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Wang C, Chen Y, Wang Y, Liu X, Liu Y, Li Y, Chen H, Fan C, Wu D, Yang J. Inhibition of COX-2, mPGES-1 and CYP4A by isoliquiritigenin blocks the angiogenic Akt signaling in glioma through ceRNA effect of miR-194-5p and lncRNA NEAT1. JOURNAL OF EXPERIMENTAL & CLINICAL CANCER RESEARCH : CR 2019; 38:371. [PMID: 31438982 PMCID: PMC6704644 DOI: 10.1186/s13046-019-1361-2] [Citation(s) in RCA: 68] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Accepted: 08/06/2019] [Indexed: 11/10/2022]
Abstract
Background Arachidonic acid (AA) metabolic enzymes including cyclooxygenase-2 (COX-2), microsomal prostaglandin E synthase-1 (mPGES-1) and cytochrome P450 (CYP) 4A11 play important roles in glioma angiogenesis. Thus, there is an urgent need to identify the underlying mechanisms and develop strategies to overcome them. Methods A homology model of human CYP4A11 was constructed using SYBYL-X 2.0. Structure-based virtual screening against COX-2, mPGES-1 and CYP4A11was performed using the Surflex-Dock of the SYBYL suite. The candidates were further evaluated their antiangiogenic activities in a zebrafish embryo and rabbit corneal angiogenesis model. Laser doppler analysis was used to measure tumor perfusion. The expression of CD31 and α-SMA was measured by immunofluorescence. Western blot was used to measure the expression of HIF-1, Akt and p-Akt. The gene expression of FGF-2, G-CSF, PDGF, TGF-β, Tie-2, VEGF, lncRNA NEAT1 and miR-194-5p were determined using qPCR. The production of FGF-2, TGF-β and VEGF were analyzed using ELISA. Bioinformatic analysis and luciferase reporter assays confirmed the interaction between lncRNA NEAT1 and miR-194-5p. Results The nearly 36,043 compounds from the Traditional Chinese Medicine (TCM) database were screened against COX-2, mPGES-1 and CYP4A11 3D models, and the 17 top flavonoids were identified. In zebrafish screening, isoliquiritigenin (ISL) exhibited the most potent antiangiogenic activities with the EC50 values of 5.9 μM. Conversely, the antiangiogenic effects of ISL in the zebrafish and rabbit corneal models were partly reversed by 20-hydroxyeicosatetraenoic acid (20-HETE) or prostaglandin E2 (PGE2). ISL normalized glioma vasculature and improved the efficacy of temozolomide therapy in the rat C6 glioma model. Inhibition of COX-2, mPGES-1 and CYP4A by ISL decreased FGF-2, TGF-β and VEGF production in the C6 and U87 glioma cells with p-Akt downregulation, which was reversed by Akt overexpression. Furthermore, ISL downregulated lncRNA NEAT1 but upregulated miR-194-5p in the U87 glioma cell. Importantly, lncRNA NEAT1 overexpression reversed ISL-mediated increase in miR-194-5p expression, and thereby attenuated FGF-2, TGF-β and VEGF production. Conclusions Reprogramming COX-2, mPGES-1 and CYP4A mediated-AA metabolism in glioma by flavonoid ISL inhibits the angiogenic Akt- FGF-2/TGF-β/VEGF signaling through ceRNA effect of miR-194-5p and lncRNA NEAT1, and may serve as a novel therapeutic strategy for human glioma. Electronic supplementary material The online version of this article (10.1186/s13046-019-1361-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Chenlong Wang
- Department of Pharmacy, Zhongnan Hospital of Wuhan University, Donghu Road 169, Wuhan, 430071, China.,Department of Pharmacology, School of Basic Medical Sciences, Wuhan University, Donghu Road 185, Wuhan, 430071, China
| | - Yaxin Chen
- Department of Pharmacology, School of Basic Medical Sciences, Wuhan University, Donghu Road 185, Wuhan, 430071, China
| | - Yang Wang
- Department of Pharmacology, School of Basic Medical Sciences, Wuhan University, Donghu Road 185, Wuhan, 430071, China
| | - Xiaoxiao Liu
- Department of Pharmacology, School of Basic Medical Sciences, Wuhan University, Donghu Road 185, Wuhan, 430071, China
| | - Yanzhuo Liu
- Department of Pharmacology, School of Basic Medical Sciences, Wuhan University, Donghu Road 185, Wuhan, 430071, China
| | - Ying Li
- Department of Pharmacology, School of Basic Medical Sciences, Wuhan University, Donghu Road 185, Wuhan, 430071, China
| | - Honglei Chen
- Department of Pathology and Pathophysiology, School of Basic Medical Sciences, Wuhan University, Wuhan, China
| | - Chengpeng Fan
- Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Wuhan University, Wuhan, China
| | - Dongfang Wu
- Department of Pharmacy, Zhongnan Hospital of Wuhan University, Donghu Road 169, Wuhan, 430071, China.
| | - Jing Yang
- Department of Pharmacology, School of Basic Medical Sciences, Wuhan University, Donghu Road 185, Wuhan, 430071, China.
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Chen Z, Chen SC, Li B, Yang YA, Zhang J. Synthesis and Evaluation of Glycyrrhetic Acid-aromatic Hybrids as Antiinflammatory Agents. Med Chem 2019; 16:715-723. [PMID: 31161995 DOI: 10.2174/1573406415666190603095502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Revised: 05/01/2019] [Accepted: 05/02/2019] [Indexed: 11/22/2022]
Abstract
BACKGROUND Inflammation is a biological response of body tissues to harmful stimuli, so it is desirable to search for novel anti-inflammatory agents with improved pharmaceutical profiles and reduced adverse effects. OBJECTIVE This study was to explore natural anti-inflammatory agents and improve therapeutic application of glycyrrhetic acid (GA) through molecular hybridization with active aromatics. METHODS Fourteen novel GA-aromatic hybrids were synthesized and evaluated for their antiinflammatory activities by inhibiting LPS-induced nitric oxide (NO) release in RAW264.7 cells. The synthesized compounds were characterized by single-crystal X-ray diffraction, 1H NMR, 13C NMR and HRMS. RESULTS The structure-activity relationship (SAR) study indicated that compounds with styryl displayed better NO inhibitory activity. Among them, compounds 2a and 3c exhibited the most promising activity with IC50 values of 9.93 μM and 12.25 μM, respectively. In addition, X-ray singlecrystal diffraction data for compounds 2e and 3c showed that the absolute configuration of GA skeleton was consistent with that of natural 18 β-glycyrrhetic acid. CONCLUSION The results showed that GA-aromatic hybrids were a new class of anti-inflammatory agents and this study provided useful information on further optimization.
