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Hoss IM, Pradal LDA, Leal TSDS, Bertolini GRF, Costa RM, Ribeiro LDFC. Articular mobilization promotes improvement in functional and inflammatory parameters in a gouty arthritis model. EINSTEIN-SAO PAULO 2023; 21:eAO0465. [PMID: 37909651 PMCID: PMC10586854 DOI: 10.31744/einstein_journal/2023ao0465] [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] [Received: 01/24/2023] [Accepted: 06/12/2023] [Indexed: 11/03/2023] Open
Abstract
OBJECTIVE Gouty arthritis is characterized by painful inflammation due to the deposition of monosodium urate crystals in joint tissues. Despite available treatments, many patients experience ineffective management and adverse effects. This study evaluated a manual therapy protocol involving passive joint mobilization at the peak of inflammation in a gouty arthritis model using functional and inflammatory parameters. METHODS Twenty male Wistar rats, 12 weeks old, were divided into two groups (n=10 each): Gouty Arthritis and Control Groups, which were further subdivided into treated and untreated groups (n=5 each). The Gouty Arthritis Group received intraarticular knee injection of 50µL of monosodium urate crystals, while the Control Group received 50µL of phosphate buffered saline. The treatment involved a 9-minutes session of grade III joint mobilization (according to Maitland). Nociception, grip strength, and edema were evaluated before induction (EV0), 7 hours after assessment (EV1), immediately after treatment (EV2), and 1 hour after treatment (EV3). The animals were euthanized, and synovial fluid was collected to analyze leukocyte migration. RESULTS The model mimicked the signs of the Gouty Arthritis Group, with a decrease in the threshold of nociception and strength and an increase in edema and leukocyte count. The mobilization protocol significantly increased the nociceptive threshold and grip strength and reduced edema; however, it did not reverse the increase in leukocyte count. CONCLUSION Our results suggest that mobilization promotes analgesia and may modulate the inflammatory process owing to reduced edema and subtle attenuation of cell migration, which contributes to strength gain.
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Affiliation(s)
- Iranilda Moha Hoss
- Universidade Estadual do Oeste do ParanáCascavelPRBrazil Universidade Estadual do Oeste do Paraná, Cascavel, PR, Brazil.
| | - Lilian de Araujo Pradal
- Universidade Estadual do Oeste do ParanáCascavelPRBrazil Universidade Estadual do Oeste do Paraná, Cascavel, PR, Brazil.
| | - Taciane Stein da Silva Leal
- Universidade Estadual do Oeste do ParanáCascavelPRBrazil Universidade Estadual do Oeste do Paraná, Cascavel, PR, Brazil.
| | - Gladson Ricardo Flor Bertolini
- Universidade Estadual do Oeste do ParanáCascavelPRBrazil Universidade Estadual do Oeste do Paraná, Cascavel, PR, Brazil.
| | - Rose Meire Costa
- Universidade Estadual do Oeste do ParanáCascavelPRBrazil Universidade Estadual do Oeste do Paraná, Cascavel, PR, Brazil.
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Caldeira TG, Saúde-Guimarães DA, González-Álvarez I, Bermejo M, de Souza J. Eremantholide C from aerial parts of Lychnophora trichocarpha, as drug candidate: fraction absorbed prediction in humans and BCS permeability class determination. Daru 2021; 29:195-203. [PMID: 33884588 PMCID: PMC8149492 DOI: 10.1007/s40199-021-00397-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Accepted: 04/13/2021] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Lychnophora trichocarpha (Spreng.) Spreng. ex Sch.Bip has been used in folk medicine to treat pain, inflammation, rheumatism and bruises. Eremantholide C, a sesquiterpene lactone, is one of the substances responsible for the anti-inflammatory and anti-hyperuricemic effects of L. trichocarpha. OBJECTIVES Considering the potential to become a drug for the treatment of inflammation and gouty arthritis, this study evaluated the permeability of eremantholide C using in situ intestinal perfusion in rats. From the permeability data, it was possible to predict the fraction absorbed of eremantholide C in humans and elucidate its oral absorption process. METHODS In situ intestinal perfusion studies were performed in the complete small intestine of rats using different concentrations of eremantholide C: 960 μg/ml, 96 μg/ml and 9.6 μg/ml (with and without sodium azide), in order to verify the lack of dependence on the measured permeability as a function of the substance concentration in the perfusion solutions. RESULTS Eremantholide C showed Peff values, in rats, greater than 5 × 10-5 cm/s and fraction absorbed predicted for humans greater than 85%. These results indicated the high permeability for eremantholide C. Moreover, its permeation process occurs only by passive route, because there were no statistically significant differences between the Peff values for eremantholide C. CONCLUSION The high permeability, in addition to the low solubility, indicated that eremantholide C is a biologically active substance BCS class II. The pharmacological activities, low toxicity and biopharmaceutics parameters demonstrate that eremantholide C has the necessary requirements for the development of a drug product, to be administered orally, with action on inflammation, hyperuricemia and gout.
