Antinociceptive action of sodium valproate in the mouse

Clindamycin inhibits nociceptive response by reducing tumor necrosis factor-α and CXCL-1 production and activating opioidergic mechanisms

Clindamycin, a bacteriostatic semisynthetic lincosamide, is useful in the management of infections caused by aerobic and anaerobic Gram-positive cocci, including bacteremic pneumonia, streptococcal toxic shock syndrome and sepsis. It has been recently demonstrated that clindamycin inhibits in vitro and in vivo inflammatory cytokine production. In the present study, we investigated the effects of clindamycin in acute and chronic models of pain and inflammation in mice and the underlying mechanisms. Intraperitoneal (i.p.) administration of clindamycin (400 mg/kg) increased the animal's latency to exhibit the nociceptive behavior induced by noxious heat (hot plate model). Intrathecal injection of clindamycin (2, 10 and 50 µg) also increased the animals' latency to exhibit the nociceptive behavior. Tactile hypersensitivity and paw edema induced by intraplantar (i.pl.) injection of carrageenan were attenuated by previous administration of clindamycin (200 and 400 mg/kg, i.p.). Clindamycin (100, 200 and 400 mg/kg, i.p.) also attenuated ongoing tactile hypersensitivity and paw edema induced by i.pl. injection of complete Freund's adjuvant (CFA). The antinociceptive activity of clindamycin (400 mg/kg, i.p.) in the hot plate model was attenuated by previous administration of naltrexone (5 and 10 mg/kg, i.p.), but not glibenclamide or AM251. CFA-induced production of TNF-α and CXCL-1 was reduced by clindamycin (400 mg/kg, i.p.). Concluding, clindamycin exhibits activities in acute and chronic models of pain and inflammation. These effects are associated with reduced production of TNF-α and CXCL-1 and activation of opioidergic mechanisms. Altogether, these results indicate that the clindamycin's immunomodulatory effects may contribute to a pharmacological potential beyond its antibiotic property.

Effect of Sodium Valproate and Docosahexaenoic Acid on Pain in Rats

INTRODUCTION

Analgesics are commonly prescribed medications used to alleviate pain of various aetiologies without affecting the patient's consciousness. They interfere with the transmission of pain signals. A commonly used antiepileptic drug, sodium valproate has been used in various non-epileptic conditions like migraine prophylaxis and in the treatment of bipolar disorder because of the multiple mechanisms by which it acts. Docosahexanoic Acid (DHA), an omega 3 fatty acid, is known to possess analgesic activity. We planned a study to assess the effect of sodium valproate alone and in combination with DHA in rat models of pain.

AIM

To evaluate the analgesic activity of sodium valproate and DHA supplementation using various experimental models in albino Wistar rats.

MATERIALS AND METHODS

For analgesic activity, A total of 48 adult Wistar albino rats were divided into eight groups of six rats each. Group I was control (distil water 1 ml/kg), Group II received intraperitoneal injection of tramadol (10 mg/kg), Group III, IV, V were injected intraperitoneal sodium valproate 100, 200, 400 mg/kg with distil water respectively and Group VI, VII, VIII were given sodium valproate 100, 200, 400 mg/kg plus DHA 300 mg/kg (intraperitoneal) respectively. Analgesic activity was assessed using hot plate, tail flick and acetic acid writhing models.

RESULTS

We found that sodium valproate at higher doses (400 mg/kg) used either alone along with DHA (300 mg/kg) showed statistically significant analgesic activity in comparison to control in various experimental models for assessing pain.

CONCLUSION

Combination of sodium valproate along with DHA has shown promising analgesic activity.