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Affiliation(s)
- Zhi Chen
- Anqing Medical and Pharmaceutical College, Anqing 246052, China
| | - Shi-Chao Chen
- Elion Nature Biological Technology Co., Ltd, Nanjing 210038, China
| | - Bo Li
- Anhui Prevention and Treatment Center for Occupational Disease, Anhui No. 2 Provincial People's Hospital, Hefei 230032, China
| | - Yong-An Yang
- Elion Nature Biological Technology Co., Ltd, Nanjing 210038, China
| | - Jing Zhang
- Anhui Prevention and Treatment Center for Occupational Disease, Anhui No. 2 Provincial People's Hospital, Hefei 230032, China
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Taher ES, Ibrahim TS, Fares M, Al-Mahmoudy AMM, Radwan AF, Orabi KY, El-Sabbagh OI. Novel benzenesulfonamide and 1,2-benzisothiazol-3(2H)-one-1,1-dioxide derivatives as potential selective COX-2 inhibitors. Eur J Med Chem 2019; 171:372-382. [PMID: 30928709 DOI: 10.1016/j.ejmech.2019.03.042] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2018] [Revised: 03/01/2019] [Accepted: 03/16/2019] [Indexed: 02/07/2023]
Abstract
Two new series of 1,2-benzisothiazol-3(2H)-one-1,1-dioxide derivatives containing either five membered heterocyclic rings or aryl hydrazones were synthesized and evaluated for their in vitro COX-1/COX-2 inhibitory activity. In vivo anti-inflammatory evaluation revealed that benzenesulfonamides bearing pyrazole moiety 19, 20 and its cyclized form 23 exhibited the highest anti-inflammatory activity with comparable potency to celecoxib. Furthermore, the ulcerogenic activity evaluation showed that compounds 19, 20 and 23 exerted the minimal ulcer index in comparison to indomethacin as a reference drug. Docking studies of the most selective COX-2 derivatives were also carried out against COX-2 active site. Benzenesulfonamide derivatives 19 and 20 displayed higher predicted binding affinities inside the COX-2 active site. Molecular modelling simulation and drug likeness studies showed good agreement with the obtained biological evaluation.
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Affiliation(s)
- Ehab S Taher
- Pharmaceutical Organic Chemistry Department, Faculty of Pharmacy, Al-Azhar University, 71524, Assiut, Egypt.
| | - Tarek S Ibrahim
- Pharmaceutical Chemistry Department, Faculty of Pharmacy, King Abdulaziz University, 21589, Saudi Arabia; Pharmaceutical Organic Chemistry Department Faculty of Pharmacy, Zagazig University, Zagazig, 44519, Egypt
| | - Mohamed Fares
- School of Chemistry, University of Wollongong, Wollongong, 2522, NSW, Australia; School of Chemistry, The University of Sydney, 2006, NSW, Australia
| | - Amany M M Al-Mahmoudy
- Pharmaceutical Organic Chemistry Department Faculty of Pharmacy, Zagazig University, Zagazig, 44519, Egypt
| | - Abdullah F Radwan
- Biochemistry Department, Faculty of Pharmacy, Egyptian Russian University, 11829, Cairo, Egypt
| | - Khaled Y Orabi
- Department of Pharmaceutical Chemistry, Faculty of Pharmacy, Health Sciences Center, Kuwait University, 13110, Safat, Kuwait
| | - Osama I El-Sabbagh
- Pharmaceutical Chemistry Department, Faculty of Pharmacy, Taif University, 11099, Taif, Saudi Arabia; Medicinal Chemistry Department, Faculty of Pharmacy, Zagazig University, 44519, Zagazig, Egypt
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Aranda-Merino N, Ramos-Payán M, Callejón-Mochón M, Villar-Navarro M, Fernández-Torres R. Effect of counter-ions on electromembrane extraction of non- steroidal antiinflammatory drugs. J Electroanal Chem (Lausanne) 2019. [DOI: 10.1016/j.jelechem.2019.03.075] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Licofelone-DPPC Interactions: Putting Membrane Lipids on the Radar of Drug Development. Molecules 2019; 24:molecules24030516. [PMID: 30709010 PMCID: PMC6384739 DOI: 10.3390/molecules24030516] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Revised: 01/20/2019] [Accepted: 01/30/2019] [Indexed: 02/08/2023] Open
Abstract
(1) Background: Membrane lipids have been disregarded in drug development throughout the years. Recently, they gained attention in drug design as targets, but they are still disregarded in the latter stages. Thus, this study aims to highlight the relevance of considering membrane lipids in the preclinical phase of drug development. (2) Methods: The interactions of a drug candidate for clinical use (licofelone) with a membrane model system made of 1,2-dipalmitoyl-sn-glycero-3-phosphocholine (DPPC) were evaluated by combining Langmuir isotherms, Brewster angle microscopy (BAM), polarization-modulation infrared reflection-absorption spectroscopy (PM-IRRAS), and grazing-incidence X-ray diffraction (GIXD) measurements. (3) Results: Licofelone caused the expansion of the DPPC isotherm without changing the lipid phase transition profile. Moreover, licofelone induced the reduction of DPPC packing density, while increasing the local order of the DPPC acyl chains. (4) Conclusions: The licofelone-induced alterations in the structural organization of phosphatidylcholine monolayers may be related to its pharmacological actions. Thus, the combination of studying drug-membrane interactions with the pharmacological characterization that occurs in the preclinical stage may gather additional information about the mechanisms of action and toxicity of drug candidates. Ultimately, the addition of this innovative step shall improve the success rate of drug development.
