Augmentation of human blood acetylsalicylate concentrations by the simultaneous administration of acetaminophen with aspirin

Reverse Engineering of an Aspirin-Responsive Transcriptional Regulator in Escherichia coli

Bacterial transcription factors (TFs) are key devices for the engineering of complex circuits in many biotechnological applications, yet there are few well-characterized inducer-responsive TFs that could be used in the context of an animal or human host. We have deciphered the inducer recognition mechanism of two AraC/XylS regulators from Pseudomonas putida (BenR and XylS) for creating a novel expression system responsive to acetyl salicylate (i.e., aspirin). Using protein homology modeling and molecular docking with the cognate inducer benzoate and a suite of chemical analogues, we identified the conserved binding pocket of BenR and XylS. By means of site-directed mutagenesis, we identified a single amino acid position required for efficient inducer recognition and transcriptional activation. Whereas this modification in BenR abolishes protein activity, in XylS, it increases the response to several inducers, including acetyl salicylic acid, to levels close to those achieved by the canonical inducer. Moreover, by constructing chimeric proteins with swapped N-terminal domains, we created novel regulators with mixed promoter and inducer recognition profiles. As a result, a collection of engineered TFs was generated with an enhanced response to benzoate, 3-methylbenzoate, 2-methylbenzoate, 4-methylbenzoate, salicylic acid, aspirin, and acetylsalicylic acid molecules for eliciting gene expression in E. coli.

4-trifluoromethyl derivatives of salicylate, triflusal and its main metabolite 2-hydroxy-4-trifluoromethylbenzoic acid, are potent inhibitors of nuclear factor kappaB activation

1. The effect of two derivatives of salicylate, 2-hydroxy-4-trifluoromethylbenzoic acid (HTB) and 2-acetoxy-4-trifluoromethylbenzoic acid (triflusal), on the activation of NF-kappaB elicited by tumour necrosis factor-alpha (TNF-alpha) on human umbilical vein endothelial cells (HUVEC) was tested. 2. The expression of the mRNA of vascular cell adhesion molecule-1 (VCAM-1) was studied as an example of a gene the expression of which is regulated by NF-kappaB. To extend these findings to other systems, the induction of nitric oxide synthase in rat adherent peritoneal macrophages was studied. 3. Both HTB and triflusal were more potent than aspirin or salicylate as inhibitors of the nuclear translocation of NF-kappaB. The calculation of the IC50 values showed approximately 2 mM for HTB, 4 mM for aspirin and >4 mM for salicylate. 4. Comparison of the potency of these compounds on VCAM-1 mRNA expression showed complete inhibition by both triflusal and HTB at a concentration of 4 mM whereas aspirin and salicylate produced only 36-43% inhibition at the same concentration. 5. Inhibition of NF-kappaB activation was also observed in rat peritoneal macrophages stimulated via their receptors for the Fc portion of the antibody molecule with IgG/ovalbumin immune complexes. This was accompanied by a dose-dependent inhibition of nitrite production by the L-arginine pathway via iNOS. IC50 values for this effect were 1.13+/-0.12 mM (triflusal), 1.84+/-0.34 (HTB), 6.08+/-1.53 mM (aspirin) and 9.16+/-1.9 mM (salicylate). 6. These data indicate that the incorporation of a 4-trifluoromethyl group to the salicylate molecule strongly enhances its inhibitory effect on NF-kappaB activation, VCAM-1 mRNA expression and iNOS induction, irrespective of the presence of the acetyl moiety involved in the inhibition of cyclo-oxygenase.

Outcome of renal replacement treatment in patients with diabetes mellitus

OBJECTIVE

To compare the outcome of renal replacement treatment in patients with diabetes mellitus and in non-diabetic patients with end stage renal failure.

DESIGN

Retrospective comparison of cases and matched controls.

SETTING

Renal unit, Western Infirmary, Glasgow, providing both dialysis and renal transplantation.

PATIENTS

82 Diabetic patients starting renal replacement treatment between 1979 and 1988, compared with 82 matched non-diabetic controls with renal failure and 39 different matched controls undergoing renal transplantation.