New chiral 4-substituted 2-cyanoethyl-oxazolines: synthesis and assessment of some biological activities

This paper describes the synthesis of new enantiomerically pure 2-cyanoethyl-oxazolines in one step starting from a wide range of amino alcohols and 4-ethoxy-4-iminobutanenitrile with high to good yields (73-96%) via an appropriate procedure which can be used for a selective synthesis of mono-oxazolines. A simple operation as well as a practical separation is additional eco-friendly attributes of this method. All the synthesized compounds were identified and characterized with their physicochemical features and their spectral data ((1)H NMR, (13)C NMR and TOFMS ES(+)). Among the prepared mono-oxazolines, the mono-oxazoline (3a) [3-[(4S)-4-benzyl-4,5-dihydro-1,3-oxazol-2-yl] propanenitrile] was tested to detect some biological activities. This compound was studied in vitro given the various types of pharmacological properties characterizing these compounds such as antioxidant, antimicrobial and analgesic activities. The antioxidant activity and mechanism of (3a) were identified using various in vitro antioxidant assays including 1,1-diphenyl-2-picryl-hydrazyl (DPPH), and superoxide anion radicals (O2(-)) scavenging activity. In addition, compared to Quercetin, the tested synthetic product reveals a relatively-strong antiradical activity towards the DPPH (activity percentage of 81.22%) free radicals and significantly decreased the reactive oxygen species such as (O2(-)) formation evaluated by the non-enzymatic (nitroblue tetrazolium/riboflavine) and the enzymatic (xanthine/xanthine oxidase) systems. Related activity values were, respectively, 66% and 60.30%. The oxazoline (3a) showed a high ability to reduce the O2(-) generation and proved to be a very potent radical scavenger. On the other hand, the analgesic property of the 3[(4S)-benzyl-4,5-dihydro-1,3-oxazol-2-yl] propanenitrile (3a) was demonstrated. The subcutaneous administration of (3a) produced a significant reduction in the number of abdominal constrictions amounting to 73.81% in the acetic acid writhing test in mice. In addition to these advances, the oxazoline (3a) has been investigated as an antimicrobial agent. Our results showed that this molecule exhibited various levels of antibacterial effect against all the tested bacterial strains.

Anticonvulsant and analgesic activities of crude extract and its fractions of the defensive secretion from the Mediterranean sponge, Spongia officinalis

This study progresses in the direction of identifying component(s) from the Mediterranean sponge, Spongia officinalis with anticonvulsant and analgesic activities. We investigated the efficacy of crude extract and its semi-purified fractions (F1-F3) of the defensive secretion from Spongia officinalis for their in vivo anticonvulsant activity using the pentylenetetrazole (PTZ) seizure model and analgesic activity using the writhing test in mice. Among the series the crude extract exhibited interesting analgesic activity in a dose dependent manner. Similarly the fraction F2 showed a partial protection of mice from PTZ-induced seizure and interesting analgesic activity in a dose dependent manner. The purification and the determination of chemical structure(s) of compound(s) of this active fraction are under investigation.

Effects induced by Apis mellifera venom and its components in experimental models of nociceptive and inflammatory pain

The effects induced by Apis mellifera venom (AMV), melittin-free AMV, fraction with molecular mass < 10 kDa (F<₁₀) or melittin in nociceptive and inflammatory pain models in mice were investigated. Subcutaneous administration of AMV (2, 4 or 6 mg/kg) or melittin-free AMV (1, 2 or 4 mg/kg) into the dorsum of mice inhibited both phases of formaldehyde-induced nociception. However, F<₁₀ (2, 4 or 6 mg/kg) or melittin (2 or 3 mg/kg) inhibited only the second phase. AMV (4 or 6 mg/kg), but not F<₁₀, melittin-free AMV or melittin, induced antinociception in the hot-plate model. Paw injection of AMV (0.05 or 0.10 mg), F<₁₀ (0.05 or 0.1 mg) or melittin (0.025 or 0.050 mg) induced a nociceptive response. In spite of inducing nociception after paw injection, scorpion (Tityus serrulatus) or snake (Bothrops jararaca) venom injected into the dorsum of mice did not inhibit formaldehyde-induced nociception. In addition, AMV (6 mg/kg), but not F<₁₀ (6 mg/kg) or melittin (3 mg/kg), inhibited formaldehyde paw oedema. Concluding, AMV, F<₁₀ and melittin induce two contrasting effects: nociception and antinociception. AMV antinociception involves the action of different components and does not result from non-specific activation of endogenous antinociceptive mechanisms activated by exposure to noxious stimuli.