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Altan L, Kasapoğlu Aksoy M, Kösegil Öztürk E. Efficacy of diclofenac & thiocolchioside gel phonophoresis comparison with ultrasound therapy on acute low back pain; a prospective, double-blind, randomized clinical study. ULTRASONICS 2019; 91:201-205. [PMID: 30139568 DOI: 10.1016/j.ultras.2018.08.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Revised: 06/29/2018] [Accepted: 08/12/2018] [Indexed: 06/08/2023]
Abstract
PURPOSE To investigate the effect of Phonophoresis (PP) with the combination of nonsteroidal anti-inflammatory drugs (NSAID's) and myorelaxant versus routine Ultrasound (US) treatment with non-therapeutic gel on the patients with acute low back pain (ABP). METHODS Sixty patients with ABP were randomly assigned into 2 groups. In Group 1 (n = 30) US was applied using diclofenac + Thiocolchicoside gel for 10 min and for a total of 10 sessions. In Group 2 (n = 30) the same US protocol was applied with the same setting and timing with Group 1 using US gel that does not contain any pharmaceutical ingredient. Evaluation parameters were Visual numeric scale (VNS), Oswestry Disability Index (ODI), and Shober test. RESULTS Comparison of the results obtained from the two groups before treatment and at second (W2) and sixth weeks (W6) posttreatment showed significant improvement in all parameters in both groups (p < 0.05). Comparison of the groups showed significantly superior improvement in Group 1 for ODI while there was no difference in other parameters at W2. At W6, there was significantly superior improvement in all parameters (p < 0.05) except for Shober test in Group1. CONCLUSION Our results showed that PP treatment is superior than conventional US therapy at short term in ABP patients.
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Affiliation(s)
- L Altan
- Uludağ University Medicine Faculty, Department of Physical Medicine and Rehabilitation, Turkey; University of Health Sciences Bursa Yüksek Ihtisas Training and Research Hospital, Department of Physical Medicine and Rehabilitation, Turkey
| | - M Kasapoğlu Aksoy
- University of Health Sciences Bursa Yüksek Ihtisas Training and Research Hospital, Department of Physical Medicine and Rehabilitation, Turkey.
| | - E Kösegil Öztürk
- University of Health Sciences Bursa Yüksek Ihtisas Training and Research Hospital, Department of Physical Medicine and Rehabilitation, Turkey
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Rana A, Singh S, Sharma R, Kumar A. Traumatic Brain Injury Altered Normal Brain Signaling Pathways: Implications for Novel Therapeutics Approaches. Curr Neuropharmacol 2019; 17:614-629. [PMID: 30207236 PMCID: PMC6712292 DOI: 10.2174/1570159x16666180911121847] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Revised: 09/01/2018] [Accepted: 09/06/2018] [Indexed: 12/20/2022] Open
Abstract
Traumatic brain injury (TBI) is the main reason of lifelong disability and casualty worldwide. In the United State alone, 1.7 million traumatic events occur yearly, out of which 50,000 results in deaths. Injury to the brain could alter various biological signaling pathways such as excitotoxicity, ionic imbalance, oxidative stress, inflammation, and apoptosis which can result in various neurological disorders such as Psychosis, Depression, Alzheimer disease, Parkinson disease, etc. In literature, various reports have indicated the alteration of these pathways after traumatic brain injury but the exact mechanism is still unclear. Thus, in the first part of this article, we have tried to summarize TBI as a modulator of various neuronal signaling pathways. Currently, very few drugs are available in the market for the treatment of TBI and these drugs only provide the supportive care. Thus, in the second part of the article, based on TBI altered signaling pathways, we have tried to find out potential targets and promising therapeutic approaches in the treatment of TBI.
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Affiliation(s)
| | | | | | - Anoop Kumar
- Address correspondence to this author at the Department of Pharmacology, Indo-Soviet Friendship College of Pharmacy (ISFCP), Moga, Punjab-142001, India; Tel: +91 636 324200/324201; E-mail:
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58
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Yagci ZB, Esvap E, Ozkara HA, Ulgen KO, Olmez EO. Inflammatory response and its relation to sphingolipid metabolism proteins: Chaperones as potential indirect anti-inflammatory agents. MOLECULAR CHAPERONES IN HUMAN DISORDERS 2019; 114:153-219. [DOI: 10.1016/bs.apcsb.2018.09.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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59
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Jeong YE, Lee MY. Anti-Inflammatory Activity of Populus deltoides Leaf Extract via Modulating NF-κB and p38/JNK Pathways. Int J Mol Sci 2018; 19:ijms19123746. [PMID: 30477268 PMCID: PMC6320835 DOI: 10.3390/ijms19123746] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2018] [Revised: 11/16/2018] [Accepted: 11/21/2018] [Indexed: 12/14/2022] Open
Abstract
Populus deltoides, known as eastern cottonwood, has been commonly used as a medicinal plant. The aim of the present study was to investigate the mechanism underlying the anti-inflammatory activity of P. deltoides leaf extract (PLE). PLE effectively inhibited the expression of inducible nitric oxide synthase (iNOS) and nitric oxide (NO) production in lipopolysaccharide (LPS)-stimulated RAW 264.7 cells, but not that of cyclooxygenase-2 (COX-2) and prostaglandin E2. Proinflammatory tumor necrosis factor alpha (TNF-α) levels were also reduced by the extract. PLE inhibited the phosphorylation of nuclear factor-kappa B (NF-κB) and inhibitor of Kappa Bα (IκBα), and blunted LPS-triggered enhanced nuclear translocation of NF-κB p65. In mitogen-activated protein kinase (MAPK) signaling, PLE effectively decreased the phosphorylation of p38 and c-Jun N-terminal protein kinase (JNK), but not of extracellular signal-regulated kinase 1/2 (ERK1/2). Taken together, these results suggest that anti-inflammatory activity of P. deltoides leaf extract might be driven by iNOS and NO inhibition mediated by modulation of the NF-κB and p38/JNK signaling pathways.
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Affiliation(s)
- Ye Eun Jeong
- Department of Medical Science, College of Medical Science, Soonchunhyang University, Asan, Chungnam 31538, Korea.
| | - Mi-Young Lee
- Department of Medical Biotechnology, College of Medical Science, Soonchunhyang University, Asan, Chungnam 31538, Korea.