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Affiliation(s)
- Tamires Guedes Caldeira
- Programa de Pós-graduação em Ciências Farmacêuticas, Escola de Farmácia, Universidade Federal de Ouro Preto, Campus Universitário Morro do Cruzeiro, Ouro Preto, Minas Gerais, 35400-000, Brazil.
| | - Dênia Antunes Saúde-Guimarães
- Programa de Pós-graduação em Ciências Farmacêuticas, Escola de Farmácia, Universidade Federal de Ouro Preto, Campus Universitário Morro do Cruzeiro, Ouro Preto, Minas Gerais, 35400-000, Brazil
| | - Isabel González-Álvarez
- Department of Engineering, Pharmaceutics and Pharmaceutical Technology Area, Universidad Miguel Hernández de Elche, Alicante, Spain
| | - Marival Bermejo
- Department of Engineering, Pharmaceutics and Pharmaceutical Technology Area, Universidad Miguel Hernández de Elche, Alicante, Spain
| | - Jacqueline de Souza
- Programa de Pós-graduação em Ciências Farmacêuticas, Escola de Farmácia, Universidade Federal de Ouro Preto, Campus Universitário Morro do Cruzeiro, Ouro Preto, Minas Gerais, 35400-000, Brazil
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Tavares ALDF, Reginato A, Neves M, Pradal LDA, Leal TSDS, Ribeiro LDFC, Menolli RA, Bertolini GRF. Analysis of Wistar Rats Submitted to a Gout Model, Treated with Double Cryotherapy Protocol. Ther Hypothermia Temp Manag 2021; 12:30-37. [PMID: 33904783 DOI: 10.1089/ther.2021.0001] [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] [Indexed: 12/26/2022] Open
Abstract
Gout arthritis commonly affects joint regions by deposition of crystals, promoting functional damage mainly during periods of exacerbation. Cryotherapy is a commonly used resource to contain inflammatory processes, however, its use during a gout crisis is not yet well understood. Therefore, the objective was to evaluate the parameters of Wistar rats submitted to an experimental gout model and treated with dual cryotherapy protocol. Twenty-one male Wistar rats were used, separated into three groups: control group (CG), lesion group (LG), and lesion + cryotherapy group (LCG). Gout model induction was through intra-articular injection, with urate crystal solution, in the right knee and cryoimmersion treatment was performed for 20 minutes at a temperature of 5° ± 2°C. Seven evaluations and two treatment moments were performed, and the following parameters were analyzed: joint edema, grip strength, joint disability, motor function, and leukocyte migration through synovial lavage. In the statistical analysis we used SPSS 20.0 with Generalized Linear Models, with least significant difference posttest, always with 5% significance level. The treatment reduced edema, promoted strength recovery, and was effective in reducing total leukocytes in the synovial fluid. No difference was observed between the injured groups for joint disability and motor function. Cryotherapy promoted edema reduction and increased pelvic limb grip strength in Wistar rats during the acute period.
