1
|
Javid FA, Alam A, Williams E, Malik SS, Mohayuddin U, Hasan SS. Trends in prescription and cost of Sativex, a cannabinoid-based medicine, in treating patients with multiple sclerosis in England. J Pharm Policy Pract 2024; 17:2342318. [PMID: 38726319 PMCID: PMC11080669 DOI: 10.1080/20523211.2024.2342318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2024] Open
Abstract
Aim Cannabis-based medication has recently been made available in the NHS for reducing pain and spasticity in patients with multiple sclerosis (MS). The currently available preparation of Sativex (nabiximols) contains a combination of botanical cannabis extracts with cannabidiol (CBD) and tetrahydrocannabinol (THC) with almost equal amounts in addition to minor cannabinoids and terpenoids and is delivered via an oro-mucosal spray. The present study aims to examine the use and trends in prescribing cannabinoid-based Sativex to control pain in patients diagnosed with MS. Methods Primary care prescribing data for cannabinoid-based Sativex (2013-2022) from the Prescription Cost Analysis were extracted and analysed. Linear regression analyses were performed to examine prescription trends and prescription costs (average change per year). Results There was a general increasing trend in the number of prescriptions each year, from 4.42 items dispensed per 100,000 people in 2013 to 5.15 in 2022. Overall, prescription items for cannabinoid-based Sativex increased by 0.34% per year (95% CI:-3.98, 4.67, p = 0.860) on average between 2013 and 2022. On average, a 2.43% (95% CI: -5.78, 0.92, p = 0.133) increase per year was observed for the costs of cannabinoid-based Sativex from 2013 to 2022. Conclusion The results suggested that cannabinoid-based Sativex should be considered an option due to its effectiveness, acceptable tolerance, and safety profile in the prescribing of Sativex.
Collapse
Affiliation(s)
- Farideh A. Javid
- Department of Pharmacy, School of Applied Sciences, University of Huddersfield, Huddersfield, UK
| | - Anam Alam
- Department of Pharmacy, School of Applied Sciences, University of Huddersfield, Huddersfield, UK
| | - Emily Williams
- Department of Pharmacy, School of Applied Sciences, University of Huddersfield, Huddersfield, UK
| | - Sidhra Sajid Malik
- Department of Pharmacy, School of Applied Sciences, University of Huddersfield, Huddersfield, UK
| | - Usama Mohayuddin
- Department of Pharmacy, School of Applied Sciences, University of Huddersfield, Huddersfield, UK
| | - Syed Shahzad Hasan
- Department of Pharmacy, School of Applied Sciences, University of Huddersfield, Huddersfield, UK
| |
Collapse
|
2
|
Bouloux GF, Chou J, DiFabio V, Ness G, Perez D, Mercuri L, Chung W, Klasser GD, Bender SD, Kraus S, Crago CA. Guidelines for the Management of Patients With Orofacial Pain and Temporomandibular Disorders. J Oral Maxillofac Surg 2024:S0278-2391(24)00200-3. [PMID: 38643965 DOI: 10.1016/j.joms.2024.03.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2024] [Accepted: 03/19/2024] [Indexed: 04/23/2024]
Affiliation(s)
- Gary F Bouloux
- Family Professor, Division Chief, Oral and Maxillofacial Surgery, Emory University School of Medicine, Atlanta, GA.
| | - Joli Chou
- Associate Professor, Department Of Oral and Maxillofacial Surgery, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA
| | - Vince DiFabio
- Associate Clinical Professor, Oral and Maxillofacial Surgery, University of Maryland School of Dentistry, University of Maryland Medical Center, Baltimore, MD
| | - Greg Ness
- Emeritus Professor-Clinical, The Ohio State University, Private Practice, Oral and Facial Surgery for Adults and Children, Columbus, OH
| | - Daniel Perez
- Associate Professor and Program Director, Oral and Maxillofacial Surgery, University Texas Health Sciences San Antonio, San Antonio, TX
| | - Louis Mercuri
- Visiting Professor, Department of Orthopedic Surgery, Rush University Medical Center, Adjunct Professor, Department of Bioengineering, University of Illinois Chicago, Chicago, IL
| | - William Chung
- Clinical Professor, Residency Program Director, Indiana University School of Dentistry and Hospital Medicine, Indianapolis, IN
| | - Gary D Klasser
- Certificate Orofacial Pain, Professor, Louisiana State University Health Sciences Center, School of Dentistry, New Orleans, LA
| | - Steven D Bender
- Clinical Associate Professor, Director, Clinical Center for Facial Pain and Sleep Medicine, Department of Oral and Maxillofacial Surgery, Texas A&M School of Dentistry, Dallas, TX
| | | | | |
Collapse
|
3
|
Soares-Santos RR, Machado DP, Romero TL, Duarte IDG. Nitric oxide and potassium channels but not opioid and cannabinoid receptors mediate tramadol-induced peripheral antinociception in rat model of paw pressure withdrawal. Can J Physiol Pharmacol 2024; 102:218-227. [PMID: 37976474 DOI: 10.1139/cjpp-2023-0314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2023]
Abstract
Tramadol, an analgesic classified as an "atypical opioid", exhibits both opioid and non-opioid mechanisms of action. This study aimed to explore these mechanisms, specifically the opioid-, cannabinoid-, nitric oxide-, and potassium channel-based mechanisms, which contribute to the peripheral antinociception effect of tramadol, in an experimental rat model. The nociceptive threshold was determined using paw pressure withdrawal. To examine the mechanisms of action, several substances were administered intraplantarly: naloxone, a non-selective opioid antagonist (50 µg/paw); AM251 (80 µg/paw) and AM630 (100 µg/paw) as the selective antagonists for types 1 and 2 cannabinoid receptors, respectively; nitric oxide synthase inhibitors L-NOArg, L-NIO, L-NPA, and L-NIL (24 µg/paw); and the enzyme inhibitors of guanylatocyclase and phosphodiesterase of cGMP, ODQ, and zaprinast. Additionally, potassium channel blockers glibenclamide, tetraethylammonium, dequalinium, and paxillin were used. The results showed that opioid and cannabinoid receptor antagonists did not reverse tramadol's effects. L-NOarg, L-NIO, and L-NPA partially reversed antinociception, while ODQ completely reversed, and zaprinast enhanced tramadol's antinociception effect. Notably, glibenclamide blocked tramadol's antinociception in a dose-dependent manner. These findings suggest that tramadol's peripheral antinociception effect is likely mediated by the nitrergic pathway and sensitive ATP potassium channels, rather than the opioid and cannabinoid pathways.