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Liu Y, Tang H, Liu X, Chen H, Feng N, Zhang J, Wang C, Qiu M, Yang J, Zhou X. Frontline Science: Reprogramming COX-2, 5-LOX, and CYP4A-mediated arachidonic acid metabolism in macrophages by salidroside alleviates gouty arthritis. J Leukoc Biol 2018; 105:11-24. [PMID: 30265377 DOI: 10.1002/jlb.3hi0518-193r] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2018] [Revised: 08/28/2018] [Accepted: 09/07/2018] [Indexed: 12/13/2022] Open
Abstract
Cyclooxygenase-2 (COX-2), 5-lipoxygenase (5-LOX), and cytochrome P450 (CYP) 4A-mediated arachidonic acid (AA) metabolism play an essential role in human inflammatory disorders. Blocking COX-2 pathway would shunt AA metabolism to the other pathway, thereby decreasing the efficacy and exacerbating adverse effects. Here we demonstrated that reprogramming COX-2, 5-LOX, and CYP4A-mediated AA metabolism in macrophages by salidroside (Sal) ameliorates monosodium urate (MSU) crystal-induced inflammation. Compared with COX-2 inhibitor celecoxib, Sal (80 mg/kg) presented a superior anti-arthritic profile in MSU crystal-treated rats, accompanied with the decreased expression of COX-2, 5-LOX, and CYP4A and production of prostaglandin E2 (PGE2 ), leukotriene B4 (LTB4 ), and 20-hydroxyeicosatetraenoic acid (20-HETE) in the synovial fluid macrophages. Sal decreased representative M1 marker (iNOS and CD86, etc.) expression and M1 cytokine (TNF-α and IL-1β) production, whereas it increased M2 marker (CD206 and Arg-1) expression and M2 cytokine (TGF-β and IL-10) production. The injection of conditioned medium from MSU crystal-treated macrophages into the ankle joint of rats reproduced the gouty inflammation, which was attenuated by Sal. Mechanistically, down-regulation of COX-2, 5-LOX, and CYP4A in the RAW264.7 and NR8383 macrophages by Sal skewed macrophage polarization away from the M1 phenotype, and thereby prevented neutrophil migration and chondrocyte degradation with STAT1 and NF-κB inactivation. Conversely, overexpression of COX-2, 5-LOX, CYP4A or STAT1, or exogenous addition of IL-1β or TNF-α partially abolished these effects. Together, inhibition of COX-2, 5-LOX, and CYP4A in macrophages by Sal ameliorates MSU crystal-induced inflammation through decreasing TNF-α and IL-1β production, and may serve as a novel therapeutic strategy.
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Affiliation(s)
- Yanzhuo Liu
- Department of Cardiology, Renmin Hospital, Wuhan University, Wuhan, China
| | - Honglin Tang
- Department of Cardiology, Renmin Hospital, Wuhan University, Wuhan, China
| | - Xiaoxiao Liu
- Department of Pharmacology, School of Basic Medical Sciences, Wuhan University, Wuhan, China
| | - Honglei Chen
- Department of Pathology and Pathophysiology, School of Basic Medical Sciences, Wuhan University, Wuhan, China
| | - Na Feng
- Department of Anatomy, Hubei University of Medicine, Shiyan, China
| | - Jing Zhang
- Animal Experimental Center of Wuhan University, Wuhan, China
| | - Chenlong Wang
- Department of Pharmacology, School of Basic Medical Sciences, Wuhan University, Wuhan, China
| | - Miao Qiu
- Department of Pharmacology, School of Basic Medical Sciences, Wuhan University, Wuhan, China
- Hubei Key Laboratory of Medical Information Analysis and Tumor Diagnosis & Treatment, South-Central University for Nationalities, Wuhan, China
| | - Jing Yang
- Department of Pharmacology, School of Basic Medical Sciences, Wuhan University, Wuhan, China
| | - Xiaoyang Zhou
- Department of Cardiology, Renmin Hospital, Wuhan University, Wuhan, China
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Pereira-Leite C, Nunes C, Bozelli JC, Schreier S, Kamma-Lorger CS, Cuccovia IM, Reis S. Can NO-indomethacin counteract the topical gastric toxicity induced by indomethacin interactions with phospholipid bilayers? Colloids Surf B Biointerfaces 2018; 169:375-383. [DOI: 10.1016/j.colsurfb.2018.05.019] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Revised: 04/16/2018] [Accepted: 05/09/2018] [Indexed: 12/18/2022]
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Kolman V, Kalčic F, Jansa P, Zídek Z, Janeba Z. Influence of the C-5 substitution in polysubstituted pyrimidines on inhibition of prostaglandin E2 production. Eur J Med Chem 2018; 156:295-301. [DOI: 10.1016/j.ejmech.2018.07.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Revised: 07/04/2018] [Accepted: 07/05/2018] [Indexed: 12/18/2022]
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Hua H, Zhang H, Kong Q, Wang J, Jiang Y. Complex roles of the old drug aspirin in cancer chemoprevention and therapy. Med Res Rev 2018; 39:114-145. [PMID: 29855050 DOI: 10.1002/med.21514] [Citation(s) in RCA: 76] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Revised: 05/04/2018] [Accepted: 05/12/2018] [Indexed: 02/05/2023]
Abstract
The nonsteroidal anti-inflammatory agent aspirin is widely used for preventing and treating cardiovascular and cerebrovascular diseases. In addition, epidemiologic evidences reveal that aspirin may prevent a variety of human cancers, while data on the association between aspirin and some kinds of cancer are conflicting. Preclinical studies and clinical trials also reveal the therapeutic effect of aspirin on cancer. Although cyclooxygenase is a well-known target of aspirin, recent studies uncover other targets of aspirin and its metabolites, such as AMP-activated protein kinase, cyclin-dependent kinase, heparanase, and histone. Accumulating evidence demonstrate that aspirin may act in different cell types, such as epithelial cell, tumor cell, endothelial cell, platelet, and immune cell. Therefore, aspirin acts on diverse hallmarks of cancer, such as sustained tumor growth, metastasis, angiogenesis, inflammation, and immune evasion. In this review, we focus on recent progress in the use of aspirin for cancer chemoprevention and therapy, and integratively analyze the mechanisms underlying the anticancer effects of aspirin and its metabolites. We also discuss mechanisms of aspirin resistance and describe some derivatives of aspirin, which aim to overcome the adverse effects of aspirin.