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Affiliation(s)
| | - Aline Reginato
- Universidade Estadual do Oeste do Paraná-Unioeste, Cascavel, Brazil
| | - Morgana Neves
- Universidade Estadual do Oeste do Paraná-Unioeste, Cascavel, Brazil
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Azevedo VF, Kos IA, Vargas-Santos AB, da Rocha Castelar Pinheiro G, Dos Santos Paiva E. Benzbromarone in the treatment of gout. Adv Rheumatol 2019; 59:37. [PMID: 31391099 DOI: 10.1186/s42358-019-0080-x] [Citation(s) in RCA: 63] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Accepted: 07/19/2019] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Benzbromarone is a uricosuric drug that has been used in the treatment of gout over the last 30 years. Due to its potent inhibition of the dominant apical (luminal) urate exchanger in the human proximal tubule URAT1, it reduces the urate reabsorption, diminishing serum urate levels and therefore preventing gout flares. Through several clinical trials, Benzbromarone has been proved effective and safe, inclusive in patients with chronic kidney disease and as combination therapy with allopurinol. Due to hepatotoxicity reports, it was withdrawn from the European market by the manufacturer, however many authors have questioned the product's withdrawal due to a lack of clinical evidence in order to support its hepatotoxicity. Benzbromarone is still available in several European countries, New Zealand, Brazil and several other countries. Despite the product's marketing over more than 20 years after the first hepatotoxicity reports, we have found only five reports in our literature search, and no prospective or retrospective study correlating hepatotoxicity with benzbromarone use. SHORT CONCLUSION Benzbromarone is a safe and effective molecule for the treatment of gout. However, due to in vitro and in vivo data related to hepatotoxicity, it is prudent to prescribe it with some caution, especially for patients with an already known liver condition.
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Affiliation(s)
- Valderilio Feijó Azevedo
- Universidade Federal do Paraná, Rua General Carneiro 181, Centro, Curitiba, Paraná, Brazil. .,Edumed Educação em Saúde, Rua Bispo Dom José, 2495, Curitiba, Paraná, Brazil.
| | - Igor Age Kos
- Edumed Educação em Saúde, Rua Bispo Dom José, 2495, Curitiba, Paraná, Brazil
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Rocha FAC, Landim JIVD, da Rocha LN. Advances in rheumatology practice in Brazil. Rheumatol Int 2018; 39:1125-1134. [PMID: 30506466 DOI: 10.1007/s00296-018-4211-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2018] [Accepted: 11/21/2018] [Indexed: 02/07/2023]
Abstract
Despite resilient inequities, Brazil has seen progressive improvement in health care in the last 25 years. Infectious diseases rendered place to chronic non-communicable diseases as a major cause of death. Existence of traditional schools of medicine and training services in rheumatology helped form a reasonable number of specialists, though irregular distribution due to the economic issues favoring their clustering in major cities. The Brazilian Society of Rheumatology provides continued medical education, helps training rheumatologists, family physicians and other health professionals and has worked to publish national recommendations for the diagnosis and treatment of major rheumatic diseases. Access to medications and health care facilities is provided for most patients, free of direct charge, including biologics. Specialized services for autoimmune and rare diseases, including pediatric rheumatology and autoinflammatory diseases, have improved, particularly in developed centers of the southern best developed parts of the country. A major unmet need is the lack of access to non-pharmacological treatment modalities. In this article, we will summarize some of the strengths and points that need improvement to enhance access to the rheumatological health care in Brazil.
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Affiliation(s)
- Francisco Airton Castro Rocha
- Laboratório de Investigação em Osteoartropatias, Department of Internal Medicine, Liga de Reumatologia e Doenças Autoimunes, Instituto de Biomedicina, Faculdade de Medicina, Federal University of Ceará, Rua Cel. Nunes de Melo, 1315, 1°. Andar, Rodolfo Teófilo, Fortaleza, CE, 60430-270, Brazil.
| | - Joaquim Ivo Vasques Dantas Landim
- Laboratório de Investigação em Osteoartropatias, Department of Internal Medicine, Liga de Reumatologia e Doenças Autoimunes, Instituto de Biomedicina, Faculdade de Medicina, Federal University of Ceará, Rua Cel. Nunes de Melo, 1315, 1°. Andar, Rodolfo Teófilo, Fortaleza, CE, 60430-270, Brazil
| | - Leila Nascimento da Rocha
- Laboratório de Investigação em Osteoartropatias, Department of Internal Medicine, Liga de Reumatologia e Doenças Autoimunes, Instituto de Biomedicina, Faculdade de Medicina, Federal University of Ceará, Rua Cel. Nunes de Melo, 1315, 1°. Andar, Rodolfo Teófilo, Fortaleza, CE, 60430-270, Brazil
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Konjac glucomannan improves hyperuricemia through regulating xanthine oxidase, adenosine deaminase and urate transporters in rats. J Funct Foods 2018. [DOI: 10.1016/j.jff.2018.07.062] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
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