Characterization of the antinociceptive and anti-inflammatory activities of riboflavin in different experimental models

Riboflavin, similar to other vitamins of the B complex, presents anti-inflammatory activity but its full characterization has not yet been carried out. Therefore, we aimed to investigate the effect of this vitamin in different models of nociception, edema, fever and formation of fibrovascular tissue. Riboflavin (25, 50 or 100 mg/kg, i.p.) did not alter the motor activity of mice in the rota-rod or the open field models. The second phase of the nociceptive response induced by formalin in mice was inhibited by riboflavin (50 or 100 mg/kg). The first phase of this response and the nociceptive behavior in the hot-plate model were inhibited only by the highest dose of this vitamin. Riboflavin (25, 50 or 100 mg/kg, i.p.), administered immediately and 2 h after the injection of carrageenan, induced antiedema and antinociceptive effects. The antinociceptive effect was not inhibited by the pretreatment with cadmium sulfate (1 mg/kg), an inhibitor of flavokinase. Riboflavin (50 or 100 mg/kg, i.p., 0 and 2 h) also inhibited the fever induced by lipopolysaccharide (LPS) in rats. Moreover, the formation of fibrovascular tissue induced by s.c. implant of a cotton pellet was inhibited by riboflavin (50 or 100 mg/kg, i.p., twice a day for one week). Riboflavin (10 or 25 mg/kg, i.p.) also exacerbated the effect of morphine (2, 4 or 8 mg/kg, i.p.) in the mouse formalin test. In conclusion, the study demonstrates the antinociceptive and anti-inflammatory activities of riboflavin in different experimental models. These results, associated with the fact that riboflavin is a safe drug, is approved for clinical use and exacerbates the antinociceptive effect of morphine, may warrant clinical trials to assess its potential in the treatment of different painful or inflammatory conditions.

Anticonvulsants for neuropathic pain syndromes: mechanisms of action and place in therapy

Neuropathic pain, a form of chronic pain caused by injury to or disease of the peripheral or central nervous system, is a formidable therapeutic challenge to clinicians because it does not respond well to traditional pain therapies. Our knowledge about the pathogenesis of neuropathic pain has grown significantly over last 2 decades. Basic research with animal and human models of neuropathic pain has shown that a number of pathophysiological and biochemical changes take place in the nervous system as a result of an insult. This property of the nervous system to adapt morphologically and functionally to external stimuli is known as neuroplasticity and plays a crucial role in the onset and maintenance of pain symptoms. Many similarities between the pathophysiological phenomena observed in some epilepsy models and in neuropathic pain models justify the rational for use of anticonvulsant drugs in the symptomatic management of neuropathic pain disorders. Carbamazepine, the first anticonvulsant studied in clinical trials, probably alleviates pain by decreasing conductance in Na+ channels and inhibiting ectopic discharges. Results from clinical trials have been positive in the treatment of trigeminal neuralgia, painful diabetic neuropathy and postherpetic neuralgia. The availability of newer anticonvulsants tested in higher quality clinical trials has marked a new era in the treatment of neuropathic pain. Gabapentin has the most clearly demonstrated analgesic effect for the treatment of neuropathic pain, specifically for treatment of painful diabetic neuropathy and postherpetic neuralgia. Based on the positive results of these studies and its favourable adverse effect profile, gabapentin should be considered the first choice of therapy for neuropathic pain. Evidence for the efficacy of phenytoin as an antinociceptive agent is, at best, weak to modest. Lamotrigine has good potential to modulate and control neuropathic pain, as shown in 2 controlled clinical trials, although another randomised trial showed no effect. There is potential for phenobarbital, clonazepam, valproic acid, topiramate, pregabalin and tiagabine to have antihyperalgesic and antinociceptive activities based on result in animal models of neuropathic pain, but the efficacy of these drugs in the treatment of human neuropathic pain has not yet been fully determined in clinical trials. The role of anticonvulsant drugs in the treatment of neuropathic pain is evolving and has been clearly demonstrated with gabapentin and carbamazepine. Further advances in our understanding of the mechanisms underlying neuropathic pain syndromes and well-designed clinical trials should further the opportunities to establish the role of anticonvulsants in the treatment of neuropathic pain.