Collapse
Affiliation(s)
- Raquel R Soares-Santos
- Department of Pharmacology, Federal University of Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Daniel P Machado
- Department of Pharmacology, Federal University of Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Thiago L Romero
- Department of Pharmacology, Federal University of Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Igor D G Duarte
- Department of Pharmacology, Federal University of Minas Gerais (UFMG), Belo Horizonte, Brazil
| |
Collapse
|
4
|
Temporomandibular Joint Surgery. J Oral Maxillofac Surg 2023; 81:E195-E220. [PMID: 37833023 DOI: 10.1016/j.joms.2023.06.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2023]
|
5
|
Gale JR, Gedeon JY, Donnelly CJ, Gold MS. Local translation in primary afferents and its contribution to pain. Pain 2022; 163:2302-2314. [PMID: 35438669 PMCID: PMC9579217 DOI: 10.1097/j.pain.0000000000002658] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 04/08/2022] [Indexed: 02/06/2023]
Abstract
ABSTRACT Chronic pain remains a significant problem due to its prevalence, impact, and limited therapeutic options. Progress in addressing chronic pain is dependent on a better understanding of underlying mechanisms. Although the available evidence suggests that changes within the central nervous system contribute to the initiation and maintenance of chronic pain, it also suggests that the primary afferent plays a critical role in all phases of the manifestation of chronic pain in most of those who suffer. Most notable among the changes in primary afferents is an increase in excitability or sensitization. A number of mechanisms have been identified that contribute to primary afferent sensitization with evidence for both increases in pronociceptive signaling molecules, such as voltage-gated sodium channels, and decreases in antinociceptive signaling molecules, such as voltage-dependent or calcium-dependent potassium channels. Furthermore, these changes in signaling molecules seem to reflect changes in gene expression as well as posttranslational processing. A mechanism of sensitization that has received far less attention, however, is the local or axonal translation of these signaling molecules. A growing body of evidence indicates that this process not only is dynamically regulated but also contributes to the initiation and maintenance of chronic pain. Here, we review the biology of local translation in primary afferents and its relevance to pain pathobiology.
Collapse
Affiliation(s)
- Jenna R Gale
- Department of Neurobiology, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213
| | - Jeremy Y Gedeon
- Department of Neurobiology, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213
| | | | - Michael S Gold
- Corresponding author: Michael S Gold, PhD, Department of Neurobiology, University of Pittsburgh School of Medicine, 200 Lothrop Street, Pittsburgh, PA 15213, P: 412-383-5367,
| |
Collapse
|
6
|
Abdalla HB, Napimoga MH, Teixeira JM, Trindade-da-Silva CA, Pieroni VL, Dos Santos Araújo FSM, Hammock BD, Clemente-Napimoga JT. Soluble epoxide hydrolase inhibition avoid formalin-induced inflammatory hyperalgesia in the temporomandibular joint. Inflammopharmacology 2022; 30:981-990. [PMID: 35303234 DOI: 10.1007/s10787-022-00965-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Accepted: 03/02/2022] [Indexed: 11/27/2022]
Abstract
Epoxyeicosatrienoic acids (EETs) are endogenous molecules that exerts effective antinociceptive and resolutive actions. However, because of their rapid metabolism by the soluble epoxide hydrolase (sEH), EETs are unable to remain bioavailable. Therefore, the aim of this study was to investigate whether local sEH inhibition could prevent inflammatory hyperalgesia in the temporomandibular joint (TMJ) of rats. For that, rats were pre-treated with an intra-TMJ injection of TPPU, followed by the noxious stimulus (1.5% of formalin intra-articular) to evaluate nociceptive behavior. Histological analysis was conducted to explore the inflammatory exudate and mast cell degranulation. Periarticular tissue over the TMJ was used to measure inflammatory lipids and cytokines/chemokine by Enzyme-Linked Immunosorbent Assay (ELISA). We demonstrated that peripheral pretreatment with TPPU prevents formalin-induced inflammatory hyperalgesia in the TMJ, and this effect is strictly local. Moreover, TPPU mitigates the leukocyte exudate in the TMJ, as well as inflammatory lipids mediators. Mast cell number and degranulation were abrogated by TPPU, and the inflammatory cytokine levels were decreased by TPPU. On the other hand, TPPU up-regulated the release of interleukin 10 (IL-10), an anti-inflammatory cytokine. We provide evidence that locally sEH by intra-TMJ injection of TPPU produces an antinociceptive and anti-inflammatory effect on rats' TMJ.
Collapse
Affiliation(s)
- Henrique Ballassini Abdalla
- Faculdade São Leopoldo Mandic, Instituto de Pesquisas São Leopoldo Mandic, Laboratoy of Neuroimmune Interface of Pain Research, Rua José Rocha Junqueira, 13-Swift, Campinas, SP, CEP: 13405-755, Brazil
| | - Marcelo Henrique Napimoga
- Faculdade São Leopoldo Mandic, Instituto de Pesquisas São Leopoldo Mandic, Laboratoy of Neuroimmune Interface of Pain Research, Rua José Rocha Junqueira, 13-Swift, Campinas, SP, CEP: 13405-755, Brazil
| | - Juliana Maia Teixeira
- Faculdade São Leopoldo Mandic, Instituto de Pesquisas São Leopoldo Mandic, Laboratoy of Neuroimmune Interface of Pain Research, Rua José Rocha Junqueira, 13-Swift, Campinas, SP, CEP: 13405-755, Brazil
| | - Carlos Antônio Trindade-da-Silva
- Faculdade São Leopoldo Mandic, Instituto de Pesquisas São Leopoldo Mandic, Laboratoy of Neuroimmune Interface of Pain Research, Rua José Rocha Junqueira, 13-Swift, Campinas, SP, CEP: 13405-755, Brazil
- Department of Entomology and Nematology and UC Davis Comprehensive Cancer Center, University of California, Davis, CA, USA
| | - Victor Luís Pieroni
- Faculdade São Leopoldo Mandic, Instituto de Pesquisas São Leopoldo Mandic, Laboratoy of Neuroimmune Interface of Pain Research, Rua José Rocha Junqueira, 13-Swift, Campinas, SP, CEP: 13405-755, Brazil
| | - Fernanda Souto Maior Dos Santos Araújo
- Faculdade São Leopoldo Mandic, Instituto de Pesquisas São Leopoldo Mandic, Laboratoy of Neuroimmune Interface of Pain Research, Rua José Rocha Junqueira, 13-Swift, Campinas, SP, CEP: 13405-755, Brazil
| | - Bruce D Hammock
- Department of Entomology and Nematology and UC Davis Comprehensive Cancer Center, University of California, Davis, CA, USA
| | - Juliana Trindade Clemente-Napimoga
- Faculdade São Leopoldo Mandic, Instituto de Pesquisas São Leopoldo Mandic, Laboratoy of Neuroimmune Interface of Pain Research, Rua José Rocha Junqueira, 13-Swift, Campinas, SP, CEP: 13405-755, Brazil.
