurisy with the signs of constriction, arthralgias; pleural punctures provided serous exudates with 80% lymphocytes. A year later there was ascitis and shin and foot edemas, which concurrent with hepatomegaly and cholestasis was regarded as cryptogenic liver cirrhosis. The signs of constrictive pericarditis were further revealed. The disease was complicated by the development of pulmonary artery thromboembolism (PATE) (which required the use of warfarin) and hemorrhagic vasculitis. Therapy with metipred in combination with isoniazid yielded a slight effect. The diagnoses of tuberculosis, liver cirrhosis, and autoimmune hepatitis, systemic vasculitis were consecutively rejected; the diagnosis of rheumatoid polyarthritis with systemic manifestations was made, by taking into account persistent arthalgias with the minimum signs of arthritis, noticeably increased C-reactive protein, rheumatoid factor, and cyclic citrullinated peptide antibodies (CCPA); plasmapheresis, therapy with metipred and methotrexate, and subtotal pericardectomy were performed. Constrictive polyserositis concurrent with PATE, hemorrhagic vasculitis (probably, drug-induced one), and hepatic lesion has been first described in a CCPA-positive patient with rheumatoid arthritis in the presence of moderate true arthritis (during steroid therapy).

[Causes and risk factors of pleural empyema and complicated parapneumonic pleural effusion]

OBJECTIVE

To analyze the causes and risk factors of pleural empyema and complicated parapneumonic pleural effusion and to evaluate age, sex, concomitant pathology of the patients studied, time of consulting a doctor, and antibacterial treatment before the diagnosis.

MATERIAL AND METHODS

A total of 120 patients with pleural empyema (n=67) and complicated parapneumonic pleural effusion (n=53) were studied. When pus in the pleural space was present, pleural empyema was considered. Complicated parapneumonic pleural effusion was diagnosed when multiloculated fluid in the pleural cavity by ultrasound examination, more than 50% neutrophils of all leukocytes in the pleural fluid, and pleural fluid pH <7.0 were found.

RESULTS

Most patients with pleural empyema and complicated parapneumonic pleural effusion were middle aged (53+/-17 years); men were twice as likely as women to have these conditions. Less than half (46%) of patients had at least one risk factor such as neoplasia (37%), treatment with immunosuppressive medicine (15%), alcohol abuse (15%). Persons consulted a doctor after 12 days, on the average, following the onset of the symptoms of the illness. The risk factors were found more often for the patients with pleural empyema than with complicated parapneumonic pleural effusion (50.75% versus 39.62%). Patients with pleural empyema consulted a doctor later than patients with complicated parapneumonic pleural effusion (21+/-28.6 days versus 9.5+/-9.8 days, P=0.0052). Three-fourths (75%) of the patients were treated with antibiotics, and monotherapy was applied most frequently (86% of cases). Penicillins (28%), cephalosporins (26%), aminoglycosides (20%), and macrolides (10%) were prescribed most commonly. One-quarter (25%) of patients were not treated with antibiotics mostly because of misdiagnosed intercostal neuralgia.

CONCLUSIONS

Causes of pleural empyema and complicated parapneumonic pleural effusion are multifactorial. Patients consult a doctor too late after the onset of the symptoms, nearly half of the studied patients were found to have conditions that might cause immunosuppression, and a part of patients did not receive antibiotics or antibacterial treatment was administered improperly.

[Intrapleural hypotonic cisplatin treatment for carcinomatous pleuritis in cases of primary lung cancer]

Intrapleural hypotonic cisplatin treatment, which was introduced by Ichinose and colleagues, was performed for 5 cases of primary lung cancer with carcinomatous pleuritis: one case intraoperatively, one case postoperatively and 3 unresected cases. Fifty microg/mL of cisplatin distilled water solution was administered into pleural cavity and drained 10 minutes later in the intraoperative case or 30 minutes later in the bedside cases. No adverse effect was observed. For 2 dissemination- dominant cases, 2 regimens of single cytotoxic agent followed by gefitinib were administered, and the two patients died in 26 and 69 months, respectively. For one case with dissemination and effusion, 5 regimens including combination chemotherapy were administered, and the patient died in 41 months. For 2 effusion-dominant cases, gefitinib was administered and one case is still in PR status for 21 months, and the other was alive for 19 months. Ipsilateral pleural effusion was controlled in all 5 cases. This therapy is helpful for systemic chemotherapy as a main therapeutic means in cases of lung cancer with carcinomatous pleuritis by controlling malignant pleural effusion and relieving dyspnea.

