Anti-inflammatory effect of Stereospermum suaveolens ethanol extract in rats

The anti-inflammatory effect of the ethanol extract of Stereospermum suaveolens (Roxb.) DC (Bignoniaceae) bark given orally at the dose of 200 and 400 mg/kg body weight was studied in rats using the carrageenan-, dextran-, and histamine-induced hind paw edema, and cotton pellet-induced granuloma formation models. Indomethcin at the dose of 10 mg/kg body weight was used as a standard drug. The extract (400 mg/kg body weight per os) showed maximum inhibition of edema 64.6, 53.48, and 50.06% at the end of 3 h with carrageenan-, dextran-, and histamine-induced rat paw edema, respectively. The extract (400 mg/kg) exhibited significant reduction (34.77%) in granuloma weight in the cotton pellet-induced granuloma model. From these results it could be concluded that, the ethanol extract of Stereospermum suaveolens possesses maximum anti-inflammatory activity in a dose-dependent manner, in various experimental models.

Acute renal failure from nitrofurantoin-induced acute granulomatous interstitial nephritis

We report here a case of acute renal failure with nitrofurantoin-associated acute granulomatous interstitial nephritis (GIN), which was commenced as a long-term prophylactic agent for suspected recurrent urinary tract infections. Renal function improved with withdrawal of this agent and without the requirement of corticosteroids. All new medication changes should be held in suspicion as a cause of acute onset abnormalities in serum biochemistry.

Evaluation of anti-inflammatory potential of Chloranthus erectus (Buch.-Ham.) Verd. leaf extract in rats

AIM OF THE STUDY

Chloranthus erectus (Buch.-Ham.) Verdcourt (Chloranthaceae) is a shrub native to tropical and temperate zone of Eastern Himalaya of India and South-East Asia and have traditionally been used as a folklore medicine to treat localised swelling, joint pain, skin inflammation, fever and bodyache. In this study, an attempt has been made to demonstrate the anti-inflammatory activity of methanol extract obtained from Chloranthus erectus leaves (MECEL) in acute, sub-acute and chronic mouse models.

MATERIALS AND METHODS

Inflammation in the hind paw of Wistar albino rat was induced by carrageenan, histamine and serotonin, and tissue granuloma pouch was induced by cotton pellet method. Anti-inflammatory drug-phenylbutazone was used as standard drug for comparison.

RESULTS

In acute carrageenan-induced rat hind paw edema, oral administration of MECEL at 200 mg/kg produced significant inhibition of edema by 38.34% (p < 0.01) while the histamine- and serotonin-induced sub-acute model, the inhibition of paw edema reached 52.54% (p < 0.001) and 25.5% (p < 0.01), respectively. In a 7-day study, MECEL at 20 and 50 mg/kg produced significant suppression of cotton pellet-induced tissue granuloma formation in rats.

CONCLUSIONS

This preliminary study revealed that the methanol extract of Chloranthus erectus exhibited significant anti-inflammatory activity in the tested models, and may provide the scientific rationale for its popular folk medicine as anti-inflammatory agent.

The effect of the aqueous extract of Helietta parvifolia A. Gray (Rutaceae) stem bark on carrageenan-induced paw oedema and granuloma tissue formation in mice

AIMS OF STUDY

Despite the ethnopharmacological relevance of Helietta parvifolia A. Gray (Rutaceae) in Mexico, we found no significant pharmacological studies of this plant in the scientific literature. The aim of the present study was to establish the anti-inflammatory effect of an aqueous extract of the stem bark of Helietta parvifolia in mice.

MATERIALS AND METHODS

The anti-inflammatory activity of the aqueous extract of the stem bark of Helietta parvifolia was evaluated using carrageenan-induced paw oedema in mice, and the cotton pellet granuloma method.

RESULTS

An extract dose ranging from 20 to 80 mg/kg p.o. showed a non-significant effect over the initial phase of carrageenan-induced oedema. However, it showed a significant inhibition of oedema after 3h, which can be related to the inhibition of the release of kinin-like substances. An ID(50) value of 47.4 mg/kg was obtained for the plant extract. The extract also suppressed granulomatous tissue formation during chronic inflammation. The inhibitory values were 19.2, and 22.2, corresponding to 40 and 80 mg/kg doses of extract respectively.