| |
Collapse
|
7
|
Cisneros-Covarrubias CA, Gómez-Durán CF, Aguirre-Bañuelos P, Hernández-Esquivel RA, Palestino G. Tramadol extended-release porous silicon microcarriers: A kinetic, physicochemical and biological evaluation. J Drug Deliv Sci Technol 2022. [DOI: 10.1016/j.jddst.2022.103132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
|
8
|
Mazuqueli Pereira EDSB, Basting RT, Abdalla HB, Garcez AS, Napimoga MH, Clemente-Napimoga JT. Photobiomodulation inhibits inflammation in the temporomandibular joint of rats. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY B-BIOLOGY 2021; 222:112281. [PMID: 34388640 DOI: 10.1016/j.jphotobiol.2021.112281] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 07/30/2021] [Accepted: 08/03/2021] [Indexed: 02/07/2023]
Abstract
Photobiomodulation (PBM) has been applied as a non-invasive technique for treating temporomandibular joint symptoms, especially on painful condition's relief, however the anti-inflammatory mechanism underlying the effect of PBM remains uncertain. This study aims to evaluate the mechanisms of action of PBM (808 nm) in a carrageenan-induced inflammation on temporomandibular joint (TMJ) of rats. In this study male Wistar rats were pre-treated with irradiation of a low-power diode laser for 15 s on TMJ (infra-red 808 nm, 100 mW, 50 J/cm2 and 1.5 J) 15 min prior an injection in the temporomandibular joint of carrageenan (100 μg/TMJ). 1 h after the TMJ treatments, the rats were terminally anesthetized for joint cavity wash and periarticular tissues collect. Samples analysis demonstrated that PBM inhibit leukocytes chemotaxis in the TMJ and significantly reduces amounts of TNF-α, IL-1β and CINC-1. In addition, Western blotting analysis demonstrated that PBM significantly decreased the protein levels of P2X3 and P2X7 receptors in the periarticular tissues. On the other hand, PBM was able to increase protein level of IL-10 (anti-inflammatory cytokine). In summary, it is possible to suggest that PBM inhibit inflammatory chemotaxis, modulation the balance of the pro- and anti-inflammatory characteristics of inflammatory cells.
Collapse
Affiliation(s)
| | - Rosanna Tarkany Basting
- São Leopoldo Mandic Institute and Research Center, Laboratory of Neuroimmune Interface of Pain Research - Campinas, SP, Brazil
| | - Henrique Ballassini Abdalla
- São Leopoldo Mandic Institute and Research Center, Laboratory of Neuroimmune Interface of Pain Research - Campinas, SP, Brazil
| | - Aguinaldo Silva Garcez
- São Leopoldo Mandic Institute and Research Center, Laboratory of Neuroimmune Interface of Pain Research - Campinas, SP, Brazil
| | - Marcelo Henrique Napimoga
- São Leopoldo Mandic Institute and Research Center, Laboratory of Neuroimmune Interface of Pain Research - Campinas, SP, Brazil
| | | |
Collapse
|
9
|
Abdalla HB, Napimoga MH, de Macedo Maganin AG, Lopes AH, Cunha TM, Gill HS, Clemente-Napimoga JT. The role of adenosine A 1 receptor in the peripheral tramadol's effect in the temporomandibular joint of rats. Int Immunopharmacol 2021; 97:107680. [PMID: 33932698 DOI: 10.1016/j.intimp.2021.107680] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2020] [Revised: 03/20/2021] [Accepted: 04/12/2021] [Indexed: 01/06/2023]
Abstract
Peripheral tramadol's delivery in the temporomandibular joint (TMJ) leads to significant analgesic outcomes and inflammatory process's resolvent actions. Mechanistically, these properties are apart from the opioid system. Nevertheless, the molecular mechanisms behind these effects are still unclear. Therefore, the present study investigated the hypothesis that adenosine A1 receptors are involved in the tramadol-induced analgesic and anti-inflammatory effects in the TMJ. Animals were pretreated with an intra-TMJ injection of DPCPX (antagonist of A1 receptor) or tramadol and subsequent nociceptive challenge with an intra-TMJ injection of 1.5% formalin. For over 45 min, the nociceptive behavior was quantitated, and by the end of this assessment, the animals were euthanized, and the periarticular tissue was collected. Lastly, an in vitro assay of BMDM (Bone Marrow-Derived Macrophages) was performed to investigate tramadol activity in macrophages. The intra-TMJ injection of tramadol ameliorates formalin-induced hypernociception along with inhibiting leukocyte migration. The tramadol's peripheral anti-inflammatory effect was mediated by the adenosine A1 receptor and was associated with increased protein expression of α2a-adrenoceptor in the periarticular tissues (p < 0.05: ANOVA, Tukey's test). Also, tramadol inhibits formalin-induced leukocyte migration and protein expression of P2X7 receptors in the periarticular tissue (p < 0.05); however, DPCPX did not alter this effect (p > 0.05). Moreover, DPCPX significantly reduced the protein expression of the M2 macrophage marker, MRC1. In BMDM, tramadol significantly reduces inflammatory cytokines release, and DPCPX abrogated this effect (p < 0.05). We identify tramadol's peripheral effect is mediated by adenosine A1 receptor, possibly expressed in macrophages in the TMJ tissue. We also determined an important discovery related to the activation of A1R/α2a receptors in the tramadol action.