[Thoracic impairment from familial Mediterranean fever: review of the literature and a case study]

Familial Mediterranean fever (FMF) is a recessive autosomal disease, predominantly affecting the population around the Mediterranean. The main clinical signs consist of attacks of fever associated with abdominal, articular and thoracic pain. Based on a case report, the authors describe the main thoracic forms of this illness comprising pleural pain, pleural effusion and pulmonary amyloidosis. The authors also discuss the association of mesothelioma and FMF. Colchicine is successfully used in the treatment of FMF.

Bioassay-guided isolation of anti-inflammatory C-glucosylflavones from Passiflora edulis

Passiflora edulis, commonly known as "maracujá", is widely cultivated in Brazil for the industrial production of juice. The species of Passiflora are popularly used as a sedative or tranquillizer, and also against intermittent fever and skin inflammation. In this study we evaluated the anti-inflammatory activity of four sub-fractions and three isolated compounds from the butanolic fraction of P. edulis var. flavicarpa leaves, using the mouse model of pleurisy induced by carrageenan. The butanolic fraction obtained from an aqueous extract of P. edulis (50 and 100 mg/kg, I. P.) showed anti-inflammatory activity by inhibiting leukocytes and neutrophils (p < 0.01). Sub-fraction C showed itself to be more effective than the other sub-fractions (p < 0.01). Isoorientin ( 1), vicenin-2 ( 2) and spinosin ( 3) were isolated from the active sub-fraction C derived from the butanolic fraction. The sub-fraction C (50 mg/kg, I. P.), as well as its major isolated compounds (25 mg/kg, I. P.), inhibited leukocytes and neutrophils (p < 0.05). Additionally, the butanolic fraction and isoorientin also inhibited myeloperoxidase activity (p < 0.05). The present study showed that the C-glucosylflavones isolated from P. edulis leaves can be responsible for the anti-inflammatory effect of P. edulis on the mouse model of pleurisy.

Hyperforin is a novel type of 5-lipoxygenase inhibitor with high efficacy in vivo

We previously showed that, in vitro, hyperforin from St. John's wort (Hypericum perforatum) inhibits 5-lipoxygenase (5-LO), the key enzyme in leukotriene biosynthesis. Here, we demonstrate that hyperforin possesses a novel and unique molecular pharmacological profile as a 5-LO inhibitor with remarkable efficacy in vivo. Hyperforin (4 mg/kg, i.p.) significantly suppressed leukotriene B(4) formation in pleural exudates of carrageenan-treated rats associated with potent anti-inflammatory effectiveness. Inhibition of 5-LO by hyperforin, but not by the iron-ligand type 5-LO inhibitor BWA4C or the nonredox-type inhibitor ZM230487, was abolished in the presence of phosphatidylcholine and strongly reduced by mutation (W13A-W75A-W102A) of the 5-LO C2-like domain. Moreover, hyperforin impaired the interaction of 5-LO with coactosin-like protein and abrogated 5-LO nuclear membrane translocation in ionomycin-stimulated neutrophils, processes that are typically mediated via the regulatory 5-LO C2-like domain. Together, hyperforin is a novel type of 5-LO inhibitor apparently acting by interference with the C2-like domain, with high effectiveness in vivo.

Treatment of advanced breast cancer with chemotherapeutics and inhibition of coagulation and fibrinolysis

A case of advanced breast cancer with cerebral metastasis and pleurisy is reported in which irradiation and cytostatics had failed to retard progressive growth and spread of the tumour. Adjuvant therapy with heparin combined with the fibrinolytic inhibitor tranexamic acid was followed by regression of the cerebral metastasis as well as the pleurisy. When last seen one year later, the patient was free from symptoms.

[Inhibiting effect of Shuang-huang-lian microemulsion on cytokines of carrageenan induced pleuritis in rats]

OBJECTIVE

To explore the anti-inflammatory effect and possible mechanism of Shuang-huang-lian (SHL) microemulsion.

METHOD

Rat model of pleuritis was established by thoracic injecting 0.2 mL of 1% carrageenan. Rats in the treated groups were orally administered with SHL microemulsion prescription 1, 2, and oral liquid, while those in the positive control group were given aspirin. Rats in the normal group and the model group were given equal volume of water. Each groups were given their medicine for successive 6 days. Modeling was performed 30 mins after the 5th day medication. After 12 hrs of modeling, took suction of the pleurorrhea and measured the amount of tumor necrosis factor alpha (TNF-alpha), interleukin-8 (IL-8), prostaglandin E2 (PGE2) and protein (pro).