CONCLUSIONS

Aqueous extract showed a statistically significant anti-inflammatory effect in mice during the late phase of acute inflammation and during chronic inflammation. However, the exact mechanism(s) of anti-inflammatory effects of Helietta parvifolia observed in this study remains unclear.

Antiinflammatory and immunoregulatory effects of total glucosides of Yupingfeng powder

BACKGROUND

Yupingfeng, a traditional Chinese complex prescription, has been used efficaciously in China for the cure and prevention of inflammatory diseases related to immunodeficiency such as allergic rhinitis and chronic bronchitis. However, the active components of this prescription remain unclear. The present study focused on investigating the antiinflammatory and immunoregulatory effects of the glucosidic extract from Yupingfeng.

METHODS

We tested animal models for ear swelling induced by dimethylbenzene in mice; palm swelling induced by carregeenin and granuloma induced by cotton pellet in rats; level of haemolysin, antibody generation by the splenic cells, delayed hypersensitivity and T cell subsets in spleen of immunosuppressed mice.

RESULTS

Glucosidic extract of 24 mg/kg, 48 mg/kg and 96 mg/kg significantly inhibited mice's ear swelling induced by dimethylbenzene. Similarly glucosidic extract of 16 mg/kg, 32 mg/kg and 64 mg/kg inhibited rats' palm swelling induced by carregeenin and granuloma induced by cotton pellet. Glucosidic extract of 24 mg/kg, 48 mg/kg and 96 mg/kg improved the IgM level in serum and level of haemolysin in splenocytes in mice immunosuppressed by cyclophosphamide. Delayed hypersensitivity in mice suppressed by cyclophosphamide was enhanced by glucosidic extract of 24 mg/kg, 48 mg/kg and 96 mg/kg. These results suggested that Yupingfeng could recover humoral and cellular immune function in mice with immunosuppression. Glucosidic extract of 48 mg/kg and 96 mg/kg significantly resisted the immunosuppressive mice ear swelling and maintained it at nearly normal level. The enhanced, delayed hypersensitivity actions of glucosidic extract, suppressed by cyclophosphamide, might be brought about by inducing TH cell and regulating T lymphocytes subset.

CONCLUSIONS

The glucosidic extract from Yupingfeng has antiinflammatory and immunoregulation action, suggesting that these glucosides are the principal active components of the traditional Chinese prescription Yupingfeng.

Reversible bone marrow granulomas-adverse effect of oxyphenbutazone therapy

A 48-year-old woman treated with oxyphenbutazone developed fever, gastrointestinal disturbances, mucocutaneous reactions, leukopenia, eosinophilia and thrombocytopenia. Bone marrow biopsy showed granulomatous lesions. Following withdrawal of the drug, all signs and symptoms subsided and the blood changes and the bone marrow biopsy normalized. The granulomatous reaction in the bone marrow is considered to be a hypersensitivity manifestation of oxyphenbutazone.

Granulomatous hepatitis in a patient receiving carbamazepine

A 60-year-old woman, previously in good health, received carbamazepine in a total dose of 10 g during 1 month. Fever, upper abdominal pain and abnormal liver function appeared after 3 weeks. Liver biopsy showed non-caseating granulomas. One week after withdrawal of carbamazepine the patient was clinically well with normal liver function. Carbamazepine was then reinstituted for 4 days, resulting in fever, upper abdominal pain and deteriorating liver function. One month after this provocation test the patient was clinically well with normal liver function and normal liver biopsy showing only slight fatty vacuolization but no granulomas. A reversible positive mitochondrial antibody test was seen.

Syntheses and anti-inflammatory activity of Diphenylamine-2,2′-dicarboxylic acid and its metal complexes

Diphenylamine-2,2'-dicarboxylic acid and its Cu(II), Ni(II), Co(II) and Zn(II) complexes have been synthesized and characterized by their elemental analyses, molecular weight determination, molar conductance, infrared and electronic spectra and magnetic measurements. The Zinc complex was tested by different methods for its anti-inflammatory activity and found to be equipotent to naproxen and ibuprofen, though at higher doses.

Interstitial granulomatous dermatitis associated with darifenacin

Interstitial granulomatous dermatitis is most commonly associated with rheumatoid arthritis (RA) but may be induced by medications as well. Darifenacin is a muscarinic antagonist which was FDA approved for the treatment of overactive bladder in December 2004. The authors describe a case of interstitial granulomatous dermatitis associated with darifenacin.