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Affiliation(s)
- Hui Hua
- Laboratory of Stem Cell Biology, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, Chengdu, China.,Collaborative Innovation Center of Biotherapy, Chengdu, China
| | - Hongying Zhang
- Collaborative Innovation Center of Biotherapy, Chengdu, China.,Laboratory of Oncogene, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, Chengdu, China
| | - Qingbin Kong
- Collaborative Innovation Center of Biotherapy, Chengdu, China.,Laboratory of Oncogene, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, Chengdu, China
| | - Jiao Wang
- School of Basic Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Yangfu Jiang
- Collaborative Innovation Center of Biotherapy, Chengdu, China.,Laboratory of Oncogene, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, Chengdu, China
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Liu Y, Duan C, Chen H, Wang C, Liu X, Qiu M, Tang H, Zhang F, Zhou X, Yang J. Inhibition of COX-2/mPGES-1 and 5-LOX in macrophages by leonurine ameliorates monosodium urate crystal-induced inflammation. Toxicol Appl Pharmacol 2018; 351:1-11. [PMID: 29763636 DOI: 10.1016/j.taap.2018.05.010] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Revised: 05/02/2018] [Accepted: 05/10/2018] [Indexed: 12/21/2022]
Abstract
Cyclooxygenase-2 (COX-2), 5-lipoxygenase (5-LOX) and microsomal prostaglandin E synthase-1 (mPGES-1)-derived eicosanoids play an essential role in human inflammatory disorders. Here, we investigated whether inhibition of COX-2/mPGES-1 and 5-LOX in macrophages by leonurine ameliorates monosodium urate (MSU) crystal-induced inflammation. Virtual screening assay and in vitro enzyme inhibition assay showed that leonurine was a potential inhibitor of COX-2, mPGES-1 and 5-LOX. Compared with COX-2 inhibitor celecoxib, leonurine (30 mg/kg) significantly decreased ankle perimeter, gait score and neutrophil number in synovial fluid in MSU crystal-treated rats, accompanied with the decreased expression of COX-2, mPGES-1 and 5-LOX and production of prostaglandin E2 (PGE2) and leukotriene B4 (LTB4) in the synovial fluid macrophages. In addition, leonurine decreased representative M1 marker (iNOS and CD86) expression, NLRP3 inflammasome activation and M1 cytokine (TNF-α and IL-1β) production. In the in vitro cultured RAW264.7 and human monocyte-derived macrophages (MDMs), blockade of COX-2/mPGES-1 and 5-LOX by leonurine inhibited macrophage M1 polarization and NLRP3 inflammasome activation in response to MSU crystals, and thus down-regulated IL-1β and TNF-α with STAT1 and NF-κB inactivation. Conversely, these effects were partially abolished by overexpression of COX-2, mPGES-1, 5-LOX or STAT1. Furthermore, leonurine prevented a positive feedback loop between COX-2/mPGES-1/5-LOX and IL-1β/TNF-α in MSU crystal-induced inflammation. Together, simultaneous down-regulation of COX-2/mPGES-1 and 5-LOX by leonurine ameliorates MSU crystal-induced inflammation through decreasing IL-1β and TNF-α production. Our study may provide novel multi-target agents toward the arachidonic acid (AA) network for gouty arthritis therapy.
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Affiliation(s)
- Yanzhuo Liu
- Department of Pharmacology, School of Basic Medical Sciences, Wuhan University, Wuhan 430071, China
| | - Chenfan Duan
- Department of Pharmacology, School of Basic Medical Sciences, Wuhan University, Wuhan 430071, China
| | - Honglei Chen
- Department of Pathology and Pathophysiology, School of Basic Medical Sciences, Wuhan University, Wuhan 430071, China
| | - Chenlong Wang
- Department of Pharmacology, School of Basic Medical Sciences, Wuhan University, Wuhan 430071, China
| | - Xiaoxiao Liu
- Department of Pharmacology, School of Basic Medical Sciences, Wuhan University, Wuhan 430071, China; Hubei Key Laboratory of Medical Information Analysis and Tumor Diagnosis & Treatment, South-central University For Nationalities, Wuhan 430074, China
| | - Miao Qiu
- Department of Pharmacology, School of Basic Medical Sciences, Wuhan University, Wuhan 430071, China
| | - Honglin Tang
- Department of Pharmacology, School of Basic Medical Sciences, Wuhan University, Wuhan 430071, China
| | - Feng Zhang
- Department of Pharmacology, School of Basic Medical Sciences, Wuhan University, Wuhan 430071, China
| | - Xiaoyang Zhou
- Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan 430060, China
| | - Jing Yang
- Department of Pharmacology, School of Basic Medical Sciences, Wuhan University, Wuhan 430071, China.
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Marques FM, Figueira MM, Schmitt EFP, Kondratyuk TP, Endringer DC, Scherer R, Fronza M. In vitro anti-inflammatory activity of terpenes via suppression of superoxide and nitric oxide generation and the NF-κB signalling pathway. Inflammopharmacology 2018; 27:281-289. [DOI: 10.1007/s10787-018-0483-z] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Accepted: 04/09/2018] [Indexed: 01/11/2023]
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González-Trujano ME, Uribe-Figueroa G, Hidalgo-Figueroa S, Martínez AL, Déciga-Campos M, Navarrete-Vazquez G. Synthesis and antinociceptive evaluation of bioisosteres and hybrids of naproxen, ibuprofen and paracetamol. Biomed Pharmacother 2018. [PMID: 29514128 DOI: 10.1016/j.biopha.2018.02.122] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
The aim of this work was to design, synthesize and characterize the potential anti-nociceptive and anti-inflammatory activities of a new series of bioisosteres and hybrids from known non-steroidal anti-inflammatory drugs (NSAIDs). The compounds 4-(acetylamino)phenyl (2S)-2-(6-methoxy-2-naphthyl)propanoate (GUF-1) and 4-(acetylamino)phenyl 2-(R,S)-(4-isobutylphenyl)propanoate (GUF-2) were synthesized as hybrids (also known as heterodimers); whereas those named 2-(R,S)-(4-isobutylphenyl)-N-1H-tetrazol-5-ylpropanamide (GUF-3), (2S)-2-(6-methoxy-2-naphthyl)-N-1H-tetrazol-5-ylpropanamide (GUF-4), [2-(R,S)-N-hydroxy-2-[4-(2-methylpropyl)phenyl]propanamide] (GUF-5), and (2S)-N-hydroxy-2-(6-methoxy-2-naphthyl)propanamide (GUF-6) were synthesized as bioisosteres of the NSAIDs paracetamol, ibuprofen, and naproxen, respectively. All these compounds were characterized by spectroscopic and spectrometric analysis. Antinociceptive activity of GUF-1 to GUF-6 was evaluated using the formalin test in rats. Pharmacological responses of GUF-1, GUF-2 (hybrids), and GUF-5 (bioisostere) demonstrated significant antinociceptive effects; thus these compounds were assayed in an inflammation test like carrageenan-induced paw oedema in rats. Complete molecular docking of cyclooxygenase and the GUF-1 and GUF-2 hybrids showed high docking scores, compared to the reference drugs. Our data demonstrate that compounds GUF-1, GUF-2, and GUF-5 possesses antinociceptive and antiinflammatory activities resembling and improving those known for the traditional NSAIDs, paracetamol, naproxen and ibuprofen.