RESULT

Compared with the normal group, all the parameters were higher in model group (TNF-alpha and IL-8 P<0.01, PGE2 and pro P<0.05). While compared with the model group, only the amount of TNF-alpha and PGE2 were lower in all the treated group (P<0.01).

CONCLUSION

Both SHL microemulsion prescription 1 and 2 have obvious anti-inflammatory effect. The effect might be related to inhibiting the increase of cytokines as TNF-alpha and PGE2, and intervening of the metabolic process of arachidonic acid (AA).

[Intrapleural chemotherapy--current status and problems in Japan]

The efficacy of anti neoplastic agents for chest catheter pleurodesis remains controversial, and little is known regarding the optimal treatment protocol. Of the various anti neoplastic agents, bleomycin and cisplatin are preferred for intrapleural therapy in Japan, and a wide variation among institutions is evident in agent doses and medication methods for pleurodesis. In many reported trials of anti neoplastic pleurodesis, problems exist such as disease heterogeneity, small sample size and differences in response criteria, and randomized control trials (RCTs) are needed to establish evidence. The JCOG 9515 trial randomly assigned patients to either the bleomycin (BLM) arm, the OK-432 arm, or the cisplatin+etoposide (PE) arm. Among them, OK-432 was demonstrated to be more effective than BLM or PE in terms of pleural progression-free survival. Intrapleural combination therapy (chemotherapy plus biological response modifiers) appeared to be superior to either alone, and further randomized studies are warranted.

Anti-inflammatory activity of the extract, fractions and amides from the leaves of Piper ovatum Vahl (Piperaceae)

Leaves of Piper ovatum are known in folk medicine as "joão burandi" or "anestésica" and in traditional Brazilian medicine are used to treat inflammatory disease. The hydroalcoholic extract, fractions, and a mixture of piperovatine (1) and piperlonguminine (2) in a proportion of 2:3 obtained from Piper ovatum were assayed for anti-inflammatory activity by means of carrageenan-induced pleurisy in rats and croton oil-induced ear edema in mice. The hydroalcoholic extract was analyzed by high-performance liquid chromatography. Fraction constituents were evaluated by phytochemical screening, and the mixture of amides (1 and 2) was identified by analyses of spectral data of (1)H and (13)C nuclear magnetic resonance. Acute toxicity of the extract also was evaluated. At 500mg/kg, the hydroalcoholic extract of Piper ovatum leaves did not reduce the volume of inflammatory pleural exudates compared with control animals. However, the hydroalcoholic extract and fractions F1-F3 at doses of 5.0mg/ear and a mixture of piperovatine (1) and piperlonguminine (2) at doses of 2.5, 1.25, and 0.625mg/ear significantly reduced the degree of ear edema. Taken together, the results indicate that the amide fractions piperovatine and piperlonguminine showed the greatest inhibitory activity of topical inflammation induced by croton oil.

[A long survival case of advanced colon cancer with lung metastasis and cancerous pleuritis responding to CPT-11 and S-1 combination therapy]

A 71-year-old man underwent right hemicolectomy for an ascending colon cancer (stage II, Cur A) in September 2001. Adjuvant chemotherapy with tegafur/uracil was performed, but CT scans and FDG-PET, conducted in May 2003, revealed cancerous pleuritis and lung metastasis. Although 2 courses of the chemotherapy with LV+5-FU (RPMI regimen) were completed, progressive disease was confirmed. Therefore, the chemotherapy with CPT-11 (100 mg/ day; day 1, 15)+S-1 (100 mg/day; day 1-21) was started in May 2004. After completion of 6 courses, CT scan showed a partial response. Only grade 2 vomiting was noted as an adverse reaction to the treatment, however, the patient has been managed on an outpatient basis for the last 3 years with good QOL and the cancer under control. This case suggests that this combination therapy can be expected to be highly effective as a safe approach for continuously maintaining the QOL of patients with advanced or recurrent colorectal cancer.

Low dose intravenous immunoglobulin in systemic lupus erythematosus: analysis of 62 cases

BACKGROUND

Systemic lupus erythematosus is an autoimmune disease with diverse clinical manifestations that cannot always be regulated by steroids and immunosuppressive therapy. Intravenous immunoglobulin is an optional immunomodulatory agent for the treatment of SLE, but the appropriate indications for its use, duration of therapy and recommended dosage are yet to be established. In SLE patients, most publications report the utilization of a high dose (2 g/kg body weight) protocol.