Current perception thresholds of epileptic patients treated with valproate

We investigated the current perception threshold (CPT) of epileptic patients treated with valproate. The CPTs at frequencies of 5 Hz, 250 Hz and 2000 Hz in the control group of patients were 198.9 +/- 15.8, 62.0 +/- 18.9 and 35.3 +/- 15.8, respectively. The CPTs at 5 Hz, 250 Hz and 2000 Hz in the epileptic group of patients were 350.6 +/- 61.3, 338.6 +/- 64.3 and 193.2 +/- 21.1, respectively. The CPTs at 5 Hz, 250 Hz and 2000 Hz in the epileptic group were significantly higher than those of the control group. We measured the CPTs for 6 months after the administration of valproate in three patients with traumatic epilepsy. Their CPTs were higher than that of the epileptic group. The CPTs at 5 Hz, 250 Hz and 2000 Hz reached a maximum 4 weeks after the administration of valproate for two of these patients and in 6 weeks for the other patient. When the administration of valproate to a patient was stopped, CPTs decreased.

Tiagabine antinociception in rodents depends on GABA(B) receptor activation: parallel antinociception testing and medial thalamus GABA microdialysis

The effects of a new antiepileptic drug, tiagabine, (R)-N-[4,4-di-(3-methylthien-2-yl)but-3-enyl] nipecotic acid hydrochloride, were studied in mice and rats in antinociceptive tests, using three kinds of noxious stimuli: mechanical (paw pressure), chemical (abdominal constriction) and thermal (hot plate). In vivo microdialysis was performed in parallel in awake, freely moving rats in order to evaluate possible alterations in extracellular gamma-aminobutyric acid (GABA) levels in a pain-modulating region, the medial thalamus. Systemic administration of tiagabine, 30 mg kg(-1) i.p., increased nearly twofold the extracellular GABA levels in rats and increased significantly the rat paw pressure nociceptive threshold in a time-correlated manner. Dose-related significant tiagabine-induced antinociception was also observed at the doses of 1 and 3 mg kg(-1) i.p. in the mouse hot plate and abdominal constriction tests. The tiagabine antinociception was completely antagonised by pretreatment with the selective GABA(B) receptor antagonist, CGP 35348, (3-aminopropyl-diethoxy-methyl-phosphinic acid) (2.5 microg/mouse or 25 microg/rat i.c.v.), but not by naloxone (1 mg kg(-1) s.c.), both administered 15 min before tiagabine. Thus, it is suggested that tiagabine causes antinociception due to raised endogenous GABA levels which in turn activate GABA(B) receptors.

Central analgesic effect of valproate in patients with epilepsy

Clinical practitioners have often observed in the course of their daily work that the pain thresholds of epileptic patients seem to differ from those of healthy subjects. These patients can suffer from quite severe traumatic lesions without apparently experiencing any pain. Previous studies have shown that the absence of pain is due to treatment, since most antiepileptic drugs also have analgesic effects. In the present study, it was proposed to assess the pain thresholds of 15 epileptic patients (with tonic-clonic seizures generalized at outset) treated with valproate, by measuring the leg flexion nociceptive reflex (or RIII reflex) threshold: the stimulation threshold at which this reflex is triggered is known to be correlated with the pain threshold. The results were compared with 15 control subjects. The nociceptive threshold of the patients with valproate treatment was significantly higher than that of the control population. The nociceptive threshold was also in good correlation with the valproate plasma level. These data are discussed from the point of view of the gaba-ergic system and mechanisms possibly involved.