Intrathecal granuloma in a patient receiving high dose hydromorphone

Intrathecal granuloma formation has commonly been described with morphine therapy. It has been suggested that a high concentration of intrathecal morphine may be responsible for this complication. Much less commonly, intrathecal hydromorphone has been associated with intrathecal granuloma formation. In the current case we report the evaluation and management of an intrathecal granuloma in a patient receiving a relatively high concentration of intrathecal hydromorphone. A nonsurgical, conservative approach to management involves stopping the infusion and observing the patient for improvement as the granuloma mass often slowly resolves once the infusion is stopped. Cessation of the infusion or addition of clonidine to the IDDS admixture in conjunction with close clinical monitoring may be reasonable treatment options in patients with an asymptomatic or mildly symptomatic inflammatory mass. In the current study, rapidly declining neurologic function with a confirmed inflammatory mass adherent to the spinal canal necessitated urgent surgical intervention. Though use of intrathecal hydromorphone still represents an off label application, this opiate is commonly employed as an alternative first line analgesic agent. This case report highlights the potential of high-dose and high infusate concentration intrathecal hydromorphone to form an inflammatory granuloma.

Sarcoidosis occuring during anti-TNF-alpha treatment for inflammatory rheumatic diseases: report of two cases

Anti-TNF-alpha agents have been tried in cases of refractory sarcoidosis, giving favourable results. Thus, the occurrence of a granulomatous disease in a patient receiving such drug seems paradoxical. We describe 2 patients with inflammatory rheumatic disease, the first with ankylosing spondylitis, the second with rheumatoid arthritis, under anti-TNF-alpha treatment (infliximab and etanercept respectively) who developed non-caseating granulomas of the lungs and lymph nodes consistent with the diagnosis of sarcoidosis. Limited and various similar cases have been reported. It is generally considered that these granulomatous diseases are related to the anti-TNF-alpha agent.

Interstitial granulomatous dermatitis in a patient with rheumatoid arthritis on etanercept

Tumor necrosis factor-alpha (TNF-alpha) has been implicated in the pathogenesis of numerous inflammatory conditions, possibly facilitating the induction and maintenance of these diseases through lymphocyte activation and cytokine production. Inhibitors of TNF-alpha have proven efficacious in the treatment of autoimmune diseases such as psoriasis, rheumatoid arthritis, inflammatory bowel disease, and lymphoproliferative disorders. However, recent cases of adverse cutaneous reactions have been reported in anti-TNF-alpha therapy, most notably those of granulomatous morphology. We report a patient with rheumatoid arthritis who had been treated with etanercept (50 mg/wk) for 6.5 years. The patient subsequently developed pink and red papules on large areas of the upper and lower extremities. Skin biopsy specimens revealed both poorly formed and well-circumscribed nonnecrotizing epithelioid granulomas in the superficial dermis. Application of clobetasol propionate ointment 0.05% without discontinuation of anti-TNF-alpha therapy led to complete resolution of the skin lesions. While the precise mechanisms of physiologic and pathologic TNF activity remain to be determined, it is clear that granulomatous lesions may emerge as a complication of anti-TNF-alpha therapy. Treatment with topical corticosteroids may be sufficient to eliminate such lesions.

Sarcoidosis presenting with granulomatous uveitis induced by pegylated interferon and ribavirin therapy for Hepatitis C

Sarcoidosis is a systemic granulomatous disease that is triggered by an autoimmune process, and is now a well recognized but uncommon complication of antiviral therapy for Hepatitis C virus (HCV) infection, likely related to its immunomodulatory effects. The clinical presentation of HCV related sarcoidosis is as varied as systemic sarcoidosis, but ocular presentation alone has not been reported previously. We present a 23 year-old female who developed visual disturbances due to ocular sarcoidosis during the course of antiviral therapy for chronic HCV infection. Our case presentation is then followed by a review of the literature on the topic. We aim to stress the importance of screening for eye problems in following HCV patients undergoing antiviral therapy, and raise clinicians' awareness of sarcoidosis as a possible cause for eye problems even in the absence of respiratory complaints.