OBJECTIVES

To investigate whether lower doses of IVIg are beneficial for SLE patients.

METHODS

We retrospectively analyzed the medical records of 62 patients who received low dose IVIg (approximately 0.5 g/kg body weight).

RESULTS

The treatment was associated with clinical improvement in many specific disease manifestations, along with a continuous decrease in SLEDAI scores (SLE Disease Activity Index). However, thrombocytopenia, alopecia and vasculitis did not improve following IVIg therapy.

CONCLUSIONS

Low dose IVIg is a possible therapeutic option in SLE and is associated with lower cost than the high dose regimen and possibly fewer adverse effects.

[Evaluation of bronchial arterial infusion (BAI) for lung cancer with carcinomatous pleuritis]

MATERIALS AND METHODS

Six high-risk patients of lung cancer with carcinomatous pleuritis to which BAI was done were examined. BAI was performed using CDDP (40-50 mg/m2) + CPT-11 (40-50 mg/m2). The therapeutic effects, side effects, a reduction of the symptoms and prognosis were examined.

RESULTS

All cases were revealed as stable disease according to the rule of the RECIST. The side effect of appetite loss for over grade 2 was found in one case. The reduction of respiratory symptoms (cough, dyspnea at the movement in 3, chest pain in 1 and loss of the movement in 1) was recognized by four out of five cases. Five patients died in three to seven months after the treatment of BAI. The causes of death were the recurrence of carcinomatous pleuritis and the primary lesion or the metastasis lesion of the lung in 4 cases and the recurrence of the primary lesion in 1 case. The recurrence of the malignant pleural effusion was recognized in 1 case without intra-thoracic infusion.

COMMENT

BAI was effective as a reduction of the respiratory symptoms in the high-risk patients of lung cancer with carcinomatous pleuritis. It appeared that a long-term survival was probable with the combination of BAI, intra-thoracic infusion and systemic chemotherapy.

Pleuritis as the first symptom of pulmonary embolism: a case report

Pulmonary embolism (PE) is a common problem but its diagnosis is challenging since clinical signs and symptoms are not specific. Given the significant overlap between the presentation of PE and other not life threatening entities/diseases, it is important to be acquainted with diagnostic tests and treatment of PE. It is of vital importance to suspect PE in case of chest pain. We would like to present the patient complaining of acute left-sided chest pain, referred to the hospital after being unsuccessfully treated in outpatient clinic for chest infection.

Chemical composition and anti-inflammatory activity of copaiba oils from Copaifera cearensis Huber ex Ducke, Copaifera reticulata Ducke and Copaifera multijuga Hayne--a comparative study

Copaiba oil is an oleoresin obtained from the Copaifera L. genus (Leguminoseae) commonly featured in anti-inflammatory recipe prescribed by Amazonian traditional medical practitioners and featured in Europe and North America pharmacopeias of the past. Chemical and anti-inflammatory activity investigations from the copaiba oils obtained from Copaifera multijuga Hayne, Copaifera cearensis Huber ex Ducke and Copaifera reticulata Ducke species have proved that, although similar, these oleoresins possess varied composition and anti-inflammatory activity. Chromatographic studies showed that the main compound among sesquiterpenes was beta-caryophyllene (57.5, 19.7 and 40.9%, respectively), followed by alpha-humulene, alpha-copaene, alpha-bergamotene, delta-cadinene, with different amounts in each oleoresin. Among the diterpenes, copalic acid was the main component from Copaifera multijuga Hayne (6.2%) and was found in all the oleoresins studied. In Copaifera cearensis Huber ex Ducke, clorechinic (11.3%) and hardwickiic acids (6.2%) were the major diterpenes while kaurenoic (3.9%) and kolavenic acids (3.4%) predominated in Copaifera reticulata Ducke. The pharmacologic effects of the three oleoresins were evaluated in vitro by measuring the NO production by murine macrophages and in vivo using the zymosan induced pleurisy model in mice. The Copaiba Oil from Copaifera multijuga Hayne (100 mg/kg) was the most potent, inhibiting both NO production and the pleurisy induced by zymosan. The oleoresins from Copaifera cearensis Huber ex Ducke and Copaifera reticulata Ducke were also able to inhibit NO production and the pleurisy but with less intensity.