Collapse
Affiliation(s)
- Henrique Ballassini Abdalla
- Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil; Laboratory of Neuroimmune Interface of Pain Research, Faculdade São Leopoldo Mandic, Instituto e Centro de Pesquisas São Leopoldo Mandic, Campinas, SP, Brazil
| | - Marcelo Henrique Napimoga
- Laboratory of Neuroimmune Interface of Pain Research, Faculdade São Leopoldo Mandic, Instituto e Centro de Pesquisas São Leopoldo Mandic, Campinas, SP, Brazil
| | - Alexandre Gomes de Macedo Maganin
- Center for Research in Inflammatory Diseases, Department of Pharmacology, School of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | - Alexandre Hashimoto Lopes
- Center for Research in Inflammatory Diseases, Department of Pharmacology, School of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | - Thiago Mattar Cunha
- Center for Research in Inflammatory Diseases, Department of Pharmacology, School of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | | | - Juliana Trindade Clemente-Napimoga
- Laboratory of Neuroimmune Interface of Pain Research, Faculdade São Leopoldo Mandic, Instituto e Centro de Pesquisas São Leopoldo Mandic, Campinas, SP, Brazil.
| |
Collapse
|
10
|
Teixeira JM, Pimentel RM, Abdalla HB, Sousa HMX, Macedo CG, Napimoga MH, Tambeli CH, Oliveira‐Fusaro MCG, Clemente‐Napimoga JT. P2X7‐induced nociception in the temporomandibular joint of rats depends on inflammatory mechanisms and C‐fibres sensitization. Eur J Pain 2021; 25:1107-1118. [DOI: 10.1002/ejp.1732] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Affiliation(s)
- Juliana M. Teixeira
- Faculdade São Leopoldo Mandic Área de Fisiologia Instituto de Pesquisas São Leopoldo Mandic Campinas Brazil
| | - Rafael M. Pimentel
- Faculdade São Leopoldo Mandic Área de Fisiologia Instituto de Pesquisas São Leopoldo Mandic Campinas Brazil
| | - Henrique B. Abdalla
- Faculdade São Leopoldo Mandic Área de Fisiologia Instituto de Pesquisas São Leopoldo Mandic Campinas Brazil
| | - Hortência M. X. Sousa
- Laboratory of Orofacial Pain Department of Physiology Piracicaba Dental School State University of Campinas (UNICAMP) Piracicaba Brazil
| | - Cristina G. Macedo
- Faculdade São Leopoldo Mandic Área de Fisiologia Instituto de Pesquisas São Leopoldo Mandic Campinas Brazil
| | - Marcelo H. Napimoga
- Faculdade São Leopoldo Mandic Área de Imunologia Instituto de Pesquisas São Leopoldo Mandic Campinas Brazil
| | - Cláudia H. Tambeli
- Department of Structural and Functional Biology Institute of Biology State University of Campinas (UNICAMP) Campinas Brazil
| | - Maria C. G. Oliveira‐Fusaro
- Laboratory of Studies of Pain and Inflammation School of Applied Sciences State University of Campinas (UNICAMP) Limeira São Paulo Brazil
| | | |
Collapse
|
11
|
Zhang SY, Zhao H, Xu C, Zhang Q, Chen Y, Li HY, Zhang XL, Zhao C, Chen M, Yang DH. Combination of Dexmedetomidine and Tramadol in Patient-Controlled Intravenous Analgesia Strengthens Sedative Effect in Pregnancy-Induced Hypertension. Front Pharmacol 2021; 12:739749. [PMID: 34744722 PMCID: PMC8569426 DOI: 10.3389/fphar.2021.739749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 10/07/2021] [Indexed: 02/05/2023] Open
Abstract
Objective: The aim of the present study is to explore the combination of dexmedetomidine (DXM) and tramadol (TMD) on sedative effect in patients with pregnancy-induced hypertension (PIH). Methods: A total of 356 patients with pregnancy-induced hypertension (PIH) were randomly divided into three groups: DXM, TMD and DXM + TMD groups. These patients were treated with different doses of DXM, TMD or combination of DXM and TMD by a patient-controlled intravenous injection device. The scores of static pain and dynamic pain, sedation degree, and adverse reaction were recorded. The plasma levels of inflammatory mediators IL-10 and C-reactive protein (CRP), and the serum level of p-p38-MAPK were evaluated. Results: It was found that administration with DXM 1.0 µg/kg/h + TMD 700 mg and DXM 2.0 µg/kg/h + TMD 600 mg result in stronger sedative effect than single administration with DXM or TMD. The mean arterial pressure (MAP) and heart rate (HR) of patients with PIH were decreased with the combinational treatment of DXM and TMD. Interestingly, the PIH patients injected with DXM 1.0 µg/kg/h + TMD 700 mg and DXM 2.0 µg/kg/h + TMD 600 mg showed stronger sedative effect. In addition, the plasma level of level of IL-10 was increased and CRP decreased. The serum level of p-p38/MAPK was decreased. Conclusion: Taken together, our study indicates that combination of DXM and TMD effectively lowers blood pressure and reduces inflammation through increasing the level of IL-10, reducing CRP and inhibiting p-p38/MAPK in patients with PIH. This study suggests that the combination of DXM and TMD could be an anesthetic choice in the management of PIH.