Desensitization of GABAB receptors and antagonism by CGP 35348, prevent bicuculline- and picrotoxin-induced antinociception

The effect of the GABAA antagonists, bicuculline and picrotoxin, in the hot plate and writhing tests in mice and the paw-pressure test in rats was assessed. Subconvulsant doses of bicuculline (1.3-4 mumol kg-1, s.c.) or picrotoxin (0.8-2.5 mumol kg-1, s.c.) induced a dose-related increase in latency of licking in the hot plate test in mice, whereas subconvulsant doses of strychnine and thiosemicarbazide (0.9 and 6 mg kg-1, s.c. respectively), did not modify the threshold to thermal stimuli in mice. The effects of bicuculline and picrotoxin were not modified by naloxone (3 mg kg-1, i.p., a dose which inhibited the antinociceptive effect of morphine) or by atropine (5 mg kg-1, i.p., a dose which prevented oxotremorine-induced antinociception) but were antagonized by the GABAB antagonist CGP 35348 (2.5 micrograms, i.c.v., a dose which prevented (+/-)baclofen-induced antinociception). Mice, rendered tolerant to baclofen-induced antinociception by twice daily injection of increasing doses of baclofen (5-18 mg kg-1, s.c.), were unresponsive to the antinociceptive effects of bicuculline and picrotoxin but still responded to morphine. Bicuculline and picrotoxin, in the same range of doses which affected the three models of antinociception used, inhibited pentobarbital-induced hypnosis. Large doses of bicuculline and picrotoxin (4 and 2.5 mumol kg-1, s.c. respectively), reduced locomotor activity and impaired rota-rod performance in mice. The changes in response to noxious stimuli, induced by bicuculline and picrotoxin, are interpreted as an antinociceptive effect. It is then suggested that this effect might depend on an indirect activation of GABAB receptors through release of GABA.(ABSTRACT TRUNCATED AT 250 WORDS)

Nociceptive threshold in patients with epilepsy

Clinical practitioners have often observed in the course of their daily work that the pain thresholds of epileptic patients seem to differ from those of healthy subjects. These patients can suffer from quite severe traumatic lesions without apparently experiencing any pain. Since they are usually under treatment for epilepsy, it is difficult to determine whether the absence of pain is due to these patients' epileptic condition or to its treatment, since most antiepileptic drugs also have analgesic effects. In the present study, it was proposed to assess the pain thresholds of 15 epileptic patients (10 with tonic-clonic seizures generalized at outset and 5 with temporal lobe epilepsy), by measuring the leg flexion nociceptive reflex (or RIII reflex) threshold: the stimulation threshold at which this reflex is triggered is known to be correlated with the pain threshold. The nociceptive threshold of the patients with generalized epilepsy was not found to differ from that of the control population, whereas that of the patients with temporal lobe epilepsy was spontaneously high and was not reversed upon injecting naloxone. These data are discussed from the point of view of the pain pathways and mechanisms possibly involved.

Valproate potentiates and picrotoxin antagonizes the anxiolytic action of ethanol in a nonshock conflict task

The purpose of this study was to examine the effects of the indirect GABA agonist valproate and the indirect GABA antagonist picrotoxin on the anxiolytic (anti-conflict) activity of ethanol in a behavioral conflict task that does not employ electroshock. This task (negative contrast) quantifies how animals respond to an abrupt, unexpected reduction in reward. Treatment with valproate alone did not elevated depressed behavior engendered by abrupt reduction in reward. However, when administered together with a sub-effective dose of ethanol (0.5 g/kg), valproate (50-200 mg/kg) dose-dependently potentiated the anxiolytic action of ethanol. Picrotoxin (2 mg/kg) antagonized the anxiolytic effects of a larger dose of ethanol (1.0 g/kg) given alone, as well as the ability of valproate to enhance the anxiolytic effects of smaller dose of ethanol (0.5 g/kg). As such, these data support a role for GABA in mediating the anxiolytic activity of ethanol.