MAIN OUTCOME MEASURES

Patient characteristics, history of smoking, prevalence of left ventricular hypertrophy and myocardial ischaemia at start of renal replacement treatment; survival of patients with renal replacement treatment and of patients and allografts with renal transplantation.

RESULTS

The overall survival of the diabetic patients during the treatment was 83%, 59%, and 50% at one, three, and five years. Survival was significantly poorer in the diabetic patients than the controls (p less than 0.001). Particularly adverse features for outcome at the start of treatment were increasing age (p less than 0.01) and current cigarette smoking (relative risk (95% confidence interval) 2.28 (0.93 to 4.84), p less than 0.05). Deaths were mainly from cardiac and vascular causes. The incidence of peritonitis in patients on continuous ambulatory peritoneal dialysis was the same in diabetic patients and controls (49% in each group remained free of peritonitis after one year), and the survival of renal allografts was not significantly worse in diabetic patients (p less than 0.5).

CONCLUSIONS

Renal replacement treatment may give good results in diabetic patients, although the outlook remains less favourable than for non-diabetic patients because of coexistent, progressive vascular disease, which is more severe in older patients.

Review of comparative antipyretic activity in children

Fever is one of the most common medical complaints referred to physicians for diagnosis and therapy. In addition, consumers frequently medicate themselves for fever associated with common, self-limited illnesses. The pathogenesis of fever suggests that pharmacologic therapy, which lowers the hypothalamic set-point, is an essential element in treatment. Not all fevers need to be treated; however, when indicated, therapy with antipyretics is necessary. The major antipyretic agents, acetaminophen, aspirin, and pyrazolone derivatives, are equally effective in reducing fever. However, after comparing side effects and risks of toxicity, acetaminophen may be the preferred agent in children.

Treatment of fever in 1982: a review

While there is room for questioning the need, or even advisability, of routine antipyretic therapy, the available data do not yet constitute any sort of a contraindication. There are reasons for individualizing the decision. However, having once decided, there is no compelling reason for selecting one antipyretic over any other, and aspirin remains the most satisfactory in light of the available evidence. Some serious theoretic questions persist about the safety of acetaminophen use in sick persons, and clearly there are some precautions that should be taken with regard to the doses of flavored preparations of this and any future products whose attractiveness to children is thus enhanced.

Effect of acetaminophen and salicylate on aspirin-induced inhibition of human platelet cyclo-oxygenase

Recent studies have shown that salicylic acid, a metabolite of aspirin, effectively competes for the same site on the platelet cyclo-oxygenase enzyme. In the present investigation we have evaluated the effect of salicylate and acetaminophen on aspirin induced inhibition of cyclo-oxygenase and platelet function. Results of our studies show that both drugs at equimolar concentrations had no inhibitory effect on aspirin induced blockage of cyclo-oxygenase or platelet function. Even at higher concentrations acetaminophen failed to protect cyclo-oxygenase or prevent inhibition of platelet function by aspirin. Salicylate at concentrations above 5 mM effectively blocked the inhibition of cyclo-oxygenase activity and platelet aggregation in response to arachidonate.

Plasma acetylsalicylate and salicylate and platelet cyclooxygenase activity following plain and enteric-coated aspirin

Compressed and enteric-coated acetylsalicylate (ASA) tablets have been compared in normal healthy subjects. Plasma ASA and salicylate (SA) were measured by high pressure liquid chromatography (HPLC). Platelet cyclooxygenase activity in vitro was studied by a radiometric technique. Following ingestion of 650 mg of ASA in the form of compressed tablets, cyclooxygenase activity was inhibited 95% within 45 min. Enzyme activity was observed to increase within 8 h and reached 10% of control level by 24 h. The pattern suggests that only circulating platelets are affected by ASA ingestion. Following the administration of 650 mg of ASA as enteric-coated tablets comparable inhibition of cyclooxygenase activity was observed, although the effect was delayed, reflecting the delayed appearance of ASA in the plasma. Return to control levels followed a pattern similar to that observed with the compressed tablet.