Collapse
Affiliation(s)
- Shu-Yao Zhang
- Department of Pharmacy, Guangzhou Red Cross Hospital Jinan University, Guangzhou, China
| | - Hui Zhao
- Department of Gynecology and Obstetrics, The Second Affiliated Hospital of Shantou University Medical College, Shantou, China
| | - Chengcheng Xu
- Department of Pharmacy, Guangzhou Red Cross Hospital Jinan University, Guangzhou, China
- Department of Pharmacology, Shantou University Medical College, Shantou, China
| | - Qiuzhen Zhang
- Department of Pharmacy, Guangzhou Red Cross Hospital Jinan University, Guangzhou, China
- Department of Pharmacology, Shantou University Medical College, Shantou, China
| | - Yun Chen
- Department of Pharmacy, Guangzhou Red Cross Hospital Jinan University, Guangzhou, China
| | - Hai-Yan Li
- Department of Nursing, Guangzhou Red Cross Hospital Jinan University, Guangzhou, China
| | - Xia-Lan Zhang
- Department of Gynecology and Obstetrics, The Second Affiliated Hospital of Shantou University Medical College, Shantou, China
| | - Chengkuan Zhao
- Department of Pharmacy, Guangzhou Red Cross Hospital Jinan University, Guangzhou, China
- Department of Pharmacology, Shantou University Medical College, Shantou, China
| | - Meini Chen
- Department of Pharmacology, Shantou University Medical College, Shantou, China
| | - Dong-Hua Yang
- Department of Pharmaceutical Sciences, St. John’s University College of Pharmacy and Health Sciences, Queens, NY, United States
- *Correspondence: Dong-Hua Yang,
| |
Collapse
|
12
|
Shah J, Nair AB, Shah H, Jacob S, Shehata TM, Morsy MA. Enhancement in antinociceptive and anti-inflammatory effects of tramadol by transdermal proniosome gel. Asian J Pharm Sci 2020; 15:786-796. [PMID: 33363633 PMCID: PMC7750831 DOI: 10.1016/j.ajps.2019.05.001] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Revised: 03/29/2019] [Accepted: 05/20/2019] [Indexed: 10/31/2022] Open
Abstract
Oral therapy of tramadol, an opiate analgesic, undergoes extensive hepatic metabolism and requires frequent administration. Transdermal therapy by virtue can overcome these issues and can improve the efficacy and reduce abuse liability of tramadol. The aim of this research was to investigate the possibility of transdermal delivery of tramadol by formulating proniosome gel and evaluate its therapeutic potential in vivo. The effect of formulation composition as well as amount of drug on physicochemical characteristics of prepared proniosomes were examined. Best proniosome gel (F4) was selected and evaluated for drug release, stability and transdermal efficacy by ex vivo and in vivo experiments. The vesicles demonstrated optimal properties including spherical shape, nanosize with good entrapment efficiency, adequate zeta potential, higher stability and greater transdermal flux. The amorphization and dispersion of tramadol in the aqueous core of proniosome vesicles was confirmed by differential scanning calorimeter. Release profile of F4 was distinct (P < 0.001) from control and displayed steady and prolonged tramadol release by Fickian diffusion. Transdermal therapy of F4 showed prominent reduction of induced twitches (P < 0.005) in mice and edema (P < 0.05) in rats, as compared to oral tramadol. The improvement in clinical efficacy of tramadol in transdermal therapy is correlated with the pharmacokinetic data observed. In conclusion, the observed improvement in antinociceptive and anti-inflammatory effects from proniosome carriers signifies its potential to be a suitable alternative to oral therapy of tramadol with greater efficacy.
Collapse
Affiliation(s)
- Jigar Shah
- Institute of Pharmacy, Nirma University, Ahmedabad 382481, India
| | - Anroop B. Nair
- College of Clinical Pharmacy, King Faisal University, Al-Ahsa 31982, Saudi Arabia
- Corresponding author. College of Clinical Pharmacy, King Faisal University, Al-Ahsa 31982, Saudi Arabia. Tel: +966 536 219868.
| | - Hiral Shah
- Arihant School of Pharmacy & BRI, Gandhinagar 382421, India
| | - Shery Jacob
- College of Pharmacy, Gulf Medical University, Ajman 4184, United Arab Emirates
| | - Tamer M. Shehata
- College of Clinical Pharmacy, King Faisal University, Al-Ahsa 31982, Saudi Arabia
- Faculty of Pharmacy, University of Zagazig, Zagazig 44519, Egypt
| | - Mohamed Aly Morsy
- College of Clinical Pharmacy, King Faisal University, Al-Ahsa 31982, Saudi Arabia
- Faculty of Medicine, Minia University, El-Minia 61511, Egypt
| |
Collapse
|
13
|
Peripheral soluble epoxide hydrolase inhibition reduces hypernociception and inflammation in albumin-induced arthritis in temporomandibular joint of rats. Int Immunopharmacol 2020; 87:106841. [PMID: 32736189 DOI: 10.1016/j.intimp.2020.106841] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 06/26/2020] [Accepted: 07/23/2020] [Indexed: 12/18/2022]
Abstract
Rheumatoid arthritis (RA) is characterized by chronic inflammation of the synovial tissue, joint dysfunction, and damage. Epoxyeicosatrienoic acids (EETs) are endogenous anti-inflammatory compounds, which are quickly converted by the soluble epoxide hydrolase (sEH) enzyme into a less active form with decreased biological effects. The inhibition of the sEH enzyme has been used as a strategy to lower nociception and inflammation. The goal of this study was to investigate whether the peripheral treatment with the sEH enzyme inhibitor 1- trifluoromethoxyphenyl-3-(1-propionylpiperidin-4-yl) urea (TPPU) could prevent the hypernociception and inflammation in the albumin-induced arthritis model in rats' temporomandibular joint (TMJ). After the induction of experimental arthritis, animals were assessed for nociceptive behavior test, leukocyte infiltration counts and histologic analysis, ELISA to quantify several cytokines and Western blotting. The peripheral pretreatment with TPPU inhibited the arthritis-induced TMJ hypernociception and leukocyte migration. Moreover, the local concentrations of proinflammatory cytokines were diminished by TPPU, while the anti-inflammatory cytokine interleukin-10 was up-regulated in the TMJ tissue. Finally, TPPU significantly decreased protein expression of iNOS, while did not alter the expression of MRC1. This study provides evidence that the peripheral administration of TPPU reduces hypernociception and inflammation in TMJ experimental arthritis.