[Comparative study of sodium valproate and ketoprofen in the treatment of postoperative pain]

Experimental data has shown that sodium valproate has analgesic properties in animals, probably by way of the increase in cerebral and spinal gamma amino-butyric acid (GABA) it induces. A study was therefore designed to assess this analgesia in man in the postoperative period. A first open study was carried out on 12 consenting patients, who were each given 15 mg.kg-1 sodium valproate intravenously over 20 min. A significant decrease in pain intensity, measured by an analogic visual scale, was seen from the 20th min up to the 140th min. A controlled double-blind study was then carried out; it included three groups of 13 patients each. Patients in group 1 were given placebo (5% dextrose); group 2 patients were given 15 mg.kg-1 sodium valproate intravenously over 20 min, and group 3 patients 2 mg.kg-1 ketoprofen intravenously over 20 min also. There was no difference in the pain intensity profile of groups 1 and 2: sodium valproate was no more efficient than placebo in relieving postoperative pain. However, ketoprofen gave a prompt and effective analgesic effect. The clinical data obtained with sodium valproate in man during the postoperative period stand in contrast with the promising animal results. Sodium valproate cannot be recommended for the treatment of postoperative pain.

Analgesic properties of valproic acid might be related to activation of pro-enkephalin system in rat brain

Recent in vivo and in vitro studies have shown the involvement of gamma-aminobutyric acid (GABA) in analgesia. We investigated if the analgesia induced by an acute valproic acid (VPA) administration might be related to the activation of the enkephalinergic system. VPA administration (i.p.) induces 30 min after treatment a significant and dose-dependent increase of Leu-enkephalin and Met-enkephalin in the striatum, hypothalamus, cortex and brainstem. In the hypophysis no modification was observed for these two neuropeptides. The Met-enkephalin-Arg-Gly-Leu levels are affected by VPA administration in a more complex pattern. Such results suggest the implication of an enkephalinergic system in GABAergic analgesia.

Antinociceptive action of picrotoxin in the mouse

Picrotoxin, an antagonist of GABA-associated chloride ionophores with convulsant activity, possesses antinociceptive activity in the hot-plate and writhing tests in the mouse. Analgesia produced by a subconvulsant dose of picrotoxin (0.75 mg/kg, s.c.) was reversed by naloxone (1.0 mg/kg, s.c.), atropine (5 mg/kg, i.p.), and methysergide (10 mg/kg, i.p.) in the jumping reaction (hot-plate test). These data indicate that opiate pathways, as well as cholinergic and serotoninergic pathways could be involved in the mechanism that underlies picrotoxin-induced analgesia. Furthermore, such results should be considered when interpreting the behavioral effects of picrotoxin.

gamma-Aminobutyric acid-ergic analgesia: implications for gamma-aminobutyric acid-ergic therapy for drug addictions

Recent in vivo and in vitro studies regarding the involvement of gamma-aminobutyric acid (GABA)-ergic systems in analgesia and in opiate dependence have been reviewed and analyzed. It seems evident that GABA-ergic systems play a role in mediating the effects of opiates and that some interplay might exist between endogenous opioid systems and GABA-ergic systems. Systemic administration of GABA-agonists, GABA uptake blockers and inhibitors of GABA-alpha-oxoglutarate transaminase (GABA-T) can produce potent analgesic actions in experimental animals and in man. Further study of such agents might lead to the development of new analgesics and/or new drugs for treating certain types of drug addiction.