Mycobacterial glycolipid trehalose 6,6'-dimycolate-induced hypersensitive granulomas: contribution of CD4+ lymphocytes

The granulomatous response is a characteristic histological feature of Mycobacterium tuberculosis infection responsible for organism containment. The development of cell-mediated immunity is essential for protection against disease, as well as being required for maintenance of the sequestering granulomatous response. Trehalose 6,6'-dimycolate (TDM; cord factor), a glycolipid associated with the cell wall of mycobacteria, is implicated as a key immunogenic component in M. tuberculosis infection. Models of TDM-induced hypersensitive granulomatous response have similar pathologies to that of active tuberculosis infection. Prior immunization (sensitization) of mice with TDM results in exacerbated histological damage, inflammation and lymphocytic infiltration upon subsequent TDM challenge. Adoptive transfer experiments were performed to ascertain the cell phenotype governing this response; CD4(+) cells were identified as critical for development of related pathology. Mice receiving CD4(+) cells from donor TDM-immunized mice demonstrated significantly increased production of Th1-type cytokines IFN-gamma and IL-12 within the lung upon subsequent TDM challenge. Control groups receiving naïve CD4(+) cells, or CD8(+) or CD19(+) cells isolated from TDM-immunized donors, did not exhibit an exacerbated response. The identified CD4(+) cells isolated from TDM-immunized mice produced significant amounts of IFN-gamma and IL-2 when exposed to TDM-pulsed macrophages in vitro. These experiments provide further evidence for involvement of a cell-mediated response in TDM-induced granuloma formation, which mimics pathological damage elicited during M. tuberculosis infection.

Injection-site granulomas resulting from the administration of both leuprorelin acetate and goserelin acetate for the treatment of prostatic cancer

Although injection-site granulomas caused by leuprorelin acetate have been reported, there have been no reports of granulomas caused by both leuprorelin acetate and goserelin acetate. An 81-year-old man presented with subcutaneous nodules of the abdominal wall and upper arm, where 11.25 mg of leuprorelin acetate had been injected for the treatment of prostate cancer. Because of these nodules, treatment was changed to goserelin acetate. Nevertheless, he presented with another subcutaneous nodule at the injection site. Histological examination showed that these nodules consisted of numerous giant cells that were CD3-positive T lymphocytes and CD68-positive histiocytes associated with granulomatous changes. The granulomas had likely been caused by delayed-type hypersensitivity to leuprorelin acetate injection. The granuloma that formed after goserelin acetate injection might thus have developed owing to the immunogenicity of the previous leuprorelin acetate injections. The patient underwent surgical castration. The present case suggests that both leuprorelin acetate and goserelin acetate can cause injection-site disorders.

Anti-inflammatory and free radical scavenging activities of ethanol extracts of three seeds used as "Bolengguazi"

The seeds of Herpetospermum pedunculosun (Ser.) C.B.Clarke. (HPD), Mormodica cochinchinensis (Lour.) Spreng. (MCC) and Mormodica charantia L. (MCR) share the same common name ("Bolengguazi") in the Tibetan medicine. The anti-inflammatory activities of the three "Bolengguazi" were evaluated using egg album-induced paw edema and cotton-pellet granuloma tests. Among them, HPD is the most active one in both models. Results showed that oral administration of ethanol extract of HPD seed (200 and 400mg/kg) significantly suppressed the development of egg albumin-induced paw edema (P<0.01). In the chronic test, the ethanol extract of HPD seed (200 and 400mg/kg) showed significant reduction in granuloma weight of rats (P<0.05). The anti-inflammatory effect of the ethanol HPD seed was similar to that of indomethacin (10mg/kg). Moreover, the free radical scavenging activities of "Bolengguazi" were investigated using the DPPH test. Only the ethanol extract of HPD seed showed a moderate free radical scavenging effect on DPPH (IC50, 198.69 microg/ml) when compared with the positive control, V(E), (IC50, 44.91 microg/ml). The HPD seeds showed more significant anti-inflammatory activities in additional to higher free radical scavenging activities than that of the MCC and MCR seeds. The results of the present study provide a scientific basis to explain, in part, the popular use of HPD seed in Tibetan folk medicine as "Bolengguazi". The present study also supports the claims by the traditional Tibetan medicine practitioners about the use of HPD seeds in inflammatory diseases, such as "Chiba".