Collapse
|
14
|
Abdalla HB, Napimoga MH, Lopes AH, de Macedo Maganin AG, Cunha TM, Van Dyke TE, Clemente Napimoga JT. Activation of PPAR-γ induces macrophage polarization and reduces neutrophil migration mediated by heme oxygenase 1. Int Immunopharmacol 2020; 84:106565. [DOI: 10.1016/j.intimp.2020.106565] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2020] [Revised: 04/30/2020] [Accepted: 05/03/2020] [Indexed: 01/11/2023]
|
15
|
Abdalla HB, Napimoga MH, Macedo CG, Bonfante R, De Araujo D, de Mello NF, Carvalho LB, Fraceto LF, Clemente-Napimoga JT. Poloxamer micellar system for intra-articular injection of 15-deoxy-Δ12,14-prostaglandin J2 with improved bioavailability and anti-inflammatory properties in the temporomandibular joint of rats. Int J Pharm 2020; 583:119383. [DOI: 10.1016/j.ijpharm.2020.119383] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Revised: 04/20/2020] [Accepted: 04/25/2020] [Indexed: 02/07/2023]
|
16
|
Klinke M, Vincent D, Trochimiuk M, Appl B, Tiemann B, Reinshagen K, Pagerols Raluy L, Boettcher M. Development of an improved murine model of necrotizing enterocolitis shows the importance of neutrophils in NEC pathogenesis. Sci Rep 2020; 10:8049. [PMID: 32415172 PMCID: PMC7229036 DOI: 10.1038/s41598-020-65120-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Accepted: 04/28/2020] [Indexed: 12/23/2022] Open
Abstract
Various research models to induce necrotizing enterocolitis (NEC) in animals exist, yet significant differences in NEC severity between murine animal models and human patients persist. One possible explanation for the difference in severity may be the variance in neutrophil concentration among newborn humans (50-70%) in comparison to neonatal mice (10-25%). However, neutrophil activity has yet to be evaluated in NEC pathogenesis. Thus, the aim of the study was to evaluate the effects of altered neutrophil concentrations in neonatal mice while simultaneously undergoing a NEC induction. A total of 44 neonatal mice were included in this study and 40 were subjected to an established NEC induction paradigm and 4 were assigned a sham group. Of the 40 mice, 30 received granulocyte-colony stimulating factor (G-CSF) on a daily basis, while 10 were used as controls (receiving inactivated G-CSF). Mice undergoing G-CSF treatment were further divided into two subgroups: (1) wildtype and (2) ELANE-knockout (KO). ELANE - KO mice are incapable of producing neutrophil elastase (NE) and were used to evaluate the role of neutrophils in NEC. For each of the groups, the following metrics were evaluated: survival, NEC severity, tissue damage, neutrophil count and activation, and NETs formation. An improved murine model of NEC was developed using (1) Lipopolysaccharides and Neocate gavage feeding, (2) hypoxia, and (3) G-CSF administration. The results suggest that the addition of G-CSF resulted in significantly elevated NEC manifestation rates with consequent tissue damage and intestinal inflammation, without affecting overall mortality. Animals without functioning NE (ELANE-KO) appeared to have been protected from NEC development. This study supports the importance of neutrophils in NEC pathogenesis. The optimized NEC induction paradigm, using G-CSF administration, resulted in elevated neutrophil counts, resembling those of neonatal humans. Elevation of neutrophil levels significantly improved NEC disease manifestation by modeling human physiology more accurately than current NEC models. Thus, in the future, murine NEC experiments should include the elevation of neutrophil levels to improve the transition of research findings from mice to humans.
Collapse
Affiliation(s)
- Michaela Klinke
- Department of Pediatric Surgery, UKE Medical School, Martinistrasse 52, 20246, Hamburg, Germany
| | - Deirdre Vincent
- Department of Pediatric Surgery, UKE Medical School, Martinistrasse 52, 20246, Hamburg, Germany
| | - Magdalena Trochimiuk
- Department of Pediatric Surgery, UKE Medical School, Martinistrasse 52, 20246, Hamburg, Germany
| | - Birgit Appl
- Department of Pediatric Surgery, UKE Medical School, Martinistrasse 52, 20246, Hamburg, Germany
| | - Bastian Tiemann
- Department of Pediatric Surgery, UKE Medical School, Martinistrasse 52, 20246, Hamburg, Germany
| | - Konrad Reinshagen
- Department of Pediatric Surgery, UKE Medical School, Martinistrasse 52, 20246, Hamburg, Germany
| | - Laia Pagerols Raluy
- Department of Pediatric Surgery, UKE Medical School, Martinistrasse 52, 20246, Hamburg, Germany
| | - Michael Boettcher
- Department of Pediatric Surgery, UKE Medical School, Martinistrasse 52, 20246, Hamburg, Germany.
| |
Collapse
|
17
|
Liu Y, Wu JS, Tang YL, Tang YJ, Fei W, Liang XH. Multiple Treatment Meta-Analysis of Intra-Articular Injection for Temporomandibular Osteoarthritis. J Oral Maxillofac Surg 2020; 78:373.e1-373.e18. [DOI: 10.1016/j.joms.2019.10.016] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Revised: 09/17/2019] [Accepted: 10/16/2019] [Indexed: 01/15/2023]
|
18
|
Early Phase of Type 1 Diabetes Decreases the Responsiveness of C-Fiber Nociceptors in the Temporomandibular Joint of Rats. Neuroscience 2019; 416:229-238. [DOI: 10.1016/j.neuroscience.2019.08.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2019] [Revised: 08/02/2019] [Accepted: 08/05/2019] [Indexed: 01/19/2023]
|
19
|
Improved efficacy of naproxen-loaded NLC for temporomandibular joint administration. Sci Rep 2019; 9:11160. [PMID: 31371737 PMCID: PMC6673697 DOI: 10.1038/s41598-019-47486-w] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Accepted: 07/12/2019] [Indexed: 12/23/2022] Open
Abstract
Inflammatory conditions of the temporomandibular joint (TMJ) and peripheral tissues affect many people around the world and are commonly treated with non-steroidal anti-inflammatory drugs (NSAIDs). However, in order to get desirable results, treatments with NSAIDs may take weeks, causing undesirable side effects and requiring repeated administration. In this sense, this work describes the development of an optimized nanostructured lipid carrier (NLC) formulation for intra-articular administration of naproxen (NPX). An experimental design (23) selected the best formulation in terms of its physicochemical and structural properties, elucidated by different methods (DLS, NTA, TEM, DSC, and ATR-FTIR). The chosen formulation (NLC-NPX) was tested on acute inflammatory TMJ nociception, in a rat model. The optimized excipients composition provided higher NPX encapsulation efficiency (99.8%) and the nanoparticles were found stable during 1 year of storage at 25 °C. In vivo results demonstrated that the sustained delivery of NPX directly in the TMJ significantly reduced leukocytes migration and levels of pro-inflammatory cytokines (IL-1β and TNF-α), for more than a week. These results point out the NLC-NPX formulation as a promising candidate for the safe treatment of inflammatory pain conditions of TMJ or other joints.