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Affiliation(s)
- María Eva González-Trujano
- Laboratorio de Neurofarmacología de Productos Naturales. Dirección de Investigaciones en Neurociencias, Instituto Nacional de Psiquiatría "Ramón de la Fuente Muñíz", Av. México-Xochimilco No. 101, Col. San Lorenzo Huipulco, 14370, Ciudad de México, Mexico
| | - Gerardo Uribe-Figueroa
- Facultad de Farmacia, Universidad Autónoma del Estado de Morelos, Av. Universidad 1001, Chamilpa, Cuernavaca, Morelos, 62209, Mexico
| | - Sergio Hidalgo-Figueroa
- Facultad de Farmacia, Universidad Autónoma del Estado de Morelos, Av. Universidad 1001, Chamilpa, Cuernavaca, Morelos, 62209, Mexico
| | - Ana Laura Martínez
- Laboratorio de Neurofarmacología de Productos Naturales. Dirección de Investigaciones en Neurociencias, Instituto Nacional de Psiquiatría "Ramón de la Fuente Muñíz", Av. México-Xochimilco No. 101, Col. San Lorenzo Huipulco, 14370, Ciudad de México, Mexico
| | - Myrna Déciga-Campos
- Sección de Estudios de Posgrado e Investigación, Escuela Superior de Medicina, Instituto Politécnico Nacional, Plan de San Luis y Díaz Mirón s/n, Col. Casco de Santo Tomás, 11340, Ciudad de México, Mexico.
| | - Gabriel Navarrete-Vazquez
- Facultad de Farmacia, Universidad Autónoma del Estado de Morelos, Av. Universidad 1001, Chamilpa, Cuernavaca, Morelos, 62209, Mexico.
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Abstract
The CXCR4/CXCL12 chemokine axis can chemotactically accumulate inflammatory cells to local tissues and regulate the release of inflammatory factors. Developing novel CXCR4 modulators may provide a desirable strategy to control the development of inflammation. A series of novel hybrids were designed by integrating the key pharmacophores of three CXCR4 modulators. The majority of compounds displayed potent CXCR4 binding affinity. Compound 7a exhibited 1000-fold greater affinity than AMD3100 and significantly inhibited invasion of CXCR4-positive tumor cells. Additionally, compound 7a blocked mice ear inflammation by 67% and suppressed the accumulation of inflammatory cells in an in vivo mouse ear edema evaluation. Western blot analyses revealed that 7a inhibited the CXCR4/CXCL12-mediated phosphorylation of Akt and p44 in a dose-dependent manner. Moreover, compound 7a had no observable cytotoxicity and displayed a favorable plasma stability in our preliminary pharmacokinetic study. These results confirmed that this is a feasible method to develop CXCR4 modulators for the regulation and reduction of inflammation.
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Yu J, Lu H, Zhou J, Xie Z, Wen C, Xu Z. Oral prednisolone versus non-steroidal anti-inflammatory drugs in the treatment of acute gout: a meta-analysis of randomized controlled trials. Inflammopharmacology 2018; 26:717-723. [PMID: 29357007 DOI: 10.1007/s10787-018-0442-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Accepted: 01/08/2018] [Indexed: 11/25/2022]
Abstract
OBJECTIVES To evaluate the efficacy and safety of oral prednisolone in the treatment of acute gout compared with non-steroidal anti-inflammatory drugs (NSAIDs). METHODS A comprehensive search of databases in both Chinese and English was performed. Data from the selected studies were extracted and analyzed independently by two authors. RESULTS Three double-blind, randomized, controlled trials were included in the final analysis, with a total of 584 patients. Regarding the efficacy, oral prednisolone (30-35 mg/day) was comparable with NSAIDs (naproxen at 500 mg/day or indomethacin at 50-100 mg/day) on the pain relief scale, both in activity (difference in means 0.259, 95% CI - 1.532 to 2.050, P = 0.777) and at rest (difference in means - 0.502, 95% CI - 4.961 to 3.956, P = 0.825) during the first 2-6 h. During the following 4 to 6 days, prednisolone acted with comparable efficacy either in activity (difference in means - 0.552, 95% CI - 1.364 to 0.260, P = 0.183) or at rest (difference in means - 0.164, 95% CI - 0.463 to 0.134, P = 0.281). Regarding safety, prednisolone did not increase the total adverse events (AEs) (risk ratios [RR] 0.765, 95% CI 0.473 to 1.238, P = 0.275) and reduced the withdrawal rate because of the AEs (RR 0.127, 95% CI 0.021-0.763, P = 0.024). Prednisolone decreased the risks of several AEs (including indigestion: RR 0.544, 95% CI 0.311-0.952, P = 0.033; nausea: RR 0.296, 95% CI 0.136-0.647, P = 0.002; and vomiting: RR 0.155, 95% CI 0.033-0.722, P = 0.018) but increased the risk of skin rashes (RR 4.049, 95% CI 1.241-13.158, P = 0.021). CONCLUSIONS Oral prednisolone may be of similar efficacy and a slightly safer strategy for treatment of active, acute gout compared with NSAIDs. Further clinical studies are still warranted to investigate its long-term efficacy and safety.