Collapse
|
20
|
Abstract
Tramadol-an atypical opioid analgesic-has a unique pharmacokinetic and pharmacodynamic profile, with opioidergic, noradrenergic, and serotonergic actions. Tramadol has long been used as a well-tolerated alternative to other drugs in moderate pain because of its opioidergic and monoaminergic activities. However, cumulative evidence has been gathered over the last few years that supports other likely mechanisms and uses of tramadol in pain management. Tramadol has modulatory effects on several mediators involved in pain signaling, such as voltage-gated sodium ion channels, transient receptor potential V1 channels, glutamate receptors, α2-adrenoceptors, adenosine receptors, and mechanisms involving substance P, calcitonin gene-related peptide, prostaglandin E2, and proinflammatory cytokines. Tramadol also modifies the crosstalk between neuronal and non-neuronal cells in peripheral and central sites. Through these molecular effects, tramadol could modulate peripheral and central neuronal hyperexcitability. Given the broad spectrum of molecular targets, tramadol as a unimodal analgesic relieves a broad range of pain types, such as postoperative, low back, and neuropathic pain and that associated with labor, osteoarthritis, fibromyalgia, and cancer. Moreover, tramadol has anxiolytic, antidepressant, and anti-shivering activities that could improve pain management outcomes. The aim of this review was to address these issues in the context of maladaptive physiological and psychological processes that are associated with different pain types.
Collapse
Affiliation(s)
- Ahmed Barakat
- Department of Medical Pharmacology, Faculty of Medicine, Assiut University, Assiut, 71515, Egypt.
| |
Collapse
|
21
|
Abdalla HB, Jain AK, Napimoga MH, Clemente-Napimoga JT, Gill HS. Microneedles Coated with Tramadol Exhibit Antinociceptive Effect in a Rat Model of Temporomandibular Hypernociception. J Pharmacol Exp Ther 2019; 370:834-842. [PMID: 30872390 DOI: 10.1124/jpet.119.256750] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Accepted: 02/22/2019] [Indexed: 12/31/2022] Open
Abstract
Coated microneedles have emerged as a promising drug delivery system for inflammatory pain treatment. We have previously shown that tramadol injection into the rat temporomandibular joint (TMJ) induces an antinociceptive and anti-inflammatory effect. In this study, microneedles coated with tramadol were investigated as a platform to treat TMJ pain. Male Wistar rats were administered tramadol using an intra-TMJ injection or with microneedles coated with tramadol, followed by 1.5% formalin nociceptive challenge administered 15 minutes later. The nociceptive behavior of rats was evaluated, and their periarticular tissues were removed after euthanasia for analysis. The duration of antinociceptive effect was determined by performing the formalin challenge at different time points extending up to 6 days post tramadol administration. Microneedles coated with tramadol produced an antinociceptive effect similar to injection of tramadol into the rat TMJ. Surprisingly, tramadol delivery using coated microneedles produced a more durable antinociceptive effect lasting as much as 2 days post tramadol delivery as compared with an antinociceptive effect lasting under 2 hours from intra-TMJ injection of tramadol. The proinflammatory cytokines tumor necrosis factor-α and interleukin-1β (IL-1β) were found to be reduced, whereas the anti-inflammatory cytokine IL-10 was found to be elevated in tramadol-treated groups. In conclusion, microneedles coated with tramadol can offer a therapeutic option for pain control of inflammatory disorders in the TMJ.
Collapse
Affiliation(s)
- Henrique Ballassini Abdalla
- Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil (H.B.A.); Department of Chemical Engineering, Texas Tech University, Lubbock, Texas (A.K.J., H.S.G.); and Faculdade São Leopoldo Mandic, Instituto e Centro de Pesquisas São Leopoldo Mandic, Campinas, São Paulo, Brazil (M.H.N., J.T.C.-N.)
| | - Amit K Jain
- Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil (H.B.A.); Department of Chemical Engineering, Texas Tech University, Lubbock, Texas (A.K.J., H.S.G.); and Faculdade São Leopoldo Mandic, Instituto e Centro de Pesquisas São Leopoldo Mandic, Campinas, São Paulo, Brazil (M.H.N., J.T.C.-N.)
| | - Marcelo Henrique Napimoga
- Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil (H.B.A.); Department of Chemical Engineering, Texas Tech University, Lubbock, Texas (A.K.J., H.S.G.); and Faculdade São Leopoldo Mandic, Instituto e Centro de Pesquisas São Leopoldo Mandic, Campinas, São Paulo, Brazil (M.H.N., J.T.C.-N.)
| | - Juliana Trindade Clemente-Napimoga
- Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil (H.B.A.); Department of Chemical Engineering, Texas Tech University, Lubbock, Texas (A.K.J., H.S.G.); and Faculdade São Leopoldo Mandic, Instituto e Centro de Pesquisas São Leopoldo Mandic, Campinas, São Paulo, Brazil (M.H.N., J.T.C.-N.)
| | - Harvinder Singh Gill
- Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil (H.B.A.); Department of Chemical Engineering, Texas Tech University, Lubbock, Texas (A.K.J., H.S.G.); and Faculdade São Leopoldo Mandic, Instituto e Centro de Pesquisas São Leopoldo Mandic, Campinas, São Paulo, Brazil (M.H.N., J.T.C.-N.)
| |
Collapse
|
22
|
Clemente-Napimoga JT, Silva MASM, Peres SNC, Lopes AHP, Lossio CF, Oliveira MV, Osterne VJS, Nascimento KS, Abdalla HB, Teixeira JM, Cavada BS, Napimoga MH. Dioclea violacea lectin ameliorates inflammation in the temporomandibular joint of rats by suppressing intercellular adhesion molecule-1 expression. Biochimie 2018; 158:34-42. [PMID: 30557594 DOI: 10.1016/j.biochi.2018.12.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2018] [Accepted: 12/13/2018] [Indexed: 02/07/2023]
Abstract
Inflammation of temporomandibular joint (TMJ) tissues are the most common cause of pain conditions associated with temporomandibular disorders (TMDs). After a tissue and/or neural damage, the inflammatory response is characterized by plasma extravasation and leukocytes infiltration in the TMJ tissues, which in turn, release inflammatory cytokines cascades responsible for inflammatory pain. Lectins are glycoproteins widely distributed in nature that may exhibit anti-inflammatory properties. This study demonstrated by molecular docking and MM/PBSA that the lectin from Dioclea violacea (DVL) interacts favorably with α-methyl-D-mannoside, N-acetyl-D-glucosamine, and core1-sialyl-Lewis X which are associated with leukocytes migration during an inflammatory response. Wistar rats pretreated with intravenously injection of DVL demonstrated a significant inhibition of plasma extravasation induced by carrageenan (a non-neurogenic inflammatory inductor) and mustard oil (a neurogenic inflammatory inductor) in the TMJ periarticular tissues (p < 0.05; ANOVA, Tukey's test). In addition, DVL significantly reduced carrageenan-induced leukocyte migration in the TMJ periarticular tissues mediated by down-regulation of ICAM-1 expression. These results suggest a potential anti-inflammatory effect of DVL in inflammatory conditions of TMJ.