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Affiliation(s)
- Jie Yu
- College of Basic Medical Science, Zhejiang Chinese Medical University, Binwen Road 548, Hangzhou, 310053, Zhejiang, China
| | - Haimei Lu
- College of Basic Medical Science, Zhejiang Chinese Medical University, Binwen Road 548, Hangzhou, 310053, Zhejiang, China
| | - Jia Zhou
- College of Basic Medical Science, Zhejiang Chinese Medical University, Binwen Road 548, Hangzhou, 310053, Zhejiang, China
| | - Zhijun Xie
- College of Basic Medical Science, Zhejiang Chinese Medical University, Binwen Road 548, Hangzhou, 310053, Zhejiang, China
| | - Chengping Wen
- College of Basic Medical Science, Zhejiang Chinese Medical University, Binwen Road 548, Hangzhou, 310053, Zhejiang, China
| | - Zhenghao Xu
- College of Basic Medical Science, Zhejiang Chinese Medical University, Binwen Road 548, Hangzhou, 310053, Zhejiang, China.
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Pereira-Leite C, Nunes C, Grahl D, Bozelli JC, Schreier S, Kamma-Lorger CS, Cuccovia IM, Reis S. Acemetacin–phosphatidylcholine interactions are determined by the drug ionization state. Phys Chem Chem Phys 2018; 20:14398-14409. [DOI: 10.1039/c8cp01698d] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Complementary biophysical techniques depicted the differential effects of acemetacin ionic forms on phosphatidylcholine bilayers.
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Affiliation(s)
| | - Cláudia Nunes
- LAQV
- REQUIMTE
- Departamento de Ciências Químicas
- Faculdade de Farmácia
- Universidade do Porto
| | - Débora Grahl
- Departamento de Bioquímica
- Instituto de Química
- Universidade de São Paulo
- São Paulo
- Brazil
| | - José C. Bozelli
- Departamento de Bioquímica
- Instituto de Química
- Universidade de São Paulo
- São Paulo
- Brazil
| | - Shirley Schreier
- Departamento de Bioquímica
- Instituto de Química
- Universidade de São Paulo
- São Paulo
- Brazil
| | - Christina S. Kamma-Lorger
- ALBA Synchrotron
- Consorcio para la Construcción
- Equipamiento y Explotación del Laboratorio de Luz de Sincrotrón (CELLS)
- Barcelona
- Spain
| | - Iolanda M. Cuccovia
- Departamento de Bioquímica
- Instituto de Química
- Universidade de São Paulo
- São Paulo
- Brazil
| | - Salette Reis
- LAQV
- REQUIMTE
- Departamento de Ciências Químicas
- Faculdade de Farmácia
- Universidade do Porto
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Brandolini L, d'Angelo M, Antonosante A, Villa S, Cristiano L, Castelli V, Benedetti E, Catanesi M, Aramini A, Luini A, Parashuraman S, Mayo E, Giordano A, Cimini A, Allegretti M. Differential protein modulation by ketoprofen and ibuprofen underlines different cellular response by gastric epithelium. J Cell Physiol 2017; 233:2304-2312. [DOI: 10.1002/jcp.26102] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Accepted: 07/14/2017] [Indexed: 01/14/2023]
Affiliation(s)
| | - Michele d'Angelo
- Department of Life; Health and Environmental Sciences; University of L'Aquila; L'Aquila Italy
| | - Andrea Antonosante
- Department of Life; Health and Environmental Sciences; University of L'Aquila; L'Aquila Italy
| | - Sara Villa
- Department of Life; Health and Environmental Sciences; University of L'Aquila; L'Aquila Italy
| | - Loredana Cristiano
- Department of Life; Health and Environmental Sciences; University of L'Aquila; L'Aquila Italy
| | - Vanessa Castelli
- Department of Life; Health and Environmental Sciences; University of L'Aquila; L'Aquila Italy
| | - Elisabetta Benedetti
- Department of Life; Health and Environmental Sciences; University of L'Aquila; L'Aquila Italy
| | - Mariano Catanesi
- Department of Life; Health and Environmental Sciences; University of L'Aquila; L'Aquila Italy
| | - Andrea Aramini
- Dompé Farmaceutici Spa; via Campo di Pile; L'Aquila Italy
| | - Alberto Luini
- Institute of Protein Biochemistry (IBP); National Research Council (CNR); Napoli Italy
| | | | - Emilia Mayo
- Institute of Protein Biochemistry (IBP); National Research Council (CNR); Napoli Italy
| | - Antonio Giordano
- Sbarro Institute for Cancer Research and Molecular Medicine; Department of Biology; Temple University; Philadelphia Pennsylvania
- Department of Medicine; Surgery and Neuroscience; University of Siena; Siena Italy
| | - Annamaria Cimini
- Department of Life; Health and Environmental Sciences; University of L'Aquila; L'Aquila Italy
- Sbarro Institute for Cancer Research and Molecular Medicine; Department of Biology; Temple University; Philadelphia Pennsylvania
- Gran Sasso National Laboratory (LNGS); National Institute for Nuclear Physics (INFN); Assergi Italy
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Li B, Cai S, Yang YA, Chen SC, Chen R, Shi JB, Liu XH, Tang WJ. Novel unsaturated glycyrrhetic acids derivatives: Design, synthesis and anti-inflammatory activity. Eur J Med Chem 2017; 139:337-348. [PMID: 28803048 DOI: 10.1016/j.ejmech.2017.08.002] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Revised: 07/31/2017] [Accepted: 08/01/2017] [Indexed: 01/31/2023]
Abstract
To develop novel anti-inflammatory agents, a series of unsaturated glycyrrhetic acids were designed, synthesized and evaluated for anti-inflammatory activity using RAW264.7 cells. The structure-activity relationship (SAR) of NO inhibitory activity was analyzed. α,β-Unsaturated glycyrrhetic acids showed better activity, among them, compounds 6k and 6l with piperazine unit exhibited the most potent nitric oxide (NO) and interleukin-6 (IL-6) inhibitory activity (IC50 = 13.3 and 15.5 μM respectively). Furthermore, compound 6k could also significantly suppress LPS-induced iNOS and COX-2 expression and IL-6 production through MAPKs and NF-kB signaling pathway.
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Affiliation(s)
- Bo Li
- School of Pharmacy, Anhui Province Key Laboratory of Major Autoimmune Diseases, Anhui Institute of Innovative Drugs, Anhui Medical University, Hefei 230032, China
| | - Shi Cai
- School of Pharmacy, Anhui Province Key Laboratory of Major Autoimmune Diseases, Anhui Institute of Innovative Drugs, Anhui Medical University, Hefei 230032, China
| | - Yong-An Yang
- Elion Nature Biological Technology Co., Ltd, Nanjing 210038, China
| | - Shi-Chao Chen
- School of Pharmacy, Anhui Province Key Laboratory of Major Autoimmune Diseases, Anhui Institute of Innovative Drugs, Anhui Medical University, Hefei 230032, China
| | - Rui Chen
- School of Pharmacy, Anhui Province Key Laboratory of Major Autoimmune Diseases, Anhui Institute of Innovative Drugs, Anhui Medical University, Hefei 230032, China
| | - Jing-Bo Shi
- School of Pharmacy, Anhui Province Key Laboratory of Major Autoimmune Diseases, Anhui Institute of Innovative Drugs, Anhui Medical University, Hefei 230032, China
| | - Xin-Hua Liu
- School of Pharmacy, Anhui Province Key Laboratory of Major Autoimmune Diseases, Anhui Institute of Innovative Drugs, Anhui Medical University, Hefei 230032, China.
| | - Wen-Jian Tang
- School of Pharmacy, Anhui Province Key Laboratory of Major Autoimmune Diseases, Anhui Institute of Innovative Drugs, Anhui Medical University, Hefei 230032, China.
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Han J, Saraf SL, Lash JP, Gordeuk VR. Use of anti-inflammatory analgesics in sickle-cell disease. J Clin Pharm Ther 2017; 42:656-660. [PMID: 28695614 DOI: 10.1111/jcpt.12592] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Accepted: 06/19/2017] [Indexed: 12/12/2022]
Abstract
WHAT IS KNOWN AND OBJECTIVE Non-steroidal anti-inflammatory drugs (NSAIDs) have been commonly used to treat pain in sickle-cell disease (SCD), but NSAID use is associated with renal, gastrointestinal and cardiovascular toxicities. Our objective was to evaluate the use of aspirin and non-aspirin NSAIDs in SCD. COMMENT Despite analgesic and anti-inflammatory benefits in SCD, non-aspirin NSAIDs are associated with renal, cardiovascular and gastrointestinal toxicities in this patient population. Aspirin may have less renal and cardiovascular toxicities. The different side effect profile of NSAIDs is related to the COX-1/COX-2 selectivity at their therapeutic doses. Individual risk factors and genetic biomarkers should be considered when selecting appropriate NSAIDs and their dose. WHAT IS NEW AND CONCLUSION NSAIDs have the potential to be an important component of pain regimens in SCD, but the use of NSAIDs should be individualized based on potential side effects and patient risk factors and the lowest effective dose should be prescribed with proper monitoring in patients with SCD.
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Affiliation(s)
- J Han
- Department of Pharmacy Practice, College of Pharmacy, University of Illinois at Chicago, Chicago, IL, USA.,Comprehensive Sickle Cell Center, Section of Hematology/Oncology, Department of Medicine, University of Illinois at Chicago, Chicago, IL, USA.,Center for Pharmacoepidemiology and Pharmacoeconomic Research, University of Illinois at Chicago, Chicago, IL, USA
| | - S L Saraf
- Comprehensive Sickle Cell Center, Section of Hematology/Oncology, Department of Medicine, University of Illinois at Chicago, Chicago, IL, USA
| | - J P Lash
- Section of Nephrology, Department of Medicine, University of Illinois at Chicago, Chicago, IL, USA
| | - V R Gordeuk
- Comprehensive Sickle Cell Center, Section of Hematology/Oncology, Department of Medicine, University of Illinois at Chicago, Chicago, IL, USA
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Daily JW, Zhang T, Cao S, Park S. Efficacy and Safety of GuiZhi-ShaoYao-ZhiMu Decoction for Treating Rheumatoid Arthritis: A Systematic Review and Meta-Analysis of Randomized Clinical Trials. J Altern Complement Med 2017; 23:756-770. [PMID: 28609129 DOI: 10.1089/acm.2017.0098] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVES GuiZhi-ShaoYao-ZhiMu decoction (GSZD), a traditional Chinese herbal medication for the management of rheumatoid arthritis (RA), has a long history of use and modern scientific research support for efficacy, but the studies have not been systematically evaluated. Therefore, this study systematically reviewed the efficacy of GSZD using the available human clinical trials and conducted a meta-analysis. METHODS The available databases were searched using proper languages of English, Korean, and Chinese. The key erms used for searching were "GSZD," "Cassia Twig," "Guizhi," "Paeonia lactiflora," "Shaoyao," "Anemarrhena Rhizome," "Zhimu," "rheumatoid arthritis," "randomized," "controlled trial," and "clinical trial." Randomized clinical trials (RCTs) using GSZD were included in the review and meta-analysis. According to heterogeneity, odds ratio and confidence intervals in the pooled RCTs were assessed by a fixed or random model in meta-analysis. Risk of bias was evaluated for all included studies. RESULTS Thirteen RCTs met the inclusion criteria and were included in the meta-analysis. All studies evaluated the efficacy of GSZD for treating RA, but the herbal formulations varied since some studies added herbs to the basic GSZD formulation. However, all formulations contained the essential herbs: Guizhi, Shaoyao, and Zhimu. Each RCT included an experimental group (GSZD with or without Western-style medicine) and a control group (either standard Western-style medicines or placebo). When compared to placebo, the GSZD treatment was found to be three to six times more effective than standard Western drugs for some symptoms. Furthermore, only two studies reported any adverse events associated with the GSZD group, whereas several reported serious adverse events in the control groups. CONCLUSIONS The Traditional Chinese Medicine, GSZD, may have equal or superior effectiveness and safety for treating RA compared to Western RA drugs. It should be considered a viable alternative to Western medicine. However, more long-term research is needed in larger patient groups to better establish its safety and efficacy.
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Affiliation(s)
- James W Daily
- 1 Department of R&D Daily Manufacturing, Inc. , Rockwell, NC
| | - Ting Zhang
- 2 Department of Food and Nutrition, Institute of Basic Science, Obesity/Diabetes Research Center, Hoseo University , Asan, South Korea
| | - Shihua Cao
- 2 Department of Food and Nutrition, Institute of Basic Science, Obesity/Diabetes Research Center, Hoseo University , Asan, South Korea
| | - Sunmin Park
- 2 Department of Food and Nutrition, Institute of Basic Science, Obesity/Diabetes Research Center, Hoseo University , Asan, South Korea
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