Collapse
Affiliation(s)
- Juliana T Clemente-Napimoga
- Faculdade São Leopoldo Mandic, Instituto de Pesquisas São Leopoldo Mandic, Área de Fisiologia, Campinas, Brazil
| | - Maria A S M Silva
- Faculdade São Leopoldo Mandic, Instituto de Pesquisas São Leopoldo Mandic, Área de Fisiologia, Campinas, Brazil
| | - Sylvia N C Peres
- Laboratory of Biopathology and Molecular Biology, University of Uberaba, Uberaba, Brazil
| | - Alexandre H P Lopes
- Department of Pharmacology, Medical School of Ribeirão Preto - University of São Paulo, Ribeirão Preto, Brazil
| | - Claudia F Lossio
- Department of Biochemistry and Molecular Biology, Federal University of Ceará, Brazil
| | - Messias V Oliveira
- Department of Biochemistry and Molecular Biology, Federal University of Ceará, Brazil
| | - Vinicius J S Osterne
- Department of Biochemistry and Molecular Biology, Federal University of Ceará, Brazil
| | - Kyria S Nascimento
- Department of Biochemistry and Molecular Biology, Federal University of Ceará, Brazil
| | - Henrique B Abdalla
- Laboratory of Orofacial Pain, Department of Physiology, Piracicaba Dental School, State University of Campinas, Piracicaba, SP, Brazil
| | - Juliana M Teixeira
- Faculdade São Leopoldo Mandic, Instituto de Pesquisas São Leopoldo Mandic, Área de Fisiologia, Campinas, Brazil
| | - Benildo S Cavada
- Department of Biochemistry and Molecular Biology, Federal University of Ceará, Brazil.
| | - Marcelo H Napimoga
- Faculdade São Leopoldo Mandic, Instituto de Pesquisas São Leopoldo Mandic, Área de Imunologia, Campinas, Brazil.
| |
Collapse
|
23
|
Srebro D, Vučković S, Milovanović A, Savić Vujović K, Prostran M. Evaluation of Prophylactic and Therapeutic Effects of Tramadol and Tramadol Plus Magnesium Sulfate in an Acute Inflammatory Model of Pain and Edema in Rats. Front Pharmacol 2018; 9:1326. [PMID: 30505275 PMCID: PMC6250800 DOI: 10.3389/fphar.2018.01326] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Accepted: 10/29/2018] [Indexed: 12/23/2022] Open
Abstract
Background: Inflammatory pain is the most commonly treated clinical pain, since it develops following trauma or surgery, and accompanies rheumatic or arthritic diseases. Tramadol is one of the most frequently used opioid analgesics in acute and chronic pain of different origin. Magnesium is a widely used dietary supplement that was recently shown to be a safe analgesic drug in different models of inflammatory pain. Aim: This study aimed to evaluate the effects of systemically or locally injected tramadol with/without systemically injected magnesium sulfate in prophylactic or therapeutic protocols of application in a rat model of somatic inflammation. Methods: Inflammation of the rat hind paw was induced by an intraplantar injection of carrageenan (0.1 ml, 0.5%). The antihyperalgesic/antiedematous effects of tramadol (intraperitoneally or intraplantarly injected), and tramadol-magnesium sulfate (subcutaneously injected) combinations were assessed by measuring the changes in paw withdrawal thresholds or paw volume induced by carrageenan. The drugs were administered before or after inflammation induction. Results: Systemically administered tramadol (1.25-10 mg/kg) before or after induction of inflammation reduced mechanical hyperalgesia and edema with a maximal antihyperalgesic/antiedematous effect of about 40-100%. Locally applied tramadol (0.125 mg/paw) better reduced edema (50-100%) than pain (20-50%) during 24 h. Administration of a fixed dose of tramadol (1.25 mg/kg) with different doses of magnesium led to a dose-dependent enhancement and prolongation of the analgesic effect of tramadol both in prevention and treatment of inflammatory pain. Magnesium increases the antiedematous effect of tramadol in the prevention of inflammatory edema while reducing it in treatment. Conclusion: According to results obtained in this animal model, systemic administration of low doses of tramadol and magnesium sulfate given in combination is a potent, effective and relatively safe therapeutic option for prevention and especially therapy of somatic inflammatory pain. The best result is achieved when tramadol is combined with magnesium sulfate at a dose that is equivalent to the average human recommended daily dose and when the drugs are administered when inflammation is maximally developed.
Collapse
Affiliation(s)
- Dragana Srebro
- Department of Pharmacology, Clinical Pharmacology and Toxicology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Sonja Vučković
- Department of Pharmacology, Clinical Pharmacology and Toxicology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Aleksandar Milovanović
- Institute of Occupational Health Dr Dragomir Karajovic, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Katarina Savić Vujović
- Department of Pharmacology, Clinical Pharmacology and Toxicology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Milica Prostran
- Department of Pharmacology, Clinical Pharmacology and Toxicology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| |
Collapse
|
24
|
Bonfante R, Napimoga MH, Macedo CG, Abdalla HB, Pieroni V, Clemente-Napimoga JT. The P2X7 Receptor, Cathepsin S and Fractalkine in the Trigeminal Subnucleus Caudalis Signal Persistent Hypernociception in Temporomandibular Rat Joints. Neuroscience 2018; 391:120-130. [DOI: 10.1016/j.neuroscience.2018.09.005] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Revised: 08/21/2018] [Accepted: 09/05/2018] [Indexed: 11/13/2022]
|
25
|
Metallic crown-induced occlusal trauma as a protocol to evaluate inflammatory response in temporomandibular joint and periodontal tissues of rats. Clin Oral Investig 2018; 23:1905-1912. [DOI: 10.1007/s00784-018-2639-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Accepted: 09/11/2018] [Indexed: 02/07/2023]
|